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Can you imagine you may die today taking your insulin injection?

Posted Oct 20 2008 8:01am

The other morning I heard on the Today show someone with type 1 diabetes say, "Any moment I could die," referring to a low from taking too much insulin. Yes, it's possible, but how many times do you ever think it could really happen to you? Ten times a week? Once a day? Ever? Never? People die of diabetes every day, but usually due to something that's been brewing for years, like heart disease, stroke or kidney disease. Yet anyone using insulin can die any minute, any day, by erring with their dose.

So how is it that we can get up every day, go about our business, take our medicine and never think about this? I was musing about this because of a book I'm now reading,The Unthinkable: Who Survives When Disaster Strikes - and Whyby Amanda Riply. It's about how our brains work when we're in dire circumstances: a fire, plane crash, kidnapping, 9/11. People don't react and respond at all the way we expect. Our brain shuts down and it both heightens and blocks certain senses. People become temporarily blind or deaf, unable to see or hear--obviously blocking the horror of the event. Time appears to slow down for most, while it speeds up for some. People freeze, they literally go limp and lifeless, probably an adaptation of how we escaped predatory animals eons ago. We move into a space of denial and disassociation during the event.

Is this denial and disassociation at work when you take insulin, a life-giving and life-threatening medicine? I go far to protect myself living with diabetes: I'm enormously educated about diabetes, how it works, how to care for myself, I know how to prevent hypoglycemia (low blood sugar) and how to treat it if it should occur. Yet in 31 years of using insulin I've never had a Glucagon kit (injectible glucose if you lose consciousness) in the house and when I take my injection three to seven times a day I never fear or panic. In fact, I'm more likely to take a little too much insulin rather than a little too little, preferring to tolerate a low rather than long-term complications. I see insulin only as protecting me against complications, not the damage it can do.  

Just like any thought of the "unthinkable," who ever thinks something awful will happen to them? There's almost a kind of arrogance in this thinking. "Hubris" as a dear friend and I used to say, using the word often just because we loved how it sounded.  If the brain blocks us from thinking something horrible can happen to us ordinarily, maybe it's doing the same every day when it comes to taking insulin. I guess it's a good thing or we'd run screaming every time we had to pick up that syringe or press buttons on our pump. 

The Unthinkableis a fascinating read. You won't find anything about diabetes in it, but then again, you might just get something about diabetes out of it. 

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