If the economy collapsed and the apocalypse started, and you couldn’t get your supplies, how would you manage your diabetes? How would you survive?
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I would assume they would have insulin, never know.
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Eat a minimal amount of food. Eat foods that drop my blood sugar, such as shitake mushrooms and celery. Spend a lot of the day doing physical work which would burn blood sugar. Without testing supplies and/or cgm it would be much tougher for some then for others. Some of us are very sensitive to our low and high BG while others have no feel for it.
I worry a lot more about being kidnapped or jailed in a foreign country without the availability of supplies than an economic collapse leading to apocalypse.
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Those are valid points. If you could see my CGM you would worry about me. I am one of those whose blood sugar swings very easily. Plus I am genuinely afraid of not having insulin.
A little backstory will help you understand my fear.
I was diagnosed T1 about 8 years ago. Literally over Christmas my grandfather passed away and so at the funeral some friends of my family( they didn’t know my grandfather) came to show support. And the dad walked up to me and as he shook my hand the first thing out of his mouth was ‘ man you have lost a lot of weight!’ That took my family by surprise and then after the funeral we went and ate. And on my way home I went out of my head and had my first episode of serious hyperglycemia. The progression of my diabetes was so gradual that no one had noticed. I was was peeing a lot. Was thirsty all the time. But it was so gradual that I was oblivious to problems. And yes I lost a lot of weight. I am currently about 125 pounds and that is a perfect amount for me. At the diagnosis I weighed 95 pounds. Diabetes was eating me alive. Within a few hours of my first insulin dose I started feeling better. I couldn’t believe how much pain I was in.
That said I am afraid of going back to that state. And the world only seems to be getting crazier by the minute. I have even thought of buying a year’s supply in advance if I could find the money. But that would be terribly expensive. Maybe I will just have to shrivel up and die? I did have a pharmacist tell me that to my face. So I am praying and preparing.
First I would use every drop of stockpiled insulin from the stockpile, including Lantus and Humalog that expired 8-9 years old.
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In that case, I would be more worried that over time, unaddressed anxiety could contribute to heart disease, a leading cause of death for diabetics.
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My post will not answer the question, but a couple of novels that explore the question of what can a T1DM do to survive in an apocalypse.
Something to think about, our modern supply chain is extremely vulnerable to disruptions. Remember the problems with one factory closing that caused shortages of all baby formula products.
The old adage about not putting all your eggs in one basket has been ignored by industries following extreme economies of scale.
So about the novels, here you go.
My first thought was remembering the apocalyptic novel, “Lucifer’s Hammer” by Larry Niven & Jerry Pournelle. Much of the human population is destroyed by an asteroid strike. One of the surviving characters is a scientist and type 1 diabetic. He hopes to be able to purify insulin from sheep pancreases before he runs out of insulin.
Then there is “Sugar Scars” by Travis Norwood. I have not read this but it will be on my reading list. A virus kills off most people. There is a lot of stuff available for the taking, the main character is a T1DM who scrounges available insulin.
This is off topic, but I found this great list of books with diabetic characters.
Books with Diabetic Characters | T1D Living - Grab a Book!.
I will put some of these on my reading list, and will read “Lucifer’s Hammer” again and for sure will read “Sugar Scars.
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I hesitated to respond to your post since I think the likelihood of your apocalyptic fears pale in comparison to the much more common factors that you can control. Yet I think it’s rational to accumulate up to a one year supply of your usual insulin uptake.
You have dominant control over the amount of hyper-processed simple sugar and starch “foods” you consume. You have ultimate sway over the timing and amount of insulin you deliver. Your education of these factors never stops; you can always learn and improve.
Exercise intensity is largely under your authority. Neither too much nor too little would serve you best.
Mindfulness is always good practice, even moreso during a crisis.
I hope that considering this unlikely premise will help improve your everyday choices. By the way, welcome to TuD, @Jup30!
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Thank all of you for your answers! Greatly appreciated. Specifically to CJ114. I am afraid that anxiety is becoming more prevalent for me. In the early days of my diagnosis, the doctors told me that diabetes management gets easier with time. In a way they were right. But in other ways they were totally wrong. People around me do not understand why I am so exhausted. Why anxiety comes. They don’t understand living life like you have two full-time jobs. One keeps you for eight hours. The other keeps you for 24. And the cycle just keeps repeating. I would say that, between exhaustion with constantly dealing with diabetes management and anxiety about my blood sugar levels, I am heading straight for heart disease. I am trying to stay positive, but I am finding it very challenging these days. I go to my endo next week and I know my A1C It is going to be off track. The last 90 days I have been either high or low, but seldom just regulated. I know my anxiety isn’t helping. But when you’re blood sugar is in the 300s and drops to the 60s throughout the day for such a long time it is very discouraging. We have changed my dosage multiple times. I am not sure why it is this way. But such is my life right now. But even though I have only been here a few days, I am grateful for this community of people that actually understand what I am going through. Thank you! Thank the staff and folks that keep this place running. Maybe one day I can return the favor and help someone else as I have been helped. Thanks again
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I wouldn’t be a huge fan of it, but I’d adopt a keto diet and follow that pretty strictly to mange blood sugar levels.
(Context: I’m 34 years old, diagnosed T1D on my 19th birthday; I’m decently active, still using Humalog and Lantus pens in lieu of pump, etc.)
A few years ago, in support of my wife and as an experiment for myself, I followed a keto lifestyle (I don’t think you can call it a “diet” if you do it properly) for 3 months. I jumped all the way in, I don’t think I consumed more than 20-25g of carbs a day. I completely stopped taking Humalog. I still took 20 units of Lantus every night, or at least most nights.
A week before I stopped keto and went back to consuming carbs regularly, I had blood work done at my doctor’s office; timing of bloodwork was coincidence, but I was excited/curious/nervous to see results. (When you eat 4-5 scrambled eggs every morning for breakfast for 3 straight months, you start to wonder what your cholesterol levels look like and if your physician is going to beat you with the printout of the results.) However, my HDL levels were the best they’ve ever been, LDL was unaffected, triglycerides were great. A1C was the lowest it had ever been at 4.2 or 4.4, something like that. The only things I didn’t really care for, and why I decided not to continue with keto, was the repetitiveness of meals I ate and feeling limited on what I could eat when I was away from the house. Also, my body took a little longer to recover from workouts - I was sore for a day or two longer than normal post workout.
But it was proof that if something crazy happened and my supplies were suddenly limited, I could make do by changing my diet. I would like to know where my A1C would have been if I hadn’t taken my Lantus as well, but not enough to do it again for 3 more months.
On another note, I like to pickup my prescriptions monthly, as close as I can to the day I last picked them up. A pack of pens could last me for 6 or 7 weeks, but I still like to get them as soon as I can so I can create a supply buffer just in case something were to ever happen. My wife will wait until she’s on the last couple days of her last pair of contacts before ordering more and it drives me bananas. Don’t do that with your insulin lol.
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Actually PattyG12 I did that for 3 years. Things were tight and I couldn’t get health insurance at the time. I will say that going keto works for a short time in my experience. When I started that I had what my doctor said was an awesome A1C. After those 3 years though because I was wasn’t seeing a doctor regularly it was higher than it than it needed to be. And I was strictly keto during those years. So I am not sure about the longevity of such a plan. Maybe we should start a Tudiabetes community farm where we raise pigs for insulin collection purposes. Or mass produce Insulin plants. Costus Igneus: Side Effects of the Insulin Plant for Diabetes.
Who knows? Hopefully it won’t ever come to that but who can say? Leave it with God,
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@Jup30, I’m sorry that you’re experiencing diabetes distress - but know that you’re not alone in that.
One question I have is whether a different management style could help. Not sure if you’re MDI or on a pump, but if you’re not on a closed loop system like Omnipod 5 or ControlIQ, that might be something to explore. What are you on now? Sounds like you have a CGM?
The other thing I would say is to ask your doctor to ever so slightly overprescribe insulin and then as someone mentioned, pick it up ASAP every time it’s available. I have generated quite a good backup stock this way that definitely lowers anxiety levels. I even had an endo who overprescribed my pump supplies before I realized what a gift that was.
(Less likely to be relevant, but if you ever switch pumps or switch insurances you can often get good backup supplies. (1) Get a new pump before you actually use all the old supplies. (2) order as soon as your new insurance kicks in and maybe you’ll still have a supply from the old insurance that the new folks don’t know about. This approach works better if you’re getting a 3-month supply of your prescriptions. I’ve also had the opposite happen, where switching insurance used down all my backups because of all the hoops I had to go through to get approved for covered supplies.)
This probably will not fully solve diabetes distress and is not a quick solution, especially when health insurance is no guarantee in this country. But I would talk to your endo about it and see if there is anything they can do. I have used these strategies so much that I have built up months of backup diabetes supplies since that insurance switch ran me down in early 2020.
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To answer your question ECnerd. I do use a CGM. I am currently using pens. I started the pump conversation with my doctor last visit. She wanted me to study carb counting for a while. That was 3 months ago. I go see her next week and I think I will take the plunge. I have been labeled a brittle diabetic. For people new to D life that merely means I have crazy blood sugar swings of high and low and that happens very easily and without obvious cause. It is hard to regulate. I want to try the pump to see first if I even like it, plus can regulate better. So we shall see. I will take the rest of your advice in to consideration. Thanks
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I’d eat very low carb and low sugar and exercise after every meal. I’d drink a lot of water
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I worry about dying in a US county jail, @CJ114.
I was an EMT with the current county jail nurse. That always provides me with some comfort. I trust her. But, the neighboring counties would be hit or miss. I don’t trust them.
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I suspect habitual guests of US county jails have compounded problems reaching far beyond their diabetes.
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Without insulin, and death without insulin was an eventual given, several things:
- See if I could procure supplies through other means, illicitly if necessary
- As much as is possible, since in dire circumstances food production would be slowed and/or stopped, follow the century old regimen of few carbs, high protein, milk, and fruit/veg, plus compensating with exercise.
- Do whatever I can to make sure my loved ones are prepared for my passing, to live without my support
- Do whatever I can that my last remaining days were a benefit to humanity
Diabetic Brothers Beat Odds With Grit and Luck - The New York Times (nytimes.com)
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First, welcome to the community. You will find lots of support and information here that hopefully will help you lessen your anxiety about being diabetic. Management DOES become easier as things you used to think about become more habitual in your daily life.
I, too, am a brittle diabetic. I have had T1 diabetes for 58 years, being diagnosed when I was 12. For over 40 years, I resisted a pump because I did not want to be tied to a tube and a machine hanging from my belt. Being female, if I wore a dress, I did not always HAVE a belt onto which I could hang a controller.
My life changed in 2009 when my Endo introduced me to the OmniPod. That tube-free pump has changed my life for the better in many ways. Since it is tubeless, I can wear it under clothing and no one even knows I am wearing a pump. I do not have to disconnect anything to take a shower or to jump into a swimming pool. Control is easier because I can just input data, press a button, and get my insulin no matter where I am… at home, in a restaurant, sitting in a city park, or wherever. If I notice a continuing high trend, I simply give myself a little boost of insulin without having to dig out an alcohol swab and a pen. If I want to take a brisk walk, I can turn on Activity mode to stop all insulin so that I do not drop too low. (And the pump itself automatically stops all insulin several times a day to keep me from going low.)
I now use the OmniPod 5 and the Dexcom G6. Although I still will see some after-meal highs and some too-much-activity lows, those both have decreased significantly. My time in range (TIR) is always over 80%, and I have totally eliminated alarms waking me up at night as my blood sugar stays within range.
A CGM and an automated insulin pump CAN work for a brittle diabetic. Although we all are different and no system you use will ever be perfect, the CGM and OmniPod 5 (or other automated pumps) may make life easier for you in the long run.
I hope that you and your Endo can find something that eventually will work for you.
Hang in there! We are here for you!
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Thank you SherryAnn. As well as to everyone here. In the few days I have been here I have found something that I didn’t even realize I was missing. I don’t know many diabetics personally. And the few that I do don’t manage their diabetes in a way that regulates it. They have it, they admit. But they live like they don’t. And so, other than my doctor I don’t have anyone really to talk to about my day to day life when it comes to dealing with diabetes. So this forum has lifted my spirits already, just being able to interact with folks who are going through or have been through these things. I am not trying to complain, but I think that the sheer loneliness of not having a support system beyond my doc has genuinely been one of my greatest challenges. I know that there are way worse diseases. That there are people out there that if they had diabetes rather than whatever they are actually dealing with they would happily trade places. And in truth I don’t blame them. And knowing that makes me just feel like I am a wimp and I should just be better than this. But I genuinely can’t move my feet anymore. I feel drained of energy. And no I am not suicidal. Just absolutely, utterly and completely, burned out. Maybe I am thinking about this wrong and if there is a member here that works as a mental therapist feel free to weigh in here. I am not above asking for help. I just don’t know where to turn to. I do believe in God. And I know He hears my prayers. But I know that He is also a God of means. That He uses people and things to carry out His Will. So while I am seeking his help, am putting myself in the way of help here as well. Thank you for this great support system. Appreciate the info on the pump as well. I think that is my next move.
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I’d recommend more emphasis on the big picture. There are so many other conditions /afflictions that people get that work out much worse than diabetes. It helps to remember that diabetes is a condition that you can work around. Be patient snd think long term. If you can get to tbe point where insulin therapy, either MDI or pump, is in the background most of the time and “excursions” outside your BG goals can be managed with some confidence that things will eventually ger back to normal … what more can we possibly wish for? Keeping a sizeable stockpile of expired insulin is about as good as it gets for me when thinking apocalypticcally. Everything else is day to day.
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