Diabetes in jail or prison


#22

Yeah but what is the plea. If it’s not on your record I’m not sure there would be a problem.


#23

So I have never been to jail nor do I intend to commit a crime. But I do know two people who have been in jail who use insulin and I was on a jail medical advisory group once.

Generally speaking at least in Indiana, they will give you the exact amount of insulin prescribed. No more or less. High blood sugar, talk to the doctor. Testing for high or low blood sugar talk to the doctor. Unconscious we are off to the ER. Low carb, no carb, regular, keto, blah blah blah eat or dont eat. Inject or we will inject you. Gotta love bureaucracy.

Best bet, stay the hell out of jail. Which is the same thing I say about hospitals

Just saying


#24

I have thought to myself “How does someone in jail manage type 1?” I don’t know but I would guess they get very very poor care. I’m sure they can’t test or eat as needed.


#27

@IgotT1 please note that @Dave44 is correct that our Community Guidelines don’t allow political discussions, and we also don’t allow comments disrespectful of other members (one tends to lead to the other). This discussion is obviously about a sensitive topic so we’re keeping an eye on it, but as long as it stays within bounds we’re not taking any action.

The community guidelines are here: https://forum.tudiabetes.org/faq


#28

@IgotT1

Call the jail and ask if you can have Lantus. Generally, you can have medications, but if you are arrested on the spot, then you may need to call someone who will answer their phone and drop off insulin to you at the jail and advocate for you.

I expect that the jail will give you only enough insulin to survive. I expect you will run very hyper - maybe 350, maybe 450. Its anyones guess. You will be sick. I advise against eating. Pretend like your gonna eat, take the basal, and use that to correct, if you can. Thats what I do in the hospital.

If you think you might go to jail, you need to be wearing medical alert tags - somewhere they can see them if you pass out. I recommend wearing a bracelet. If you go to the hospital, then they will figure it out.

But, diabetics do die in jail. It is risky there for us. Very risky. You want to survive long enough to get out. I think you can expect to get very sick - hyperglycemic.

Have a lawyers number in your phone. A criminal lawyer, if thats what you think you need. Preferably, someone you have worked with before. They will show up at the jail and help you get out. Find a good, young, energetic criminal lawyer that knows your medical problems.


#29

Last time they threatened me with jail time, I researched. No insulin pumps. No snacks. No Dexcom. But, I think its valuable for everyone to know the protocol in their local area. Make a phone call to the jail. They will tell you. Then, you can have a plan with friends and family.

I am fortunate that I know the jail nurse who works near my house. But, I’m sure she doesn’t work 24 hours a day, 7 days a week. I trust her. We know each other. We went through EMT training together when we were young. However, I very much doubt that her protocols are equipped to deal with me very well. I would want to get out as soon as possible to be safe.


#30

Rules may differ from state to state, but I can speak confidently about WA. Two insulins used: NPH and regular. Target BG is 250-300. 3-6 BG’s per day. This is for T1.


#31

No jail, but lots of hospitals. The problem is bureaucracy. They got a list of my 25+ pills and two shots per day that I take. But it means getting a hospitalist doctor to write a new script for each of the meds. One time it took a week to get a med and I started bleeding internally.

I knew dropping into a hospital bed this time would be trouble, so I kept my diabetic equipment hidden in my room and treated my D myself.

Robert


#32

Many years ago, because of overworked, over stretched work schedules, nurses made mistakes. My family vowed to never let that happen again. When a family member is in the hospital, we try to always have someone sit with them to work with the nurses who have too high a patient load do a good job. We’ve stopped so many things. Nurses come in to give an insulin injection to my grandmother who was not diabetic. She threatened to call security, I asked her to and got out my cell phone and started dialing the hospital main number. She checked names and said - wrong room - and walked out. Had I not been there, someone may have died. I have trouble blaming nurses working 12 patients at the same time for 12 hours in a row. In the end, it helps to minimize the risk of the hospital bureaucracy causing harm to your health. The irony of that statement is not lost on me.


#33

We do the same. What do you suppose is the analogue to jail? We should have a strategy that is the jail equivalent. I’m not sure that I know what it is.


#34

Do you know what the procedure is for lows? What about corrections?

I believe the DKA they are bringing up is a real possibility. I would be surprised if that didn’t happen frequently.


#35

That’s pretty much what I’ve heard in other threads on this topic. It’s essentially the old-school R/N regimen we were on before the analog insulins, but with all refinements shaved off. So no carb counting, no trying to adjust for changes in exercise, food or other factors, they just treat as much as possible like doling out a pill once a day for some other condition. They don’t adapt to you, you adapt to them. You just get your R/N, hope the curves line up with when and what you’re eating, and try to hold on. Totally crude, dangerous, and needlessly inhumane.

Ironically I’ve always described my own experience of finally getting off of the R/N regimen as being released from prison because it was so constricting. From what I read about T1 in a real jail or prison, it’s almost literally true.


#36

Would it be fair to say that you have better likelihood of getting the necessary medical care of a gender reassignment surgery than a reasonably adequate insulin regimen?


#37

The problem is if this is accurate its likely putting someones life at more risk and probably reducing their life expectancy. Whatever time they are reviewing this type of care is likely doing long term harm to their body.

It seems like in the past a diagnosis of type 1 was 10-20 years shorter lifespan. Modern advancements have likely improved that but it sounds like those in jail are using techniques from 20 years ago.

Outside of diabetes I wonder how other chronic illnesses are treated and if there are similar issues.

What do you do when you can’t afford to take care of people in jail? I don’t know what the answer is but it’s a very troubling situation.


#38

It doesn’t matter – and shouldn’t matter – what an inmate’s medical or psychological condition is: the Eighth Amendment legally requires prisons to provide inmates with medically necessary treatment. It doesn’t say the “latest” treatment or the “best” treatment – just “necessary.” And that generally translates to “the bare minimum,” especially in a country where most jail and prison health care is handled by for-profit companies.

Someone who’s inclined to be incarcerated may be better off moving to somewhere like New York City, where health-care provision is independent of the corrections system, and health-care providers take a human-rights approach rather than a profit-driven approach.

The dismal state of care in jails provided by for-profit care companies was recently written about in The New Yorker:
https://www.newyorker.com/magazine/2019/03/04/the-jail-health-care-crisis


#39

Actually, no, not remotely a fair statement. Trans people are at high risk of being denied treatment (including hormonal medications they may be already taking prior to incarceration; not even necessarily talking about surgery), and recent changes implemented under the current administration have made key changes that increase odds of trans prisoners’ gender identity being ignored and trans women being housed with men, for example. Not surprising that trans individuals are at a much higher risk of harassment and sexual assault in jails. Just because some folks have gotten gender confirmation surgery while in prison doesn’t mean it reflects anything close to the typical experience.


#40

Well, there are many chronic illnesses for which things are MUCH worse. People are getting thrown into jail for not being able to even access a doctor. Thats true, across the board, for mental health. Its good to remember that. While we are less likely to get thrown into jail, directly, for having chronic illness, we have greater risks once we are there.

MN is the top three. However, we are still quite terrible. http://www.mentalhealthamerica.net/blog/best-and-worst-states-mental-health


#41

The problem is also not just in prisons but I think there an an overall ignorance about how difficult this disease really is. When I was dx as a teenager I was suffering from sever depression and bulimia and agreed to go into treatment at a hospital. It was an impatient facility and I couldn’t keep my meter in my room, nor could I keep food in my room or leave the room. I was suffering from a sever hypo reaction and was being punished from staff when I tried to communicate with them I needed help. People just don’t understand what we go through and how nothing is actually predicable even if we try our best for it.


#42

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#44

I don’t know if we are allow to post links so I’ll just say Google: Legal Rights of Prisoners and Detainees with Diabetes: An Introduction and Guide for Attorneys and Advocates. It is geared for attorneys so it’s full of legalise but it might give you some idea (at least what your rights are).

http://main.diabetes.org/dorg/living-with-diabetes/correctmats-lawyers/legal-rights-of-prisoners-detainees-with-diabetes-intro-guide.pdf