This is not a happy gee-isn’t-diabetes-great post, so the ‘happy police’ can turn back now
I was watching coverage of the EQ in China and was again reminded that no one’s going to pull a type 1 diabetic out of the rubble after 5 days. Well, unless they’re trapped relatively unharmed in a void/dead space and have a vial with enough left in it within their reach and some way to inject it and figure all this out in cramped quarters in the pitch blackness. I would guess that being in the rubble in the first place would make all that highly unlikely.
If you’re on shots you’ve got tops 24 hours if you JUST gave yourself a shot of Lantus. Probably more like 12 hours or less. If you’re on the pump you could actually get up to maybe 4 days (since you’re not eating you won’t be using insulin as quickly, in theory) if you JUST changed your reservoir & set moments before the quake. There’s just as high of a chance that you didn’t change it that day, so it’s nearly empty. And that’s assuming your battery isn’t almost dead (hey, if it’s new you could use the little LED light in it to see the rubble around you). It’s also assuming that the pump wasn’t damaged in the collapse and the tubing isn’t being crushed by a 10 tons of concrete or steel.
If all these conditions are right… you’re on a pump, just changed your res & set, battery is good, pump not damaged and you’re not injured, it would make it theoretically possible to get pulled out days after. However, the extreme stress of the event and even minor injuries or the pain from being stuck in one position for hours would lead to very high levels of stress hormones and a much greater need for insulin. Assuming you’re not checking your blood sugar in your tiny empty space every couple of hours, you might not even know that you’ve already climbed to 400 and need to kick your basal rate up about 200% to get by in your present circumstances (if you can reach your pump). Not eating for extended periods will also cause extra glucagon release. Now you’ve got high blood sugar, a quickly dwindling insulin supply, glucagon getting pumped into your blood from fasting and stress, possible infection beginning in even minor injuries and the big killer for everyone, dehydration or organ shut-down from being squished in a weird position and unable to move and drink water for days. We know already that if you’re dehydrated, DKA will attack you faster and harder. And kidneys… well, we all kind of need those!
So it all goes back to the first statement… 99% chance no diabetic will be pulled from the rubble after 5 days. Just another thing about diabetes that SUCKS. (And that concludes my poorly written middle-of-the-night rambling.)
P.S. I read this once on another forum: someone (type 1) said that when she was a kid she asked her doctor about what to eat to prevent starvation if she was stranded on a desert island or in a jungle after a plane crash. (Probably had seen a news report or movie recently.) The doctor was honest and said, “You wouldn’t have to worry about starving to death because you’d run out of insulin long before that would ever happen.”