Monday, November 22, 2010

Like Insulin For Diabetics!

Insulin and diabetics are a metaphor in the public mind.

Frequently when I read or hear about people explaining why taking a drug is important for people with a particular condition, they say that taking Drug for Condition is like taking Insulin for Diabetics.

It's rarely a fitting comparison, for reasons I suspect everybody reading my blog can think of. But the simple reasons are because of what insulin is to people who make no insulin:
1. What keeps us from certain death between now and next Monday.
2. Among the most likely things to kill us between now and next Monday.

Few medications other than insulin are really keeping people alive in a week by week sort of way.

But this is not as interesting to me as what it reveals about what people believe about insulin.

First, it suggests to me that despite the gnatterers who tell me that with exercise or herbs I could go off insulin, most people understand that diabetics really need insulin.
Since people frequently use the "like diabetics" to try to decrease the stigma around taking psychoactive meds, they must believe that taking insulin when you are diabetic doesn't carry much stigma. Taking insulin when you are diabetic does not represent weakness.
And lastly, one of the arguments used about why something is like insulin (correctly!) is that it fixes a deficit in the body. I need to use insulin because I make vanishingly little. A person might use insulin because they have less than they need.

Fact: Insulin levels themselves are rarely measured. People using insulin usually check their blood sugar levels on their meters, not their insulin levels.
Having an insulin level checked can be done through a blood draw from a vein (not on a meter).
This is more expensive and less useful than the more commonly done c-peptide test which figures out how much insulin a person is making, rather than how much they have in their bodies.

My mother was cleaning today and she came across my labs from when I was diagnosed. I had misunderstood some tests done in my hospitalization. I thought that I'd had my c-peptide drawn twice, and that once it was negative and once it was low but measurable. As it turns out, I actually had my insulin levels measured! They were measured at 8 PM on the day I was diagnosed with diabetes, while my blood sugar was 453. I think but am not sure that this was after I was already given insulin. At that time, my insulin levels were low but measurable. My c-peptide was measured the next day and was undetectable.

1 comment:

Wendy said...

WOW! I've been a RN for 16 years and have NEVER even SEEN an order for an insulin level. I know it's possible, but have never worked with doctor who felt it was necessary to prepare a treatment plan.

Great post!