Note: While some items presented in this blog post will also pertain to type-2 diabetics, the focus is on type-1 today. All mention of diabetes in this post will concern type-1 diabetes.
In the novel One Second After, the modern classic prepper fiction novel, the main character's teenage daughter is a type-1 diabetic. And, spoiler alert, for maximum emotional impact, you know she has to die in the end. Dad was able to keep her insulin cool for a while in the toilet tank, but of course, the insulin ran out and there was no re-supply. The vast majority who read this book and those who have any understanding of type-1 diabetes assume this is true; the people with type-1 diabetes will die when our society collapses.
But do the diabetics have to die?
It's a question that's near and dear to my heart--my husband is a type-1 diabetic, since 1983, and I've gotten pretty attached to him.
For most people, including the diabetics, the answer is yes. Fortunately, for my family and my husband in particular, that answer is a resounding No! And in situations like this, it's nice to have history on our side to back us up.
Eva Saxl and her husband found themselves in China after barely escaping from the Nazis in Czechoslovakia at the onset of World War II. Shortly thereafter, she became a type-1 diabetic. Regular deliveries of insulin became increasingly unreliable; black market insulin was sometimes poor to deadly. They decided that they needed to make their own. You can read their story here. Or you can watch a Youtube about it here.
I've never found the exact protocol they followed to produce their insulin; however, it did work and they saved Eva and about 400 other diabetics in Shanghai during WWII. Here is a link to a 1926 journal article with the exact directions for producing your own insulin. It was ridiculously hard to find. If you have a diabetic in your family, I highly recommend printing several copies and storing them in different locations, as well as saving the web address for when you come across others who want copies as well.
The equipment Banting and Best used to first produce insulin in 1921 is not much different than what is found in a high school chemistry lab today. Eva Saxl and her husband were not scientists. If they could do it then, we can do it now. No, it will not be easy, but it is doable. Supposedly, it's about as complicated as making meth. The greatest challenge will likely be the constant supply of cow and pig pancreases that will need to be obtained.
If we're really lucky, we won't have to go that far. Insulin-dependent folks already know that they can build up a supply of insulin; in this respect they have it way easier than others trying to build up medication supplies. Blood glucose strips, monitors, batteries, pump supplies are all a bit harder, but still manageable, assuming that you have insurance footing the bill. If you've got to cover everything out of pocket, it could become very expensive.
Pump supplies and the accompanying boutique insulin won't likely be an option post-collapse, so people are going to have to old-school it.
- Urinalysis strips are relatively inexpensive and still available in this country, even at Walmart. It was the only method diabetics had for checking blood glucose levels at home until the 1970s. And actually, the urinalysis strips only show what the blood glucose levels were a few hours previous. But when things fall apart, they'll be useful.
- Visual-read blood glucose strips are what my husband used when he was first diagnosed in 1983. (He used to cut them in half to make them last longer. Then, when I came along, I said we could cut them in thirds, and they would still have enough color to work for us. He was skeptical but willing to try. And yes, it worked just fine. But we were in our twenties then; it might be a different matter now.) I have not been able to locate a supplier in this country. Last year we purchased a few bottles of strips from Betachek in Australia. They ship worldwide.
- Once all the strips run out, the diabetic will have to turn to taste-testing. Yep, that. Urine from a healthy person is sterile when fresh. It can safely be tasted. The kidneys start spilling sugar when the level tops 180 mg/dl. If the urine is sweet, the diabetic is above 180 mg/dl. If the urine is not sweet, the blood glucose level is below 180 mg/dl. If you happen to have a lot of sugar ants around, you may get them to do the work for you. Pour a little urine on the ground near them. Are they attracted to it? If the answer is yes, the sugars are high. If not, sugars are below 180 mg/dl.
- Most diabetics will re-use syringes as long as possible. Those needles are so fine. But you might run out of those as well. Unfortunately, the syringes cannot be autoclaved due to the type of plastic and rubber. ShopMedVet sometimes carries glass syringes (they have them in stock today, 22 July 2019). If you happen to know an anesthesiologist, or someone who works with one, you can try getting some glass syringes from him/her. Epidural trays are one of the few places where glass syringes are still used in this country. Get the right size re-usable needles for the syringe, and a means of sharpening as necessary.
Three stop-gap measures:
- Dr. Joe Alton (who has a type-1 diabetic son) of The Survival Medicine Handbook and Dr. Cynthia Koelker of Armageddon Medicine both believe that metformin, a drug used to help type-2 diabetics maintain proper blood glucose levels, could be of use to type-1 diabetics who are deprived of insulin by being able to extend the time their supply of insulin lasts. It probably wouldn't be a long-term solution, but may be able to delay the onset of diabetic coma.
- Another stop gap measure suggested by Dr. Koelker and Dr. Steve, who taught the grid-down medicine classes I took, is exchange transfusion, where blood from a donor is transfused into a diabetic, and blood from the diabetic is transfused into the donor. Yes, it's extreme and only a stop-gap for a day or two, but if insulin re-supply is delayed but expected within a day or two, it works. Successful blood transfusions were performed 200 years ago, so it could be done now as well. If it were my husband or child, I'd do it in a heartbeat. Fortunately for my type-1 husband, everyone in the family has O+ blood. Consider stocking up on some blood transfusion supplies.
- Finally, adjusting the diet to just fats and animal proteins and green salads will greatly extend the insulin supply. This isn't a great long-term solution, because the body needs carbohydrates to function optimally, but it can work for a few weeks.
What about new cases of diabetes? How does a physician diagnose
them? Well, it's a simple finger prick in the office, with a device
just like what diabetics use. If you're suspecting a new case of
diabetes, find someone with a blood glucose monitor or some urinalysis
strips to check. The main symptoms of diabetes include frequent
urination, extreme thirst, (those first two are pretty much required),
hunger, and fatigue. For my husband and a good friend of ours, the
onset came about two weeks after a bout of influenza, and indeed, new
cases of type-1 diabetes exhibit a four-fold increase after some strains of influenza pass
through a community. Another reason for good hygiene habits.
Keeping
a diabetic alive post-collapse will be difficult. But it's not like it's going to be all that easy for the rest of us. You, and mostly the diabetics around you, will
decide whether it's worth the effort.
Links to related posts:
Book review--Armageddon Medicine
Book review--The Survival Medicine Handbook.
Resources:
http://www.jbc.org/content/72/1/57.full.pdf (DIY insulin instructions from 1926)
betachek.com (visual read glucose strips)
shopmedvet.com (glass syringes--sometimes)
https://www.youtube.com/watch?v=xlOBl_nEits&feature=youtu.be (Eva Saxl mini-documentary)
Dr. Joseph Alton, The Survival Medicine Handbook. Dr. Cynthia Koelker, Armageddon Medicine.
© 2019, PrepSchoolDaily.blogspot.com
april 2 2019
