Wal Mart Insulin Didn't Kill Anyone

Dear Friends,

Wal Mart Insulin didn't kill anyone.

Diabetic Ketoacidosis did.

Wal Mart insulin is getting a bad rap lately because at least two people with type 1 diabetes, who had been denied access to healthcare and their usual analog insulin, have died of diabetic ketoacidosis. Both of these insulin-depending diabetics had switched to wal-mart insulin from their usual analog insulins because of its price and because of its over-the-counter availability.

And the interwebs are going batshit insane. The media isn't helping.

Here's what everyone's saying:

Don't ever use Wal Mart insulin! It will kill you! - this is just not factually correct.

He should have learned how to use the Wal-Mart insulin the RIGHT way - this is victim blaming and no one should ever do it, ever.

Our healthcare system failed these people! - BINGO.

Now. This is not a political post about the state of our healthcare system. We all know it's broken and we can certainly all take sides and bash the crap out of each other in an effort to convince the other side to come around to our point of view. But, my friends, we don't have time for that.

Our people are dying, Senators. We must do something quickly to stop the Ketoacidosis.

What I'm trying to do is three things:

1. Help you feel less apprehensive about Wal Mart Insulin, and convince you that even though it's not as precise as the newer analog insulins, Wal Mart insulin can be a totally acceptable stopgap for people who have temporarily lost access to their usual insulin.
2. Help prevent lawmakers from getting their pants all bunched up so they don't do something stupid like make Wal-Mart insulin prescription-only, which would likely kill many, many more people with diabetes.
3. Tell anyone who will listen that diabetic ketoacidosis can kill you FAST when you are insulin dependent.

First things first.

Dude. Don't blame Wal-Mart for diabetics dying.

Blame Diabetic Ketoacidosis, also known as DKA.

Note: people with insulin-dependent diabetes can also, although very rarely, die from low blood sugar, but that is not discussed in this article.

While I cover the full details of DKA in one my online classes, I'm just going to summarize DKA in this article, because if you're not diabetic, you probably won't have the patience for all the medical mumbo jumbo.

Diabetic Ketoacidosis is caused by having too many ketones in your body for too long.

Let's talk about your body. When you consume carbohydrates, your body turns those carbs into glucose in your blood, and then your pancreas (or, if you're diabetic, a very precise injection, injected at the exact right time, in the right spot, with the right dose) causes insulin to go into your body, which helps the glucose get into your cells.

Your cells get energy from glucose, ergo, your cells get energy from carbs.

Note: there are other biological processes that can cause glucose to get into your blood that don't have anything to do with eating carbs, and you can certainly become an expert on those details in this class, but for the sake of brevity, we won't discuss those things here.

Your cells need to use energy in order for you to stay alive.

Your cells can use the energy they got from the glucose in your body, or your cells can burn fat for energy. Fat burning is what happens when you go on the keto diet, or when you starve yourself - your body starts burning fat because there's not quite enough glucose in your cells to provide you with the energy you need.

But guess what. Burning fat for energy instead of carbs creates a nasty by-product in your body called ketones. Ketones are nasty because they are acidic, and your body doesn't like them. Your muscles can feel tingly when you have ketones. They don't like being surrounded by acid. You can feel nauseated when you have ketones. You can barf. You can have general malaise. Your body doesn't like the acid. Your body tries to pee the acidic ketones out. You pee a lot. Your body loses water and necessary electrolytes. That's why you get so thirsty and feel so crappy when you starve yourself of carbs.

Note: The people with diabetes who died were not doing the keto diet. I'm simply using keto/starvation as an example to illustrate how ketones feel and to compare how non-diabetics are able to deal with ketones naturally, while insulin-dependent diabetics have a much harder time doing so.

When your body gets ketones, your body will usually compensate by generating and releasing glucose via gluconeogenesis in a desperate effort to give the cells at least SOME glucose energy, and, for non-diabetics, the pancreas will release some insulin to help that glucose get into the cells, and most non-diabetics on keto or starvation diets will stay alive. Mostly.

But guess what.

An insulin dependent diabetic can get ketones from OTHER STUFF, and not just by doing a keto/starvation diet. And guess what else. An insulin-dependent diabetic's pancreas DOESN'T release that life-saving insulin to move the glucose into the cells. :\

An insulin dependent diabetic can get ketones simply from having a cold, or a 24 hour stomach bug. From taking steroid medication. From taking biguanides, which, incidentally, is a great way to save money on insulin (and lose weight). Or from exercising. Or by forgetting a SINGLE dose of insulin. Or by not taking enough insulin. Or by having a low blood sugar scare and avoiding insulin because they're afraid to have a low blood sugar reaction. Or from trying to save money by not eating. Or from trying to save money by rationing insulin. Or, by getting sick, barfing, getting ketones, and not taking insulin because they CAN'T because there's no glucose in their body and they can't eat anything because they'll barf it up, so if they take insulin without having any carbs in their body, they'll just die from low blood sugar. And much, much more.

The point is, there's an abundance of causes for diabetic ketoacidosis in people with insulin-dependent diabetes, and, once an insulin dependent diabetic IS in ketoacidosis (DKA), there's only one thing that will happen if they can't get the medial attention they need: Their body will shut down and die.

DKA kills. Insulin doesn't.

Let's not blame victims of DKA.
Let's not blame Wal-Mart insulin.
Let's put the blame where it belongs: lack of access to adequate healthcare.

For more information on how to use the Wal-Mart insulin, see my How to use the Cheap Old School Insulin article.

Here's a small sample of the headlines. Imagine how well they get parsed and handled by the masses.