Hey, remember when everybody was freaking out about Ebola, because of an outbreak that killed more than 10,000 people? Well, diabetes kills 1.5 million people a year worldwide, more than 200,000 of them in the U.S. And you’re probably never more than a few dozen feet away from someone who has it — there are 30 million diabetics in the U.S. alone.
In other words, for something most people consider too boring to even think about, the scale of the epidemic is mind-boggling. The U.S. alone spends an astonishing quarter of a trillion dollars a year fighting it. Or to put it another way, diabetes sucks a thousand bucks out of every single man, woman and child in America, every year.
We previously debunked the myth that sugar causes diabetes, and when we talked to someone with one variety of the disease, we learned about the parts of the experience you never hear about. He says…
#5. The Disease And The Treatment Can Both Send You To The Emergency Room
Our diabetic, Zach, once woke up in the middle of the night starving, his legs feeling near-paralyzed. His memory of the incident is hazy, but the next thing he knew, he was on a kitchen chair wearing only his boxers with an empty jar of raspberry jam on the table — he’d eaten nearly the entire thing with his bare hands like fucking Winnie the Pooh.
When he tested his blood sugar, it was 45 (the normal level is between 80 and 100). Anything below 70 is hypoglycemia, yet even after eating an entire jar of what is essentially pure sugar, his blood sugar level was still near emergency levels. If we’re being completely honest, it’s remarkable that he ever even woke up to eat that jam. By all rights he should’ve died in his bed. So this shit can get serious, is what we’re saying.
“Wait,” you ask, “isn’t diabetes that disease where you just can’t eat sugar, and have to take insulin every once in a while?” Oh, if only it was that simple.
For starters, you might be mixing up two very different types of diabetes (more on that in a bit). And when diabetics who inject insulin get their dose wrong, things can get bad fast. These problems (“insulin-related hypoglycemia and errors”) spark almost 100,000 emergency room visits a year (more visits than those related to all stimulants, including methamphetamine). A third of those visits require hospitalization, because despite how common and treatable it is, diabetes can still straight-up murder your sorry ass.
On another occasion when he was in college, Zach knew his blood sugar was low before he went to bed, so he popped a few glucose tablets and went to sleep, thinking that would straighten everything out. He woke up with the sensation of sour rust in his mouth — that’s the taste of epinephrine, and it means things are catastrophically bad.
“When I checked my blood sugar,” he says, “it was too low for the meter to give a number.” He’d already eaten all his glucose tablets, so Zach needed to think of a solution quickly or he’d soon be unable to do anything to help himself. “Somehow I remembered there was a vending machine nearby. I bought a bottle of Pepsi, drained it in two seconds, and told a person in the dorm common room all about diabetes, at the speed of 400 words per minute.”
If these episodes sound like bad drug trips gone wrong, well …
#4. Fucked-Up Blood Sugar Gets You High And/Or Drunk
If you see your roommate eating an entire trash bag full of discount Halloween candy, the go-to joke is something like, “Enjoy your diabetes, dude!” That’s because in popular culture, the disease can be a result of poor diet and lack of exercise. But again, it’s not that simple. You can in fact be born with the genes that cause it.
Type 2 diabetes (previously called “adult-onset diabetes”) is the one you probably associate with eating too much candy, as hauntingly portrayed by Jeremy Renner in Hansel & Gretel: Witch Hunters. With that type, your genes and often poor diet cause you to overwork the insulin-producing cells. But Type 1 diabetes is an entirely different beast. Here, your immune system decides to kill those insulin-producing cells, and this type is waiting for you when you pop out of the womb. That was the situation for Zach, who was just 15 months old when he was diagnosed, making him one of 3 million Type 1 diabetics in the U.S. Plus, plenty of people are only diagnosed with Type 1 after they turn 18, after being misdiagnosed by doctors with Type 2 for years.
A healthy body produces insulin to control the sugar (or glucose) in your blood stream. Type 1 diabetics can’t produce insulin, while Type 2’s produce it, but their bodies don’t process it correctly. Too little insulin, and your blood sugar levels go shooting rapidly up, like the heart rate of somebody getting chased by a bear. Too much insulin, and your blood sugar eventually plummets, like the heart rate of someone who has just been eaten by a bear. And the effects of jacked-up blood sugar are weird. Diabetics describe high blood sugar (hyperglycemia) as slowing everything down and slathering it with whipped cream. Your brain gets fuzzy, and your eyes feel tethered to your head with frayed ropes — it really is a kind of high. Just not a good kind.
Low blood sugar (hypoglycemia), meanwhile, is a bit like being drunk. For one thing, it impairs driving. Zach is usually super cautious about driving on low sugar, but his level plummeted once when he was on the road, giving him muscle spasms. He pulled over and quaffed some glucose gel, which we are sure would’ve looked like an intoxicated person pulling over to get even more high to a passing trooper. So being diabetic is like living in a world where, even with the best control, there are days where you can suddenly become uncomfortably drunk or high at any moment, without any of the fun.
And when we say “any moment,” we mean it …
#3. Sex Gives You A Sugar High
In theory, stress raises your blood sugar because hormones like adrenaline release glucose, fueling your muscles for fight or flight. And in experiments with diabetic animals, stress always raises blood sugar. However, according to Zach, “stress and panic tends to make my blood sugar run low.” Despite the fact that this makes no sense given what we know about the human body, he’s not the only one to experience this apparent witchcraft.
On the other hand, sex should theoretically reduce your blood sugar because it’s physical exertion. But for Zach and some other random diabetics, sex actually raises it. “I have no idea why,” he says. “The last time I asked a certified diabetes educator about that, she laughed and gave me a weird look.” Neither one of those responses is particularly encouraging.
Sexually active diabetics are supposed to keep three things on their nightstands: condoms, a glucose meter, and sugar tablets. It’s not particularly romantic to test your blood sugar right after orgasming, but it would be worse to fall unconscious immediately after a passionate lovemaking session (or during a passionate lovemaking session) and force your partner to call an ambulance to come collect your sex-stained body. Zach has also met severely undereducated people who think diabetes is transmitted sexually, so it’s probably best to have your personal medical history spread out on a nightstand to get that conversation out of the way immediately.
But far more often than that, presumably, he has to deal with the fact that …
#2. Every Meal Is A Minefield
When Zach was kid, a teacher was once handing out cupcakes but refused to give one to him, telling him “You’ll die if you eat that,” because apparently Zach went to school in a Roald Dahl novel. He ate one anyway, and checked his blood sugar afterward to discover that it was still low, meaning he could’ve eaten even more cupcake and still not have died. In other words, it’s not as simple as “avoid sugar.”
When he was 13, he once went trick-or-treating dressed as an IRS agent, and he collected money for diabetes research. The media thought this a heartbreaking story that they’d love to cover: The inspiring, sickly kid couldn’t eat sugar on this candilicious holiday, so he devoted himself to good works instead. You can actually watch the TV interview and hear Zach patiently explain that he still totally plans on collecting candy in addition to the diabetes fundraising (the interviewer heroically ignores this information).
That’s the thing — Zach can eat whatever he wants (get thoughts of sugar-free candy out of your mind; diabetics like him never touch the stuff). He just needs to pump himself with the appropriate dose of insulin, kind of like what the pancreas does in all you normies. It makes no difference whether the carbs in their food are in the form of china white pixy sticks or black tar quinoa — it all turns to glucose in the end, and the injected insulin can handle it. However, figuring out the dose can be a pain in the ass, and as we’ve discussed already, screwing it up can be disastrous.
“Things like Pop-Tarts and other sugary products are easy,” he says. “You would just take all the insulin you need two to five minutes before you eat.” With other foods, it’s more complicated. “Pizza takes a long time to digest. Some of the protein and fat in pizza is converted into glucose. You have to figure out how long it takes and how much is converted. After trial and a lot of error, I figured out I need to time my dose for pizza as: one-third of the insulin right before I begin eating, two-thirds over the next three and a half hours.” Now imagine you had to do that for every single meal. We would probably just stop eating, because we hate math.
High-fiber foods add a whole other level of bullshit, because they take longer to digest than regular food. And then alcohol is a special kind of bastard, because it’s loaded with carbohydrates but also blocks the glucose that the liver ordinarily releases. And no matter how much experience you have with food, you’ll inevitably come across a dish that trips you up.
A couple months ago, Zach met his ultimate nemesis: a giant plate of chicken nachos. He underestimated the fat, so the meal kept sending more glucose into his system after his insulin wore off. As we mentioned, a normal blood sugar level is between 80 and 100 techno-units — anything above 140 is hyperglycemia, which eventually screws you up bad. Zach’s blood sugar exploded to 482, way higher than the danger threshold. After he jacked in some insulin just in time, he then reveled in the experience of drinking four glasses of water and peeing three times an hour for the entire night.
Delights like this are why …
#1. The Treatment Can Turn You Into A Cyborg
There are two mechanical devices connected to Zach’s body at all times (except when he’s exercising, showering, or having sex, which is basically a combination of showering and exercising). One is an insulin pump, which infuses his body with insulin via a plastic tubing and a tiny needle. “Sometimes,” says Zach, “the adhesive of the set that connects it to you wears off, causing it to fall out. Other times it becomes so itchy you want to rip off that part of your skin.” The other device is a continuous glucose monitor, whose receiver sits in your pocket but which requires you to insert a transmitter into your body like Arnold Schwarzenegger in Total Recall.
Some people shrink at the thought of being hooked up to machines at all times, so they go for lower-tech solutions like manual insulin injections and pinpricks to test their blood sugar. Those are still backups even when you choose to go high-tech, so regardless of which avenue you take, having diabetes means stabbing the shit out of yourself with needles all of the time.
Zach started using the pump back in 1995, when the invention was brand new and almost never used by kids. A teacher of his once mistook it for a cell phone and tried to confiscate it. A friend of Zach’s actually did get her pump confiscated by a teacher, which resulted in a $10,000 settlement and a new set of guidelines training teachers how to accommodate diabetic students (including recognizing insulin pumps as life-giving robot friends and not pagers).
It can be pretty inconvenient to walk around with a tube connected to your body at all times. Once at a friend’s house, a puppy chewed through Zach’s insulin tubing before he knew what was happening. Every time he goes to the airport, the TSA (which does have special protocol for diabetic passengers) swabs the pump with explosives-detecting powder then does a pat-down and wanding. If the pump instead went through the X-ray machine, the rays would completely erase its memory.
And diabetics are only going to get even more cybernetic in the future, thanks to the newly developed bionic pancreas, which means we may soon see Will Smith battling a group of diabetics on the top floor of a skyscraper. The bionic pancreas currently uses four separate devices, including an iPhone linking them all together. In 2017, it’s set to shrink to a single device, and it’ll just keep getting smaller, as medical devices do (“The first generation of insulin pumps,” notes Zach, “were the size and weight of high school backpacks”).
Some scientists, who laugh at the constraints of nature and God, plan to genetically alter the pancreas to release insulin when prompted by radio waves, which means treating diabetes with a remote-controlled pancreas. So, maybe in the near future science will somehow fix both kinds of diabetes with a simple pill you take once a day. But until then, the plan is to just keep turning more and more of their bodies into robots. And honestly, have we ever run into a problem that couldn’t be solved that way?