Why are people so afraid of Diabetes?

Why are some people so afraid of Diabetes?

I do not wish to offend anyone but I just have to address the atmosphere of FEAR that permeates the USA (and to a lesser extent Canada) with regards to children being diagnosed with Type 1 Diabetes.

With blanket statements like those below being printed in the media on a regular basis, it is no wonder families and parents are now so afraid of Diabetes.

High blood glucose levels can impact a student's ability to concentrate and learn. Additionally high blood glucose levels can lead to severe disabling and life threatening complications including heart disease and stroke, kidney disease, blindness and amputation of the lower extremities.

Quote Source - New Legislation to fight Diabetes in California Schools - Feb 2010

Diabetes is NOT an Epidemic

It actually really bugs me that the WHO and the UN (and also the USA government) keep going on and on about how there are well over 300 million diabetics around the world, and how it is a huge epidemic. They imply that is it is the diabetic persons fault for being too sedentary or for not eating healthy. That may be true for most Type 2 diabetics, but it is certainly NOT TRUE for Type 1 diabetics.

The WHO and the UN really need to STOP with the attitude.
Where does the UN and WHO think all these diabetics come from?
That's easy - if you think about it.

It is a known fact that Diabetes has been around for thousands of years. And in that time, thousands of humans with type 1 diabetes died as children, as teenagers or as young men & women either because they were undiagnosed or once they were diagnosed, because they did not have NOT have insulin to keep them alive.

So the reason why we have so many diabetics now is because - they have access to insulin. So in that respect, diabetes is not an epidemic. It is a very common disease, having been around for thousands of years. Now that we have insulin to keep diabetics alive, it just SEEMS like an epidemic because so many more people with diabetes are surviving when previously they would have died.

The "Dead in Bed" syndrome

In the days after my son was diagnosed with Type 1, I went onto an online forum specifically for Diabetic Children, asking for support from anyone in Ontario, Canada. I was asked a few questions about how often did I do finger pokes, how often did I inject insulin, did I do finger pokes during the night, and who does the injections and finger pokes at school?

My answers were 4 finger pokes minimum (breakfast, lunch, dinner (supper) and bedtime) - more are done if needed. As for injecting insulin, I do 4 injections per day - 2 at breakfast (rapid acting and intermediate acting) and then another rapid acting at dinner time and another intermediate acting insulin at bedtime. No insulin injections are done at school. Schools in Ontario do NOT have school nurses. My son does one finger poke at lunch time, and if his Blood Glucose is low, then he gets to have an extra juice box.

As to doing the finger pokes during the night - Nope, I don't do those - I have never been told to do those.

The vitriolic that was poured down on me after that statement, was totally unexpected and quite cruel. I was told that I was NOT being a good mother, I should be reported to children's services, your child comes first and do you want your child to be "dead in bed" which is what happens if a child's blood sugar level gets too low while he is sleeping and is not treated fast enough. One mother on the forum said her child died while he was sleeping, because his blood glucose level dropped too low. I could not understand why these Americans were so angry with me.

There were some Canadians in the forum who supported me. They too had never been told to check their children's blood glucose levels overnight.

I think one of the reason why the Americans were so angry with me, is because they don't get or use the intermediate acting insulin.

Why we dont do finger pokes overnight.
And yet we still avoid the Dead in Bed syndrome

The main reason why I don't need to check overnight Blood Glucose levels is because my son gets two insulin injections at night time. He gets a rapid acting insulin right before dinner to cover what he eats, and then he gets the intermediate acting insulin 2 hours later at bed time to cover when he is sleeping. I do check on my son before I go to bed, but mostly I just check and make sure that he is still breathing.

I read one statement from an American based website about drugs that said this - Insulin should look as clear as water. Do not use the medication if has changed colors, looks cloudy, or has particles in it.

The Intermediate acting insulin (called Novolin NPH) that my son receives, IS cloudy and it has to be gently mixed before it can be used. It has an onset time of 1 to 2.5 hours, peak time of 6 to 15 hours and a duration time of 18 to 24 hours.

As I write this - I am looking at the insulin chart in my Diabetes book. The rapid acting, short acting and long acting insulin types are all clear. Only the intermediate acting insulin types are cloudy.

This is how my diabetes educator explained it all to me when I was going through those first few days in shock and having all this diabetes education shoved into my head. One of the things she said, was that the hospitals would prefer NOT to use the intermediate acting insulin, but since the children with Type 1 Diabetes are in schools, and the schools in Ontario do not allow teachers to inject insulin, (although they are permitted to inject epi-pens for anaphylactic peanut allergy reactions). the diabetes teams have to use the intermediate acting insulin until the child gets promoted to a pump.

The diabetes teams cannot really use Lantus, for a newly diagnosed Type 1 child, because that means the kids have to learn very fast, how to bolus their lunchtime and snack insulin and inject themselves with extra insulin as necessary. This is on top of just being told that they are Type 1 and will have to receive insulin injections of the rest of their lives. It's usually too much to handle. So the diabetes teams use a different method for newly diagnosed children.

There is also the fact that in Ontario, most schools Under teachers union rules, do NOT allow teachers to inject insulin at all.

So to get around this - the child receives intermediate acting insulin, so that they can have their injections at home in the morning (breakfast) and again at night (dinner and bed time). The only thing my son does do at school is to give himself a finger poke (to get his Blood Glucose level) at lunch time - that's all.

His lunch and snacks are carb counted every morning. Fortunately the school recently changed its recess times and bells to fit into the diabetes day so much better, so that my son is not eating at funny times. He can now eat at the same time as everyone else.

When my son does go onto the pump, then he will receive Lantus (which is the long acting insulin and works for 24 hours) and then he can just bolus extra rapid insulin from his pump whenever he eats. He will not be giving himself injections in the arm by syringe or pen.

I sincerely hope that my son will be on a pump in the next 4 years - before he goes to high school.


USA Diabetes Site

How to De-Stress your Diabetes - UK website



  1. If you're suggesting that the complications quoted from the snippet in your post are untrue, then I would humbly suggest you get more education. Complications such as blindness, kidney failure, & amputations are very real...& they're very much a real concern if glucose levels are not controlled. Anyone who has ever seen a person in the throes of hyperglycemia is very aware of the effects of high glucose levels on mental alertness.

    As for dead in bed syndrome, according to the JDRF, 1 in 20 people with Type 1 diabetes will die from hypoglycemia. That's another truth that's very real. If you feel safe not checking your child overnight, that's your decision. And I pray it doesn't end in tragedy for you. However, just as the parents on that site had no right to attack your parenting choices, you have no right to attack those who understand the potential dangers of overnight lows, especially in children.

    I live in the southern USA & my daughter was placed on a regimen that included NPH, for the same reasons you mention it's used in Canada. We did have a full time nurse, but the NPH allowed my daughter to adapt to her new lifestyle without need for an injection during the day. Most endocrinologists in the USA consider NPH a somewhat outdated insulin, & its instability, particularly in children, is well-known.

  2. I apologise if my attitude towards the effects of diabetes seems to be cavalier. I know the effects and the symptoms are nothing to be cavalier about. I have seen lots of people here in Canada in wheelchairs after losing a leg to diabetes. I know how real these symptoms are.

    According to my reading, those diabetic children who die in bed are usually the ones who for some reason LOSE the ability to feel shakey when their blood glucose goes low. If they dont feel shakey, they cant act on it.

    I came across an article recently about a family who were getting a diabetic dog as a service dog. This dog's job was to smell when the childs blood glucose was low and get the child up and get them to test their Blood Glucose and then do something about it.

    When I first read this article I scoffed at it, assuming it was just another case of Americans being overprotective and over the top. But when I read the article a second time, I took in the line that said - he could not feel when he was low.

    That's when I finally understood. Apparently there are some diabetic children out there, who for some reason cannot feel when they are low. They dont feel when they are shakey. If they cant feel when they are low or shakey, they cant get a juice box or some candy to replace what they have lost. If they happen to be asleep when their body goes low, they wont feel it so they dont do anything. If they stay low for too many hours, they could certainly die.

    Now I understand the American penchant for being over the top in their overnight checking.

    But the fact remains, we Canadians are not generally told that we HAVE to check our childs Blood Glucose overnight.

    I did speak to the diabetic educator about this, and she said, while it was our decision whether or not to do this, the diabetic teams at the Sick Kids hospital, just did not think it was necessary.

    Fortunately my son can feel when he is shakey and has no problems telling me how he feels, so that the situation can be rectified immediately.

    1. I hope nobody has told you that a child who detects hypoglycaemia during the day will necessarily also be able to detect it accurately at night, because that would be complete misinformation. Many, many children who are hypo-aware during the day sleep too deeply to wake up from the symptoms of low blood glucose.

  3. No Emma,

    You're right about that. Noone has told me that at all. I will have to look into that further.

    But I am concerned about this vague number you used.
    Many Many children. What was your source for that vague number?
    Do you know of any medical studies with an accurate percentage?

    I am new to the Diabetes world, so it is clear that I need to read as much and as widely as possible - and that includes the Medical journals.

    One really should not be telling the new mothers what they are doing wrong, without including some very accurate numbers as ones proof.

  4. The mother who posted about her child dying in her sleep was from New Zealand and it was her Daughter not son. I suggest you review the thread. http://forums.childrenwithdiabetes.com/showthread.php?t=70750

    In addition, you make many factual errors in your post. No one pumps using lantus. Some people use an insulin pump in addition to receiving lantus injections. That is called untethered regimen. The only intermediate acting insulin on the market is NPH. Your book is quite outdated if it refers to intermediate acting insulins. Bc there is only one kind – NPH.

    For the record, I believe it was you who mentioned Children’s Aid being called on your family prior to your son’s diagnosis.
    I do not think sick kids would ever endorse your family using the pump if they know anything about your family situation and dynamics. Sorry to say !

    Re. The literature and hypoglycemia unawareness – the topic of hypoglycemia unawareness is discussed extensively in the academic literature. You need only search nocturnal hypoglycemia unawareness in the database of your choice. Yes, people’s degree of hypoglycemia unawareness varies when they are asleep vs. whey they are awake. doesn’t that seem logical?

  5. all of these articles discuss the phenomenon Emma is talking about !
    Ahmet, A., Dagenais, S., Barrowman, N. J., Collins, C. J., & Lawson, M. L. (2011). Prevalence of nocturnal hypoglycemia in pediatric type 1 diabetes: A pilot study using continuous glucose monitoring. The Journal of Pediatrics, 159(2), 297-302.e1. doi:10.1016/j.jpeds.2011.01.064

    Bakatselos, S. O. (2011). Hypoglycemia unawareness. Diabetes Research and Clinical Practice, 93, Supplement 1(0), S92-S96. doi:10.1016/S0168-8227(11)70020-1

    Howorka, K., Heger, G., Schabmann, A., Anderer, P., Tribl, G., & Zeitlhofer, J. (1996). Severe hypoglycaemia unawareness is associated with an early decrease in vigilance during hypoglycaemia. Psychoneuroendocrinology, 21(3), 295-312. doi:10.1016/0306-4530(95)00034-8

    McCall, A. L. (2012). Insulin therapy and hypoglycemia. Endocrinology and Metabolism Clinics of North America, 41(1), 57-87. doi:10.1016/j.ecl.2012.03.001

    Snogdal, L. S., Folkestad, L., Elsborg, R., Remvig, L. S., Beck-Nielsen, H., Thorsteinsson, B., et al. (2012). Detection of hypoglycemia associated EEG changes during sleep in type 1 diabetes mellitus. Diabetes Research and Clinical Practice, 98(1), 91-97. doi:10.1016/j.diabtes.2012.04.014

  6. Thanks for those journal articles.

    Well now I see what you mean by "outdated"


    Starting from Figure 5 onwards, the text discusses the benefits versus the short comings, of intermediate versus basal and bolus insulin.

    Physiologic insulin regimens with both basal and bolus insulin components provide flexibility not possible with older twice-daily NPH and regular regimens (figure 5).
    Unfortunately, as we approach two decades after the announcement of the results of the DCCT, many individuals both in the United States and around the world still use the older therapies which make it difficult if not impossible to attain near-normal glycemic control safely in type 1 diabetes. It should be pointed out that once- or twice-daily basal injections are sometimes adequate for newly diagnosed patients with type 1 diabetes...

    Back to me now - So since my son is just a newly diagnosed diabetic, and we wont be able to go onto a pump until he has had 3 consecutive A1C scores below 10%, then for now, I beleive I will stop talking and wait a few months, until we do go onto a pump.

    It may be that when my son does go onto a pump, then I may have to start doing the overnight finger pricks and checks - God I hope not - we will just have to wait and see.

    Since my son is currently on an "old and outdated" treatment regime, for the time being, I am going to stop talking about treatment methods. I did not realise that NPH is considered to be an old treatment - execept that it is still being used for the newly diagnosed.

    So I will stop commenting on this issue - for now.

    Apologies to anyone I may have offended.