Diabetic Recipes
Imagine it's the end of the world.
There's a flu pandemic. Or The Plague. Or the sun is burning a hole in the atmosphere and we all have to be herded into caves. There's mass panic and people need medical treatment.
Imagine having to decide who is worth saving and who isn't. That was the task of an "influential group of physicians" who drew up a "grim" list of patients who simply wouldn't be treated, according to this story.
The idea is to try to make sure that scarce resources--including ventilators, medicine and doctors and nurses--are used in a uniform, objective way, task force members said.
As terrible as it sounds, I agree that there should be protocol in mass healthcare disasters. I don't want to be the one making the protocol, but I agree that for the sake of survival, someone or some group needs to make some tough decisions. I know, I know...there are serious ethical problems with making "a list" of people who get to live. Let's not go there right now.
While much of the list of those who would be left behind does not seem arbitrary--those with severe trauma, severely burned patients older than 60, those with severe mental impairment--I was struck by one category: those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.
Who's to say what exactly consitutes "poorly controlled"? There are different philosophies on what our target blood sugar ranges should be, the benefits of certain drugs and how aggressively we should be treated. So how could we possibly come to a consensus on what this means?
- Anyone with an A1C over, say, 7 should be considered poorly controlled?
- Anyone experiencing any kind of complications?
- Anyone who doesn't check their blood sugar more than, say, three times a day?
I have had several A1Cs over 7--some were my fault, some were the fault of the medicines I was taking and seasonal allergies. Am I going to be faulted because of pollen? Several of my A1Cs were over 7, but were on the way down. Again, would I have been considered "poorly controlled" even though my numbers were clearly getting better? We simply can't control every facet of what our bodies do and what we respond to.
While the wording certainly leaves much to be desired, the idea is to ration resources in favor of those most likely to survive and thrive. The way you describe these chronic diseases suggests specifically those whose conditions have deteriorated so badly that they would die very quickly without extraordinary care. People with advanced COPD, people who are on a heart transplant waiting list, and so on.
The other indicators for diabetes -- because a pandemic is the "design basis accident" for this particular type of triage -- would be the availability or scarcity of medications required for blood glucose control, and diabetes-related immunosuppression. If the pandemic creates a transportation vacuum and insulin cannot be shipped in, how long will someone with insulin-dependent diabetes survive if given the same treatment as someone without diabetes and without any immune system issues? If you only have enough antibiotic to save one person, and you have to choose between the person who will die anyway because you can't get in any insulin, and the person who is otherwise in perfect health, is there, in the dispassionate, perfectly logical mind, any question who should get that antibiotic?
In the end, though, the people who receive care will be the people who always receive care: the people rich enough to pay for it outright, the people rich enough to be able to bribe their way to the top of a waiting list, the people smart enough to blackmail their way to the top of the list, and the people able to play at public sympathy enough to get to the top of the list.
Which means, probably not you, and probably not me, and probably not anybody who is not a trust fund baby or very high up in the ranks of organized crime. Unless he or she is one of the medical care people who HAVE to be healthy in order to care for everybody else. Or unless he or she is part of the active military there to prevent you and me and everyone else from rioting to get to the "cure".
Once again, it is a disease that requires pro-active personal accountability. I guess I would figure worse case scenario in that situation and stock up. If that doesn't work, I guess we all get creative. I think it's gonna be o.k. though. I think diabetes is already at the point of being considered an epidemic......wow we could get 2 at the same
time. www.joyofdiabetes.com
Keep Learning....Keep Going...Peace, Bob
Sometimes I get so sick of having it, but I know if I don't take care of myself, I might lose myself. So I know when not to cross the line. I try hard to get it undercontrol, but the food is so tempting. Everyone's also telling me what to do and that's not helping at all! They're not listening to what I have to say, and wonder why I'm always sad. I hate feeling like this... someone help me!!!:(