Diabetes in prison

Diabetes in prison

Yesterday I started rewatching Prison Break since there’s a lack of new and interesting shows on Netflix. Protagonist Michael Scofield pretends to have type 1 diabetes in order to get access to the infirmary when he needs daily insulin injections. It made me wonder about how it works in the real world. Can you keep your insulin pens and manage your own injections if you are in prison or are the needles too much of a safety concern? In the US, more than two million people are incarcerated and 4.8% of them, or 96 000 people, suffer from diabetes, so it’s a question that concerns a lot of people.

According to the information I found, you do not get to manage your own diabetes. You wake up earlier than everyone else to get taken to the prison’s medical facilities where your blood sugar gets checked and nursing staff administer the first insulin injection of the day. Your breakfast is not even in front of you when the carb counting is done, which must lead to some wild inaccuracies with hyper- and hypoglycemia. 

A quick google search throws up many examples of inmates who developed diabetic ketoacidosis and died from the resulting coma. The worst case I came across was that of Wickie Yvonne Bryant, a 55-year-old woman who didn’t just suffer from diabetes, but also bipolar disorder and schizophrenia. Mentally ill people really struggle in the prison system. Wickie refused her insulin on the grounds that it made her sick, a request that was granted, even though her intake test showed a blood glucose level of 353 mg/dl (19.6 mmol/l). Instead, the prison physician prescribed her Metformin and she died from diabetic ketoacidosis in an unlit cell at the Atlanta City Detention Center. 

In Georgia alone, twelve people with diabetes have died from ketoacidosis in jails and prisons since 2008. It’s such a pervasive problem that the American Diabetes Association (ADA) has written policies to guide prison care. Prison lockdowns and understaffing to maximize profits leave diabetics waiting hours for their insulin shots if they receive them at all. In 2018, the ADA joined a class-action lawsuit against CoreCivic, one of the largest prison management companies in the US, which alleged that the neglect of prisoners with insulin-treated diabetes in Tennessee facilities constituted cruel and unusual punishment.  

One concern is that as sentencing guidelines continue to increase, so will the number of aging prisoners with diabetes and its complications. In other words, the problem will only get worse. We need to abandon mandatory minimum sentences and stop locking people up for non-violent crimes. It would lessen the number of people who get stuck in the American prison nightmare which, if you’re diabetic, is just a little bit worse. When you depend on insulin injections to live, it must be awful to have no control over them yourself. It robs you of your emancipation.

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