MovieChat Forums > Body of Proof (2011) Discussion > Lacy needed glucose NOT insulin

Lacy needed glucose NOT insulin


These shows drive me crazy! Though stress can make blood glucose lower, typically it makes it higher. But after all that time the kid would need glucose NOT insulin. The pump doesn't just give you continuous insulin, you still imput the carbs you've eaten and it will then deliver the required dose of insulin. So obviously she wouldn't have been inputing info for it to give her more insulin. IF the kid was that weak because she had all that insulin, she'd die if they gave her more, yet the mom doctor gives her more insulin. They did the same stupid thing in Ashley Judd's Missing...the girl went all day on the run, no food & they wrote that she needed insulin...no she needed glucose. Sorry but these minor details drive me nuts. lol

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speaking as a type one insulin pumping diabetic myself, it is very plausable that Lacey did indeed need insulin and most likely had DKA diabetic ketoacidosis - Because insulin pumps use very fast-acting insulin that only lasts three to four hours after injection, diabetic ketoacidosis (DKA), a life-threatening condition caused by lack of insulin, becomes a real possibility if the insulin pump stops delivering the required amount of insulin.

DKA could happen if the infusion pump tubing becomes blocked or comes out from under the skin, or if the infusion pump cartridge runs out of insulin. If the problem is not discovered for several hours, blood sugars will rapidly rise and ketones will appear in the urine.

Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy.

Diabetic Ketoacidosis Symptoms

A person developing diabetic ketoacidosis may have one or more of these symptoms:

excessive thirst or drinking lots of fluid,
frequent urination,
general weakness,
vomiting,
loss of appetite,
confusion,
abdominal pain,
shortness of breath,
a generally ill appearance,
dry skin,
dry mouth,
increased heart rate,
low blood pressure,
increased rate of breathing, and
a distinctive fruity odor on the breath.

DKA can happen witin a matter of hours, and given Megan operated all night im not surprise at all that Lacey was unable to run for safety.

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I'm not surprised she couldn't run, but as an insulin dependent diabetic myself, if I don't eat my blood glucose goes down requiring glucose not insulin...so I guess I find this somewhat confusing. Now I'm a type 2 so obviously that must be the difference & clearly I need more education in this department. But friends that are type 1 actually require less insulin than I do, most of whom are not on the pump and take rapid with meals as I do and lantus once a day as I do, so if she's not eating any food to require a need for insulin how is it that she needs insulin...is the liver putting out glucose because the cells aren't receiving enough, causing high blood sugar which then means insulin is needed? Would greatly appreciate any info you can give me and thank you for your patience.

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I am by no means an expert as I have only been diabetic myself for three years, so I to am still learning, but I will give it my best shot to explain as best that I understand.

Firstly the main difference between type 1 and type 2 is that type 1 diabetics produce no insulin at all (or very little and then eventually none) whilst type 2 diabetics still produce their own insulin but the body does not properly proess it, hence the troouble wit high bsl.

Diabetic ketoacidosis is a problem that occurs in people with type 1 diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin in the system so Fat is used for fuel instead.

People with type 1 diabetes do not have enough insulin, a hormone the body uses to break down sugar (glucose) in the blood for energy. When glucose is not available, fat is broken down instead.

As fats are broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis.

Blood glucose levels rise (usually higher than 300 mg/dL) because the liver makes glucose to try to combat the problem. However, the cells cannot pull in that glucose without insulin.

Just as an example of this, and again I am still getting to know my own bodies reaction to this whole thing, but last night my insulin pump came detatched overnight without my knowledge, I went a good 8 hours without any insulin getting into my system.< once I got up I realised what had happene and re attached, I had a busy day so I left the house without testing and without eating breakfast(I know very naughty) then when I got to lunch time, my blood sugar was 378 mg/dl This was a huge shock, and the only thing I can think that might have contributed to this, besies missing breakfast and all the stress I was under, was the lack of inulin overnight. Unlike diabetics that take short acting and long acting insulin, insulin pumers only recieve rapid acting insulin, therefore after the two hours when it has worn off, if your pump is not working, you have no insulin in your system, whic the leads us back to the above DKA!

Ok thats my undertaneding, please feel free anyone to correct me if im wrong. Like I said, I too am still learning.

Hope that helped, and sorry it was so lengthy.

Kait :)

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I myself have been diabetic for over 10 years. I appreciate the lengthy explanation, but I guess I'm still in the dark. Anyone I know that is type 1 says the same thing, if they go hours without food, they would have low blood sugar not high, therefore need glucose not insulin. Stress can cause glucose to spike so perhaps that's why tv shows always say they need insulin, but they still, like me, think it more likely that glucose is required not insulin. As to the pump continuously administering insulin..if that were so she'd definitely need glucose not insulin.

But all agree it's a strange disease that is never exactly the same in 2 people.

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You are correct, Katteah. They specifically said in the episode that her pump would have been empty by then, so yes, she needed insulin.

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Regardless of the type of diabetes that Lacey has, isn't it unusual to jump from diagnosis to having an insulin pump so quickly? Or perhaps because she's an adolescent, she got one? Or perhaps things have changed a lot in the past 5-10 years? My brother was a fairly brittle insulin dependent diabetic since about 1972, yet he wasn't even given the option to have a pump until about 5 years ago.
More to the topic, I also felt dismayed about the notion that Lacey needed insulin VS glucose. Add to it that the pump was running low, so it doesn't seem likely that there was any reduction in the rate...

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you are correct that they wouldn't go right to the pump, and would want to make sure she can administer injections because the pump sometimes breaks down. However one of the main issues (at least where I live) is that the pump is not covered by medical plans, but if you have the money to get it, you are more likely to do so.

The argument to make it more accessible to kids is that it's not as obvious as taking injection and they can just program in the amount of carbs they are about to or have just consumed and the pump gives the correct dose, so they can go out and live a more normal life eating crap with their friends lol.

AND this is why I feel she needed glucose not insulin. She would not be programing it to give her extra insulin if she's not eating and you have to tell it what you are eating or it won't automatically just keep giving you insulin.

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Correct the insulin pump does give you insulin based on how many carbs you are about to eat. This is called a bolus dose. The insulin pump as opposed to the daily injection, also gies you a CONSTANT dose of background insulin reguardless of whether your eating or not. this background or basal insulin is the same as the long acting insulin that diabetics on needles would give themselves, so reguardless of what they eat they always have long acting insulin in their system. Lacey would have een getting this background inulin to keep ger bsl down, once the pump ran out of unsulin, even if she was not eating, her system would have had no insulin in it after a perios of about two hours. therefore, her blood sugar levels would have risen, and I am saying this from firt hand exerience as a type one diabetic on an insulin pump.

Ao swanted to mention that the actress that portrays Lacey, Mary Mouser, is a type 1 diabetic herelf, as was Dana Delanys father, so I doubt they would have portrayed miss information...

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I'm not saying it's necessarily misinformation however as a insulin dependent diabetic I am asking how her blood glucose is rising when she runs out of her basal dose of insulin when she's not eating? When I don't eat my blood sugar drops and I take both basal and bolus insulins. Type 1 diabetics don't have a 'leaky liver' where the liver puts out sugar, esp in the a.m., which is common in type 2.

If I as an insulin dependent diabetic don't understand (and both my grandmothers were diabetic, and my father) I'm pretty sure even though the actress's father was/is diabetic doesn't mean she understands everything...also it's a job, I'm pretty sure she would do what the script says to. And as the girl being diabetic in real life, same thing she may not understand all the possibilities either

Neither actess is more qualified than I myself and I'm confused...so it's not a personal attack on these ladies. And I'm not implying you've said that, I just want to clarify...

It's such a confusing disease, not the same for any two, but the key to it all is comprehension and that's what I'm trying to do and in the long run hope I will gain knowledge and insight to help me to continue to manage my diabetes.

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Apologies if I have offended you, that was most definitely not my intention. Clearly I am not explaining myelf well.

Please check the below link for a better explaination of basal insulin and why its different for type 1 diabetics using the insulin pump.

http://www.diabetesselfmanagement.com/articles/insulin/getting_down_to_basals/all/

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No I am sorry, you didn't offend me...I am just so frustrated with trying to understand this disease, especially where I have it. One hears so many contradictory things, but I think it's because it is not the same for 2 people.

Thank you so very much for that link on basals!! I think my friend that had found the pump difficult may not have understood it...as based on his explanation to me, he didn't know it worked this way, as I obviously didn't and my knowledge was based on his.

I also found this to help explain the pump for bolus purposes.
http://www.diabetes-blood-sugar-solutions.com/insulin-pump.html

I wonder how much our diabetes educators even understand as I once asked if type 1 diabetic's livers wouldn't put out glucose all the time (comparing to type 2 with dawn phenomenom) and she couldn't answer me. Your link explains that yes of course they do and it explains sooooooo much.

Once agian my apologies to you and thank you for the link, education eliminated ignorance.

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It is a difference between type 1 and type 2. Type 1 do not make any (or very, very little) insulin so if her pump ran out of insulin she would have high blood glucose levels and DKA since there would be NO insulin in her system and her blood would get acidic from ketones. Where this is different from type 2, is that most people with type 2 still make insulin, their body just doesn't use it properly so it just floats around not being used.

As far as her being on a pump, it isn't uncommon for kids to get on a pump quickly. My 10 y/o has type 1 diabetes and we got her on a pump within 3 months of her diagnosis, if I remember correctly Lacey was diagnosed with Type 1 back in season 2. Part of it is that she had very fluctuating blood sugars and also was not always aware of low blood sugars, those fluctuations are much easier to manage on a pump as you can program different amounts of basal insulin over the course of the day, unlike a basal insulin shot (lantus or levemir) that is just kind of a steady stream over the 24 or so hours that it works. And yes, with the pump she would be getting insulin continuously whether she ate or not. Another factor in all of this is that normal infusion site changes last around 3 days before they start having absorption issues, especially in children. So even if she had insulin in her pump still it's possible that she was not getting it due to the site being old. We start seeing much higher numbers once my daughter passes that 72 hour mark on her site, just like clockwork.

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I'm not saying it's necessarily misinformation however as a insulin dependent diabetic I am asking how her blood glucose is rising when she runs out of her basal dose of insulin when she's not eating? When I don't eat my blood sugar drops and I take both basal and bolus insulins. Type 1 diabetics don't have a 'leaky liver' where the liver puts out sugar, esp in the a.m., which is common in type 2.


Actually, and I speak as a type 1 diabetic for over 6 years, Type 1 diabetics do not make insulin, therefore they go high from having no insulin injected. Essentially we have no insulin and normal sugar from our livers. So we have to take insulin shots, or use an insulin pump to even things out. Not a "leaky liver" but a broken/empty pancreas.

No basal =no insulin to level out the sugar given by the liver=high blood sugars, possible DKA(diabetic ketoacidosis) and in some cases a trip to the Emergency Room.

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The argument to make it more accessible to kids is that it's not as obvious as taking injection and they can just program in the amount of carbs they are about to or have just consumed and the pump gives the correct dose, so they can go out and live a more normal life eating crap with their friends lol.

AND this is why I feel she needed glucose not insulin. She would not be programing it to give her extra insulin if she's not eating and you have to tell it what you are eating or it won't automatically just keep giving you insulin.


Type 1 diabetes is different for everyone. Some will go high if they don't eat, and others go low. The disease is never a "all diabetics suffer this way if this occurs.." situation. The only instances where that is true is that without insulin type 1 diabetics cannot survive. I myself have been a type 1 since I was 15 1/2, and I go high if I don't eat, not low. I have a friend who goes low when he doesn't eat. So it is possible that for this character they chose to have her go high if she doesn't eat.
Also insulin pumps give a constant set of insulin every hour(known as a basal rate) this is similar to what non diabetics make with their own pancreases. When a type 1, on an insulin pump, is having high blood sugars they take what is known as a "correction" bolus, or an extra shot of insulin delievered by the pump to bring the numbers down.

Type 1 diabetes is confusing, trust me I'm still confused and I've been a type 1 for over 6 years; however, it is known to act different for each diabetic. Therefore they could make it the case that for this character her diabetes goes high without food(like myself), rather than low(like my friend)

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I understand that and thank you for the information. I know even type 2 is in fact different for each person. I was just wondering if it is known why with no food a type 1 would go high...a type 2 would be due to the fact that the liver secrets sugar and that I do know is a fact for both type 1 and type 2...the pancreas doesn't produce insulin, but in both the liver still functions and part of the liver function is to administer glucose when the body needs it and no food is delivering said glucose.

Anyway it doesn't matter. Good to learn that type 1 can in fact get high bg even without food and therefore the show wasn't off base after all.

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I realize this discussion is a few months old, but I found it very interesting and thought I'd see if I could offer any insight.

First, about me. I have been diabetic (Type 1) since I was 10 years old, which means 38 years now. I have known about insulin pumps since they were still in early experimental stages, although I was not using one. I started using a pump thirteen years ago or so, so I have a pretty clear idea of how they work.

First, the explanations given earlier about basal and bolus functions of the pump are pretty good. A Bolus is an individual dose of insulin which is programmed into the pump for one of two reasons; A) to counteract the sugar in the body from eating and B) to counter an elevated blood sugar from not getting enough insulin for some reason. One of the biggest reasons for this would be if the "cartridge" runs empty or if the pump's tubing becomes disconnected.

The issue being discussed here is the basal rate. As mentioned, the basal rate is a small amount of insulin which the pump delivers 24 hours a day. This replicates the natural insulin normally released by the pancreas throughout the day. (Note: The when we eat or have any other release of sugars into our system, the pancreas naturally releases extra insulin to balance it, which is the purpose of the bolus.)

It appears that the confusion on this is coming from the fact that the person is not eating .. in this case, the character of Lacey. The key point here is that the body does not stop processing sugars just because a person is not eating. As one person alluded to, the liver produces sugars from processing the fat in our bodies. This is a natural process any time the body detects a lack of food in the system (Just an added FYI, it is the breakdown of fatty tissues to produce sugars for the body which causes the release of ketones, the diagnostic indication of diabetic ketoacidosis).

The bottom line is that, even with a lack of eating, the body needs sugars to function (think of it as the body is a car and the sugars as the gasoline) and the body will do whatever it can to ensure there is sugar in the system. This is what triggers the processing of fats into sugars. Unfortunately, since the body does not have a way to naturally substitute for the lack of insulin, when there is a failure of some type with an insulin pump, the blood sugar levels WILL rise, even without eating.

Just for further information, with a properly programmed insulin pump, it is actually possible to go for an extended period of time without eating and NOT experience a low blood sugar (insulin reaction). This is one of the benefits of the insulin pump. Low blood sugars are actually quite rare when the insulin pump is properly programmed.

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Yes it does happen. My co-worker's child went into the hospital for a week, was diagnosed as a Type 1 and was put on the pump just like Lacey after diagnosis.

And as a diabetic myself, I have gone that long without food or water and couldn't move, let alone run for my life. It was how I ended up getting diagnosed.

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You want a truly terrible depiction of diabetes (and a few basic physics concepts) watch Panic Room. My favorite is "you need carbs fast! *dig through boxes, toss GREs aside*" lol

When you're 17 a cow can seem dangerous and forbidden...am I alone here?

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