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On Diabetes, and Thinking Outside the Box, by Dr. Cynthia J. Koelker
A thoughtful EMT wrote me to ask:
Dr. Koelker:
What effect could you have on blood sugar for a diabetic (type 1) through blood transfusions? I am a paramedic, and our field treatment for high blood sugar is IV fluids until the hospital can give them insulin to lower the blood sugar. In a SHTF scenario, there is no hospital. The thought process got me thinking though….My questions are these:
1) What, if any effect could you have on lowering blood sugar through transfusions? i.e., basically finding a non-diabetic donor match, and swapping a couple pints of blood…the non-diabetic can process any sugar, and the diabetic gets blood sugar lowered by dilution.
2) Could you time a high sugar meal for the non-diabetic to manipulate the blood you were donating? Could you get enough glucose and insulin transfused to affect the diabetic’s intracellular glucose?
3) If the science and idea are valid, would it be able to have any appreciable effects or would you be re-arranging deck chairs on the Titanic?
The idea intrigues me, because blood transfusion gear can store a lot longer than insulin.
Thank you- Eli
Here is my reply:
Excellent questions, Eli. I’ve pondered the possibility myself and will offer my preliminary conclusions.
First, theoretically, the answer is yes, it could work.
For example, in a scenario where, say, identical twins would essentially share the same pancreas, IV lines could be connected in a continuous system, allowing the diabetic’s blood to enter the non-diabetic’s system, with the “treated” blood being returned in equal amounts from the non-diabetic to the diabetic.
This is not quite the same as swapping a couple pints of blood, as I’ll address below.
Eli’s preliminary questions raise several more:
1. Who is a suitably-matched donor?
2. Would a non-diabetic be the best donor?
3. How much blood would need to be transfused?
4. How long would this arrangement work?
5. Should the non-diabetic receive blood back in return?
6. Should serum be used instead of blood?
7. Could the blood be administered via a different route?
8. Could non-human blood be used?
9. Could God have left us a simpler answer for treating diabetes Type 1 than we’ve discovered to date?
To begin with the end, I believe #9 above could well be true. Though science has investigated pancreatic transplantation, islet cell transplants, stem cell manipulation, and other high-tech options, no simple solutions have been found, but they yet may be out there.
And so, at TEOTWAWKI, what to do?
(Before I go on, let me say don’t miss the March 13, 2013 SurvivalBlog article by AERC regarding Insulin Dependent Diabetics. The author offers many excellent suggestions along with personal experience as a diabetic.)
But the question remains: what to do if no insulin is available? Would transfusion work?
A few calculations will help explain: In the non-diabetic, serum insulin levels average <30 microunits>
To simplify the computation enormously, if it takes a serum insulin level of around 10 microU/ml to metabolize a serum glucose level of 100 mg/dL, it would take about 5 times that much insulin (or non-diabetic blood) to regulate a serum glucose level of 500.
Source: http://www.survivalblog.com/2013/05/on-diabetes-and-thinking-outside-the-box-by-dr-cynthia-j-koelker.html
