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Old 10-25-2012, 19:07   #1
Morris
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Diabetic psychosis and cops

http://dfw.cbslocal.com/2012/10/24/d...r-after-crash/

I am intimately familiar with T1 (type 1) Diabetes. My grandfather had it, my youngest kiddo has it. I thoroughly understand it so I base my comments both on personal and professional interactions.

Diabetics are becoming an increasing issue for patrol officers. Too often, we have T1s and T2s operating vehicles while hypo/hyper glecemic. Our worst are those who go low and go into something I call Diabetic Psychosis. Now, the ADA takes offense to my terminology but it is the best term to describe the state many diabetics go into when they get extremely low. Further, you have diabetics who refuse to wear alert bracelets, seemingly assuming those who come to help will a) have clairvoyance to know they are diabetic and b) have a solid knowledge base about diabetes and reactions.

I've watched the video that the ADA has produced. The video does not articulate how few diabetics, especially teens who do not want to wear the alerts, endanger themselves. Increasingly, I have dealt with diabetics who have knowingly driven when they knew they were getting low. It's gotten to a point that I will cite for reckless driving because they are driving in a willful and wanton disregard for persons and/or property by knowingly driving while low. The ADA takes offense to that but advocacy stops when diabetics endanger others.

Was using an ECD appropriate in this case? Unknown as the video and audio don't show the physical state of the diabetic. I've had some passing out without fighting. In years past, I have had to wrestle diabetics with diabetic psychosis in order to get them contained and treated. One guy was so out of it that it took two officers, three firefighters and a medic with a glucose shot to get him under control. His BG (blood glucose) was below 40. Another crashed into a fence of a daycare. His behaviors were so physically active that I thought he was diving for a gun on the passenger side of his truck. Only after wrestling him out of the truck did he get the words out he was diabetic. His BG was 25. I do believe that street officers need refreshers on dealing with diabetics. However, officers should never jeopardize their safety just because someone is a diabetic.

I have challenged the ADA to improve their training and outreach to LE. Sadly, they have been reluctant to do so without giving clear reasons why. I hope that in 2013, an improved and updated training program can happen.

Meantime, document, document, document dealing with diabetics in psychotic states.
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Old 10-26-2012, 04:47   #2
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I agree. The problems come in when the diabetics knowingly drive while they are having a reaction. How about calling an ambulance?
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Old 10-26-2012, 04:58   #3
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Had to wrestle my daughter who was screaming and lapping at me, basically fighting for her life as he went low one morning.

I agree when they do this knowingly, it I not always the case, teen years, and stress can make huge fluctuations in bg levels and sometimes it's not how low th bg is, but how fast they dropped.

One thing is even when fighting they are weak and lethargic when going low, the body is starving the glucose from all systems and pushing it to the brain to keep them alive.
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Old 10-26-2012, 05:14   #4
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One thing is even when fighting they are weak and lethargic when going low, the body is starving the glucose from all systems and pushing it to the brain to keep them alive.
This is not always the case. Diabetics can be unpredictable when their sugar gets low. We had one guy that would either be calm and collective or a raving lunatic that required 8 people to hold him down so an IV can be established. I was so glad when he moved.
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Old 10-26-2012, 06:42   #5
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One thing is even when fighting they are weak and lethargic when going low, the body is starving the glucose from all systems and pushing it to the brain to keep them alive.
Gotta disagree. Had one in the mid-30s fight a motor officer. Went for his gun and broke the holster halfway from his belt. (Safariland standard shank; left hanging by the last loop.)
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Old 10-26-2012, 07:45   #6
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Gotta disagree. Had one in the mid-30s fight a motor officer. Went for his gun and broke the holster halfway from his belt. (Safariland standard shank; left hanging by the last loop.)
Type 1 with low blood sugar, I am skeptical.

When the blood glucose level gets very low vision tends to cloud and the body tries to save the brain by funneling what is left of the stores to keep essential functions moving..
I see about 10 of these a year as I also volunteer as head staff at a camp for teen diabetics..

The situations you talk of may be true, but I am skeptical that they were examples of low blood sugar, more likely due to substances or drinking or type II in a perpetual state of DKA...

Anything is possible but ussually great strength is not one of them, erratic behavior, blurred vision and reduced ability to process commands is.
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Old 10-26-2012, 07:55   #7
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This is not always the case. Diabetics can be unpredictable when their sugar gets low. We had one guy that would either be calm and collective or a raving lunatic that required 8 people to hold him down so an IV can be established. I was so glad when he moved.
I had one that wrecked out, failed to follow my commands, and came at me. He got pushed off from me and got an asp baton strike.

He was very apologetic in the ambulance.

It is all about personal responsibility which this society has forsaken. They are also gonna receive dog training to avoid shooting loose aggressive dogs that their owners can't contain.

I think it all started in a rainbow lounge but that is only my opinion.
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Old 10-26-2012, 08:17   #8
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Yeah - our agency was just "audited" and the results released today. The report was done by people who work(ed) in prisons, and it shows. Just once, I'd LOVE to have someone with experience in a MOTHER****ING COUNTY JAIL make some recommendations.

We're not a prison, never have been a prison, will never BE a prison...so quit trying to run the place as if it IS a prison. You jail guys know what I'm talking about.
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Old 10-26-2012, 17:05   #9
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I am law enforcement, (corrections), and I am diabetic. I didn't start out in the career as diabetic, nevertheless it is a disease I live with 24/7, and not by choice. My diagnosis is type 2 diabetes. I freely shared this information with my co workers in the even that I go down somewhere that they have an idea what may be wrong with me. I usually have one co worker who knows where my supplies are at all times, if they are willing to help out in diabetic episode. Also, I am not the only diabetic who works where I do, there are several of us in several positions, including one who is a supervisor.

I don't know of people personally who work the streets who are diabetic, although I have seen mention of this on Cop Talk. I pity any department or agency who would willingly turn someone away for being diabetic, as they may be turning away some very good people with a good set of people skills, and law enforcement skills.

As, to knowing symptoms: take basic first aid courses offered by organizations such as the American Red Cross. They are helpful in teaching first responders as well. This means if you have taken the training you will learn how to deal with people with all types of health issues, and not just diabetes.

As for diabetics who are willing to risk themselves and others over the folly of not keeping their sugar checked, it is wrong. However, keep in mind that if a person starts out high before they get behind the wheel, the blood sugar can drop suddenly while they are behind the wheel. If they are still able to tell by how they feel concerning their blood sugar they are probably safe to be responsible drivers.

If they have a hard time telling the differences there is a way for them to get some management tools for this. There is blood glucose monitoring equipment that warns of too low blood sugar. There are available in some areas of the country those organizations who train service dogs for diabetes, where if a handler and person are paired up then the dog can be a life saver.
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Old 10-26-2012, 17:22   #10
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Just how many of these diabetics are contacted, and are combative?

In 17 years of patrol, I've only encountered one diabetic acting like this, out of many thousands of citizen contacts.

I think it's more of a case of certain groups pushing an agenda more than its perceived problem with law enforcement.
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Old 10-26-2012, 18:50   #11
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I've never had a diabetic be combative, but I've had two cases where other officers had what they thought was a dui turn out to be a diabetic. Here in the 9th Circus, if the kid sued for excessive force, the officer would likely be held liable.
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Old 10-26-2012, 20:01   #12
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I've seen head injuries be combative and resistant to assistance. But, my opinion on this subject is what I think about epileptics and the mentally ill. If you refuse to keep people alert of your condition, and then you place yourself and the public in danger by not properly treating your condition because it is is inconvenient, annoying, or embarrasing then what happens is on you.

Just like epileptics aren't allowed out on the road, diabetics who refuse to medicate because it is inconvenient or annoying shouldn't be out on the road either.
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Old 10-27-2012, 02:54   #13
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Quote:
Originally Posted by Mayhem like Me View Post
Type 1 with low blood sugar, I am skeptical.

When the blood glucose level gets very low vision tends to cloud and the body tries to save the brain by funneling what is left of the stores to keep essential functions moving..
I see about 10 of these a year as I also volunteer as head staff at a camp for teen diabetics..

The situations you talk of may be true, but I am skeptical that they were examples of low blood sugar, more likely due to substances or drinking or type II in a perpetual state of DKA...

Anything is possible but ussually great strength is not one of them, erratic behavior, blurred vision and reduced ability to process commands is.
You can skeptical all you want. I have been on many diabetics with low blood sugar that have put up a good fight.
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Old 10-27-2012, 05:41   #14
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You can skeptical all you want. I have been on many diabetics with low blood sugar that have put up a good fight.

Read carefully. He said T1 with low blood sugar.
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Old 10-27-2012, 11:17   #15
Morris
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Read carefully. He said T1 with low blood sugar.
And every psychotic diabetic I have dealt with in 17+ years was a T1. In some cases, we help fire/medics with combative diabetics. The one I wrote about was in absolute psychosis at the time he was shot. Ten minutes later, he was his usual self and remembered nothing other than a general feeling of anger.

My youngest gets lethargic at extreme lows. At extreme highs, she's the devil come to human form. I've see the flip for adult T1s.

Quote:
Just how many of these diabetics are contacted, and are combative?

I think it's more of a case of certain groups pushing an agenda more than its perceived problem with law enforcement.
It's a tiny fraction of those I contact daily, to be sure. Again, the usual thing is that for those on the street, there is no warning or alert bracelet of a medical condition. The behaviors exhibited are not dissimilar from a tweaker who just took a bad hit.

The American Diabetes Association, for all the good that it can do, does have an agenda. I don't necessarily agree with it as it failed to recognize the culpability of the T1 or T2 to properly announce or take responsibility for showing their disease. The ADA claims it is a form of stigmatization. I say bull pucky, especially when we get a case like the one I posted in which the officer encountered. You don't always get to smelling ketones, especially when their car interior smells of mildew.

It's fine to review the video as part of training. But the ADA and diabetics who are driving bear some level or responsibility for making sure they show they have the disease so first responders have a better idea as what to look at. I take issue with the ADA in espousing that the primary responsibility for recognition falls on the first responder.

I suspect that the token $5K this person received was a payout from the insurance company as the driver certainly bore a level of responsibility for his medical condition when driving.
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Old 10-27-2012, 12:40   #16
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There was an incident here where a guy failed to stop for NHP after a caller reported he struck the center wall at several points on the highway and was weaving all over the road. He finally stopped and they and Henderson PD dragged him out of the car. One of the HPD officers kicked him and the media and general public latched onto that one second of footage and ignored the rest. It came out that he was diabetic and knew his sugar was low but decided to drive anyway. Wound up getting a $158k payout from the city and $30k from the state.

http://www.lasvegassun.com/news/2012...cer-set-recei/
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Old 10-27-2012, 13:24   #17
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Read carefully. He said T1 with low blood sugar.
My reading abilities are quite good thank you. My 20yrs in EMS has shown me that diabetics type I or II with low blood sugar and no other contributing factors have different reactions that can include psychosis or violence.
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Old 10-27-2012, 13:49   #18
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I'm a T2 on a strict diet and exercise regimen to get my BMI to 35 for another overseas contract (Afghanistan). Due to rapidly decreasing body weight I have a hard time keeping meds at the proper level, and often catch BGL after 1 1/2 hours swimming at 40-45 so I keep glucose rescue tabs handy. I can start at a BGL of 115 in the locker room and 20 minutes later be 42 so currently I have tubes of rescue tabs in my truck, wife's car and 1 in the mag pocket of my 5.11 pants and I just got a med alert necklace.

When I get low I have vision that looks bleached out, feel like every cell in my body is vibrating, heart rate goes up and I start sweating and feel weak as a kitten, from my experience I don't see how a low BGL person would have the strength to fight. Chew a couple rescue tabs and I'm fine in a minute. Even one night when I tested at 32 while I had trouble walking I never felt like I did not have full mental capability. Everybody is different.

Last edited by F350; 10-27-2012 at 13:51..
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Old 10-27-2012, 15:24   #19
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My reading abilities are quite good thank you. My 20yrs in EMS has shown me that diabetics type I or II with low blood sugar and no other contributing factors have different reactions that can include psychosis or violence.

I was merely pointing out what the man said. No need to roll out wangers - you win (maybe )
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