Topics touching diabetes never go away, but many of them seem to get sidelined at times. We often ask ourselves, "Whatever happened to...?" In this case, training police to better deal with people with diabetes (PWDs) who might be acting irrationally due to a blood sugar low? Today, fellow D-blogger and journalist Mike Hoskins joins us to report on the state of affairs (spoiler alert: it's frustrating!).
Special to the 'Mine by Michael Hoskins
We've all seen the headlines about police conduct toward those with diabetes, in those regrettable driving-while-low situations.
For example, one story recently came out of Henderson, NV., where police mistook a man's "diabetic shock" for drunken driving back in October 2010 and beat him pretty severely. Video captured it all, and now in February the city and state have agreed to pay $292,500 in damages to the man and his wife as a result.
I cringe every time I hear about these situations, not only because of the generalized fear that this could happen to any of us PWDs, but more specifically because I personally have been behind the wheel and had a low. Luckily, I've not faced any police or first responders who mistook my medical emergency for criminal behavior. But I know it happens, and that scares the heck out of me.
With all the stories about these situations, we wondered what's changed in recent years in how police receive training to recognize and deal with diabetes. What can our community expect these days compared to how things "used to be?"
The answer from some of those who monitor this: not nearly enough.
"Unfortunately, it's a hodgepodge of progress and it's all over the place," said the American Diabetes Association's legal advocacy director, Katie Hathaway. "It's hard to assess if there's been a lot done, but what I can say is that this problem certainly isn't fixed."
In 2007, the ADA released a 20-minute training video to help address this issue (available to purchase in its entirety through the ADA for just $3, or viewable on YouTube in three parts). That video stemmed from a Philadelphia lawsuit settlement and served as a jumping off point for the advocacy organization to target this topic nationally. Many police departments did request the video and used it in training, Hathaway says, but those requests eventually dwindled, and by now, only occasionally trickle in. Most of the current queries the ADA receives on this issue come from people facing these incidents or from other advocacy organizations and entities, but rarely from the police themselves.
Essentially, all the 2007 video covers are the basics about what officers should know in recognizing the signs and symptoms of hypo and hyperglycemia. It includes two "real-life" scenarios: One featuring a woman sitting in the passenger side of an SUV after the driver decides to pull over in front of a school, jump out and run to get some juice for her D-friend (leaving her by herself to encounter police in a confused fashion, of course); and a second example in which a man is arrested and taken to jail, where he's questioned about his diabetes and then later has a high because of his lack of insulin and needs to be taken to the hospital.
What the video does not feature, though, are the most common situations police officers might face dealing with PWDs, for example making on-the-fly decisions about what's happening when someone is swerving all over the road, or if they come up against a violent, arm-swinging individual (who happens to be hypoglycemic). Hathaway says these critical "driving with diabetes" and "combative" points might be fodder for an updated video. (Ya think?) That review is ongoing and some decisions will likely be announced by ADA soon, she said.
So here we are, five years later, and the number of these incidents is once again a "growing concern" for the ADA, particularly with rising number of Type 2's and LADA population, i.e. more individuals using insulin treatment.
Being behind the wheel certainly isn't the only situation where police should be aware of diabetes (remember the 2007 story about Mr. Universe, Doug Burns having a low in a movie theater?...) But the ADA says driving is one of the top situations where police involvement comes into play with PWDs. So the organization continues to prioritize it.
In this January's issue of the journal Diabetes Care, the ADA published its first-ever position statement focused on driving with diabetes. The six-page document advises against "blanket bans or restrictions," and instead recommends that patients who have issues that might pose a driving risk be assessed by an endocrinologist or other diabetes doc.
The ADA is also in the process of reviewing its training tools and determining what else might be done to better train law enforcement officers who might encounter PWDs experiencing glucose lows.
"Some are open to change, some aren't," says the ADA's Hathaway about police. "It's so department-based, and we're up against competing interests of public safety and private rights. These aren't easy situations for police to face, we get that. But we need more institutionalized training than we have now."
The ADA also struggles to have enough resources available to push for better police information and training across the nation. "When you think of the pure number of law enforcement officials, police and sheriff departments around the country... it's a challenge," Hathaway says. "We have a legal advocacy staff of six people who cover all kinds of discrimination issues. Three of those staff — myself and two lawyers who work for me — respond to the circa 250 calls we receive to our 1-800-DIABETES hotline each month."
We also queried Dr. Daniel Lorber, Director of Endocrinology at the New York Hospital of Queens in New York City, who chaired the writing group that developed the ADA position statement on driving with diabetes. He said that his experience consulting on diabetes police training and testifying in court shows that police are still lacking what they need in D-training.
"It's not widespread enough," he said. "This is a problem around the country with police not knowing about hypos or what to do. Yes, maybe things have improved just because there's more public attention. But not by much, and there's still a lot of work to do."
Both Hathaway and Lorber acknowledge that many police departments have embraced change and are willing to work with national organizations to revise policies, but the change is just not at the level it should be and no one really tracks the changes that are happening, so improvement is difficult to measure.
Sadly, two leading law enforcement training organizations — the National Law Enforcement Association and National Law Enforcement Training Center — didn't respond to our requests for their thoughts on this topic. Maybe that reflects the kinds of roadblocks the ADA faces from law enforcement authorities.
Facing that resistance, Hathaway says there's only so much the ADA can do when they're generally tapped to react to calls or court cases, rather than having the opportunity to proactively advocate in general before a situation arises.
In the Nevada traffic stop case referenced earlier, news outlets report that Henderson police "have changed the departmental use of force policies as a result of this incident." But Hathaway emphasizes that sometimes it takes proactive outcry from people living in a particular community to wake up the local law enforcement on this issue. That's where our D-community comes into play!
Police departments need some nudging from their local communities about this training and the materials available, Hathaway said. That might mean contacting local police chiefs or sheriffs and asking questions about these internal policies. Or even bringing them materials to possibly review or use.
"Make some noise, and that will get their attention that this is something to be thinking about if they haven't already," Hathaway says. So what it comes down to, like everything else diabetes, is that we need to advocate for ourselves!