Welcome once again to our weekly advice column, where we talk all about navigating life with diabetes. In this edition of Ask D'Mine, our host Wil Dubois ( veteran type 1, author and diabetes community educator) takes on another prime time TV show that recently "tried" to address diabetes, and he also gets at the real story behind insulin being used in the weightlifting world.

{Got your own questions? Email us at AskDMine@diabetesmine.com}


Nancy from Missouri, type 2, writes:  I've been enjoying the new TV series Touch. Sort of. But a recent  episode on Hulu had Kiefer Sutherland finding an unconscious man whom it turns out was diabetic. "There are some loaded insulin syringes in the fridge..."  Kiefer injects the man in the crook of his arm with what—despite the dialog—looks like glucagon, and the man recovers consciousness almost immediately. It's such a glaring piece of dangerous stupidity... we see diabetic inaccuracies in the media all the time, but this one was a killer. What can we PWDs do to fight these kinds of things?

Wil@Ask D'Mine answers: Talk about the shot heard 'round the blogosphere, this little scene has generated quite a bit of conversation and commentary. As it should!

Where to even start? Oh my goodness!

Now, Mr. Sutherland, there're three main reasons a PWD (person with diabetes) might be unconscious. First: their blood sugar might be too low and they've passed out. Second: their blood sugar might be too high and they've passed out. Third: they might be stone-cold drunk and they've passed out.

How you should respond to each of the three is different.

If they're too low, giving insulin will actually make them lower, and probably kill them. So, please, Mr. Sutherland, don't give me insulin if you find me passed out from a low! Now, glucagon, which we'll talk more about in a minute, would be appropriate—but there's actually something better you can do.

If they're high, Mr. Sutherland, insulin will help. But frankly, if they're high enough to have passed out, they're going to need a lot more than insulin; and anyway, at this point, the insulin really needs to be pumped into their bodies through an IV in a controlled way. Not shot into the crook of the arm.

If they're drunk, giving them insulin can actually trigger a low. Skip step two and go directly back to step one, Mr. Sutherland. Coffee and a call to their spouse/parent is actually the most appropriate action in this case.

Of course the real problem is that you have no easy way to know if the PWD is low, high, or drunk (or do you know how to use a glucometer, Mr. Sutherland?). Because taking blind intervention, as I've just shown you, can make the situation worse, the best thing to do is do the exact same thing you'd do if you found a non-PWD passed out: call frickin' 911.

But what about that glucagon? You know what? Don't f** with glucagon if you aren't trained to use it, and if you don't know the passed-out person's blood sugar. If you know the person is low, by testing, and if you know how to use the glucagon kit (which is never "loaded" in the fridge, but involves injecting water into a vial, mixing it, drawing it up again, and injecting the appropriate amount into the PWD), then by all means please do so. Otherwise, just wait for the damn ambulance.

By the way, if you've been trained in glucagon and you use it properly, will the dead-to-the-world PWD then recover "almost immediately?" No. It can take up to 20 minutes before the lights flicker back on in the PWD's head following a glucagon shot.

Oh. And the PWD will as likely as not throw up as soon as they recover. Didn't see that on TV, did ya?

Oh, and they still have to go to the frickin' hospital, too. Glucagon dumps the liver's stores of glucose to bring us back from the dead. All the stores. Post-glucagon, we have nothing left if there is an after-shock hypo.

So you still should have called 911, anyway.

So much for the review of the facts. Touch got it all wrong. Both in dialog and visuals. Now what? What can we do? What should we do?

I am sharpening my pitchfork as we speak. (I love a good revolution.) I think a merciless barrage of emails, faxes, letters, and calls is the best approach. I think, as a community, we need to both make a lot of noise and have a zero-tolerance policy every time this kind of nonsense happens. The general public is clueless enough without the entertainment media making things worse with dramatic falsehoods.

If we took even 10% of the energy vented in our own communities over this, and turned that energy outwards, maybe we can change the world. One TV show at a time.

May I suggest attacks at the following "enemy" locations:

Touch's Facebook page is here. Friend and flame.

FOX TV email links are here. Ya gotta scroll to the bottom and click the big blue (ironic) ASKFOX. Or find your local FOX affiliate here.

You can find a snail-mail address for Touch creator Tim Kring here, and you can get the low down on the production companies here.

Last but not least, Touch's star Kiefer Sutherland has his own website (with guest book, chat, and contact links) and Facebook pages. Maybe you should (all) reach out and touch him. Let him know we're watching.

And that we don't like to be misrepresented.

John from California, type 1, writes:  I've heard that insulin has a "growth factor," and some bodybuilders actually use it to help grow muscle (which sounds crazy). So. If you're weight training you can put on muscle a little bit easier than regular people. That's what my endo told me, too, but he probably just wants me to dose precisely and aggressively. Wil, please confirm or deny!

Wil@Ask D'Mine answers: Oh God, this is just like when my son Rio asked me why the sky is blue. I know the answer, but how to explain it without taking all day? And I'm guessing that just saying "because" isn't going to cut it with this crowd!

So... foundation first. A "growth factor" is a substance that stimulates cellular growth, and these substances are most commonly proteins or steroids.

I think you can all see where this is going: steroids, weightlifting... Oh, and insulin is a protein, of course... But hold on one second. It's not a simple as you might think.

Because insulin itself isn't really a significant growth factor. But another pair of hormones called IGF-1 and IGF-2 are. IGF stands for Insulin-like Growth Factor. These are hormones that are kinda sorta like insulin, but aren't really insulin at all.  (IGF can be measured by a lab to check for pituitary problems or growth issues, especially in children.) But, as their name suggests, they're growth factors.

Still, what you heard was more or less right. Growth factors do make cells grow. So IGF could help you build muscles, at least in theory; which has led to a not-so-cottage industry of IGF pills, sprays, and shots. Well, more correctly, pills, sprays, and shots marketed as IGF. Here in the USA, most aren't really IGF at all, but are substances alleged to stimulate the body's IGF production. But in other parts of the world, or with a prescription pad, you can get the real stuff.

So, with all of that said, do some crazy-ass weightlifters use IGF? Yes. And other crazy-ass people jump off suspension bridges with rubber bands tied to their feet. That doesn't make it a good idea. In addition to making muscle cells grow, IGF can also help cells you don't want growing to grow, too, like cancer cells. Cancer cells have a tendency to grow too damn fast to start with, so do you really want to light a fire under those puppies?

But what about insulin itself? Is anyone out there injecting insulin instead of taking IGF? No. Not in mainstream bodybuilding anyway, although there is a lot of talk about diet plans to maximize endogenous insulin in the body-building community. But out on the fringes, yes, there sure are people shooting up to try to beef up.

It risks hypos for non-dFolk, and hasn't been proven to be effective... and probably isn't, as insulin itself isn't a truly potent growth factor.

Still, that doesn't keep some people from trying. If there's anything we can count on it will be that some people will try anything, and that kids will ask why the sky is blue.


This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.