More On Trust

I’ve been thinking a lot since the Animas cartridge recall. (If you had recalled cartridges, you should have received your replacement shipment by now, but if you use Animas and want to be sure, check your cartridges).

I used the recalled cartridges for almost two months before they were recalled. And in those two months, I had a lot of problems with high blood sugar. Sure, there were other reasons, but it made me think. I could have gone into DKA without a notification from my pump that there was an occlusion due to the defect in the cartridges. Even if I had noticed, I would have changed my site and left the cartridge. It’s scary to think about.

I’m not mad at Animas, really. Things happen. Mistakes happen. What is on my mind today is how much trust we put into our medications and medical devices. We trust that our pumps will deliver insulin in the right amounts when we tell them to. We trust that our meters are giving us a number close enough to our actual number so that we can dose the right amount of insulin. We trust the FDA to regulate the fact that our insulin is insulin and not something toxic or just saline. We trust the pharma companies to sell us medication that works at a reasonable price and to make medical devices that work – to test them and ensure that that there are plenty of saftey checks to avoid life threatening malfunctions.

Take meters for example. 20 percent is a big margin of error, and that’s the FDA approved margin. But on Wednesday, I tested literally five minutes before I went in for my lab. My meter read 193. My endo told me at my appointment the next day that my blood sugar at the time of draw was 158. That’s a 35 mg/dL difference – over 20 percent. That’s almost two full units of insulin, which would put me 40 mg/dL below my target range, at 65 instead of 105. That my friends, is scary, especially in someone who is hypoglycemic unaware.

The problem is, we can’t live without trusting in these things. Most of us can’t count the milligrams of sugar in our blood ourselves. We can’t extract insulin from dead animals or create it synthetically ourselves, and we cant’ live without the stuff. So we trust, and we continue on, and we just hope that companies catch their mistakes before we or someone else gets hurt.

Yes, it’s scary. But unfortunately we have no choice.

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