The ER Doctor Ordered Insulin When She Was Hypoglycemic

Linda Crasco/Linda C

It’s the middle of the night, and Joe* hears his seven-year-old daughter cry out. His wife, who gave birth to their second son only a few weeks before, is still sleeping beside him. Joe goes to comfort his daughter, who he assumes just had a nightmare. Instead, he finds she is confused, shaking, and soaked with sweat.

Jessica was diagnosed with type 1 diabetes when she was three, and Joe recognizes she is experiencing hypoglycemia. There is too much injected insulin in her system, and he knows he needs to give her some kind of sugary snack or drink to bring her blood sugar levels back up. But Jessica becomes combative and won’t eat or drink.

Frightened, Joe calls 911. While waiting for the ambulance, he wakes his wife. They agree that she should stay home with their other children. The local hospital is only five minutes away, he says, and he will call her if she should come.

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The EMTs arrive, bundle Jessica onto a stretcher, and race her to the community hospital.  Once there, Joe tells the triage nurse his daughter has type 1 diabetes and is hypoglycemic. The nurse uses a handheld glucose meter to measure her levels.

When the doctor arrives, the nurse turns to him and says the reading was 300 mg/dL.

“No”, says Joe. “There is no way her blood sugar is that high. Her blood sugar is low. Something must be wrong with the meter.”

The doctor ignores Joe and orders insulin.

Joe panics, knowing that if they give his daughter a dose of insulin when her low blood sugar is so low, it could kill her.

“No,” he says again, his voice rising. “She has low blood sugar. I won’t allow you to give her insulin.”

The doctor tells him, “She is a type 1 diabetic; she needs insulin.”

Joe steps between the doctor and his daughter, a move the doctor will later claim was aggressive. He requests an ambulance to another hospital. The doctor tells Joe he is interfering with his daughter’s treatment, and the police will be called if he doesn’t step away. Joe doesn’t budge.

A police officer arrives soon, and Joe and the doctor each give their side of the story. The officer asks the doctor to test with a different meter.  

“What can it hurt?” the officer asks.

With a new meter, Jessica’s blood glucose is tested, and it comes back in the twenties. Jessica is given glucagon and her condition improves.

Joe still thinks of how close he came to losing his daughter that night. It took a police officer to prescribe the right treatment instead of the doctor, who didn’t seem to know the symptoms of hypoglycemia.

The next time you worry you’re talking too much to others about your type 1 diabetes or asking too many questions of a doctor or nurse, just remember that you might be educating an ER doctor or a police officer who could make all the difference in a crisis.

*We changed the father’s name to protect the family’s privacy. This essay is based on his best recollections from the event.   


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