Still Fighting Insulin Indifference

The prison's segregation unit at Calhoun State Prison (CSP) has a practical policy of delaying an insulin-dependent diabetic's finger-stick & insulin injection until several hours after meals have already been served and the empty meal trays collected back up. This is even though their medical orders call for them to receive finger-sticks & insulin before meals, not afterward. This is a textbook example (or, in this prison setting, a case-law example) of a prison policy of indifference which exists in violation of both the contemporary standards recognized by the medical profession (medical malpractice), and the federal constitution's 8th Amendment's proscription against cruel & unusual punishments.

A factor contributing to this policy is that at CSP's segregation (seg) unit breakfast is passed out anytime between 4:30 a.m. & 5 a.m. but CSP's administration doesn't have its medical staff clocking in for work until 6 a.m. every morning. By that time (1-1.5 hours after breakfast) the diabetics housed in seg are badly in need of relief from the dangerously high blood glucose/sugar level resulting from their having ate breakfast without any insulin. I know from my own experience as an insulin-dependent diabetic that if I eat without first taking insulin I develop a dangerously high glucose level in the 300s, 400s, 500s, or higher. This is a typical insulin-dependent's reaction to eating without first receiving the prescribed dosage of insulin he requires for the particular meal.

When nurses clock in at 6 a.m. all of the diabetics housed in prison general population have not ate yet. However, instead of first proceeding to seg to promptly attend to those diabetics who are in acute distress, nurses are instead choosing to administer insulin to the diabetics in general population. Next, they are choosing to perform pill call for the entire non-diabetic general population.

Depending on the efficiency of the particular nurses working on a given day, by the time it's all said and done nurses aren't arriving in seg with glucose meters & insulin until anywhere from 7-10 a.m. every morning, sometimes even later. Delays are also occurring at lunchtime & suppertime, even though nurses are already clocked in and on duty, and so there is really no explanation apparent to justify these additional delays. I kept a record of the delays between meals & insulin, and the nurses responsible for the worst delays are Nurse Williams, Nurse Deefe, Nurse Gilbert, Nurse Porter, and Nurse Mills.

To clear the air on how dangerous hours-long delays are, I am going to quote to you from page 54 of Dr. Jorge E. Rodriguez's book Diabetes Solution, where he explains the dangers of high blood sugar, also called hyperglycerin:

"Hyperglycemia, by definition, is a level of sugar in the blood above the accepted normal range... the normal range for a person's fasting blood sugar ("fasting" means after 8 or more hours without eating anything) level is below 100 milligrams per deciliter (mg/dl) of blood, and the normal range at any other time should be below 180 mg/dl)... Elevated blood sugar in and of itself causes tissue damage but having a blood sugar that is extremely elevated can cause life-threatening changes in the body in a matter of hours. An extremely high blood sugar level, and I mean at least 300 — remember, normal is under 100 (fasting) or 180 (any other time) — can cause an imbalance in the delicate acid-based structure in the tissues of the body. When the body can no longer use sugar as an energy source it starts breaking down fat and protein, one of the by-products of these two alternative sources of energy is ketones. A high level of circulating ketones not only damages tissues, but can cause confusion, unconsciousness, and coma."

The above medical expert's opinion sufficiently shows how diabetics housed in CSP's segregation unit are in imminent danger of serious physical injury and/or death. Georgia Department of Corrections (GDC) will try to remedy a prisoner's medical complaints by transferring him to another prison. In just 3 years my complaints of improper diabetic care has caused my transfers to 8 different prisons (there is also a deficiency in the diabetic care at my present prison, Wheeler Correctional Facility).

These repeated failures are evidence which supports a civil complaint, not only against these individual prisons, but against the entire GDC, under the litigation theory that there's no prison in the GDC network it can transfer me to where I won't be in imminent danger of serious physical injury or death, due to a lack of adequate diabetic care. I will keep you informed of all the latest developments.

MIM(Prisons) responds: This is a followup to the articles "Insulin Indifference Endangers Prisoners", and "Fixing Insulin Indifference", which we published in 2017 on this same insulin problem in Georgia. These medical battles are literally life and death for some people. Just a further example of the indifference and negligence of the criminal injustice system.