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Hypothetical Cast Away Situation - T1D

Diamattic

Diamattic

Well-Known Member
Messages
678
Type of diabetes
Type 1
Treatment type
Insulin
I was watching Cast Away last night and had that thought. That same one I am sure we all get when we watch movies, or read about people stranded on an island for years at a time.

I know this forum has been through the Zombie Apocalypse debate and how to handle that, but I this scenario is slightly different.

If you were stranded on a desert island, with no insulin but also no outside food, knowing you had T1D would it be possible to survive for years before a rescue?

My thinking may not make sense provided i am not a doctor or biologist.
Everyone would vary but many T1D can still produce very small amounts of insulin, this combined with all the physical work that you would likely do, and lack of food (perhaps we would live off of fish and maybe wild pigs or something ) but certainly no breads, and likely very little fruits. Would it be possible to survive in a no carb, no insulin, lots of exercise environment for years ?

EDIT - lets add to this, you are stranded with whatever insulin/ supplies you would normally have on you, in your airline seat (not your overhead bag, you wouldn't be able to grab that in a crash). How long do you estimate your survival in the aforementioned environment ?
 
I get asked by people at work how long I could survive without insulin (I think they are plotting to kill me off?). And always wondered the answer
 
I think you could "survive" for quite a long while without insulin, especially as on the island, as you say, wouldn't have access to the types of foods we've learned to avoid/minimise. But, eventually, I think you would succumb. Without being able to use the glucose in your blood for energy, you would eventually, effectively, starve to death.
 
This is really interesting and a great thread. I honestly wouldn't know. If there were no carbs, lots of physical work, depending on the individual, size, weight, and any other medical conditions, if you had them. But if there was fruit available that would have carbs, fish, none, meat none.
Probably die of dehydration first if there was no fresh water ?? or possible sun stroke.
I'm sure I read somewhere that type 1 diabetics, in WW11, went without Insulin for a long period ? maybe someone has read this too or something along those lines.
Probably some could survive for months and the odd few more than a year, it's a hard one to call, and I wouldn't want to be in that position :( scary though :eek:

RRB
 
Interesting, you can of course get glucose into the cells without insulin if you are doing exercise but what you can't do is stop the liver producing unnecessary glucose. Would you be able to exercise enough to over come this ie to use all the glucose released from the liver.
Without the signal to stop (ie presence of insulin) then it will continue to release glucose (and you will make it if you are eating fish) Glucose levels will rise but still no signal to stop and so your body would start breaking up fat for fuel; ketones would rise and you would get DKA and die.
Having said that, the starvation treatment of diabetes pre insulin did extend life and the older you were when you developed it, the longer you survived so having more insulin of your own must help a lot. I don't think that you were strong enough to do much exercise though
(Allen era is the 'starvation 'period, Banting era is the start of insulin use )
life expectancy Joslin.PNG

It wasn't very pleasant though and people became very thin.
Here though is the account of a man diagnosed before insulin who survived for 14 years. It is suggested that he had LADA. ( he only weighed 37kg at one point )
http://download.springer.com/static/pdf/762/art%3A10.1007%2Fs00125-007-0641-0.pdf?auth66=1420826854_f60b83d89b8f089633184947a3b24e21&ext=.pdf
 
A grim but interesting scenario. I have often thought about this. As phoenix says, even if you consume zero carbs you can't stop the uncontrolled dumping of glycogen. And I guess your body will stupidly assemble more glycogen, from scavenged protein, so it can stupidly dump it into your bloodstream to poison you. So the trick would be to consume mainly fat and perhaps alcohol, use whatever trace elements of insulin you are still producing to fight off the glycogen.

The Zombie Apocalypse is kind of a variant of the same thing. Preserve whatever injectable insulin you have, as long as possible (bury it in the ground to keep it cool?), but meanwhile, absolutely minimise your insulin needs to the bare minimum needed to suppress or clear glycogen release.
 
It's surprising that the introduction of insulin didn't immediately lead to large improvements in life expectancy. Diabetics were still dying very young, even with insulin.
 
Agree with phoenix and spiker. The other key aspect of insulin is that it regulates the release of fats as fuel. With no insulin, not only do you not reduce glucose, you also massively increase ketones. I seem to recall that the life expectancy pre-insulin was typically 3-5 years, for a thirty year old, but you have to eat no carbs to achieve this and when you die it will be unpleasantly of major complications, so your feet have probably got gangrene and you are most likely blind.

Of course the other thing you can do is use up whatever glycogen you have on board by working out with whatever will stand in as weights to consume all the glycogen in your system. Roughly four hours of heavy lifting should do this. You can then run more easily on a non-fat diet.
 
Intersting.. My levels without insulin pumping through me due to set or pump probs will be in 20's within 2 hours of failure. I think I would be comatosed without insulin within 24 hrs. Don't know why I go so high so quick??

As for marooned on an island I would hope that it was with beautiful clear blue sea so I could try to catch fish. Thus making my insulin last a bit longer and still getting some fat to my brain.
I would definitely dig up worms and fry them... Oh.. But I would have to be able to devise a way of frying them!
 
Cheers for sharing the stories all. I have wondered how ppl survived pre-insulin and during wars ect. I'll read them now.
 
I would think that after a while of very low carving your livers store of glucose would deplete ?

And you would be able to collect and drink rain water and stay out if the sun (caves, trees) you wouldn't dehydrate. But I was thinking that if the liver is depleted from no incoming glucose then it wouldn't release as much and the exercise (foraging, building, hunting etc) you could lower your levels to stay out of DKA, but no starve due to eating meats.

I have read a study where a teenage girl ran away and stopped her insulin completely and was able to go without a full year and she claimed to have always felt completely fine, she claimed to just eat low carb and exercise to control it and avoid insulin. After a doctors exam she had no complications.

I guess this depends a lot on if you still produce any insulin at all, everyone would likely loose so much weight and be eating so little that perhaps all one would need is that very little produced and exercise?

It's a stretch I know, but it's fun to hope haha.
 
There is a guy (Sergio Butenko - I might have spelt that wrong) who is type 1 (I wondered whether he really was - but he was diagnosed as a child - so guess he really is?) and who doesn't take insulin... He lives off green smoothies and does loads of exercise - plus lives in the US (ie where it's warm) - which is *kinda* the same as our dessert island scenario...
 
The pre insulin diets were horrendous.. Well, at least the whisky given was ok!! But whisky and lettuce leaves??
On a desert island I could find the leaves of some sort but where would I find the whisky?
 
One could read up about the extraction of insulin in advance. There would surely be some insulin producing animals on the Island. Insulin from fish even some invertebrates is similar enough to human to work. (just need the equipment to inject it)
During WW2, when insulin supplies dried up for Jewish people in China, Eva Saxl and her husband managed to extract insulin from water buffalo .
http://en.wikipedia.org/wiki/Eva_Saxl
 
@phoenix - I have tried reading up on extracting insulin when i was in the Zombie thread, and concluded that its not very well documented (at least i didn't exactly find a 'How-To' guide online), it would also be much to difficult in every day life, let alone on an island :S

I wish it was as easy as just eating the pancreas of an animal to gain their insulin... i could handle that haha
 
donnellysdogs said:
The pre insulin diets were horrendous.. Well, at least the whisky given was ok!! But whisky and lettuce leaves??
On a desert island I could find the leaves of some sort but where would I find the whisky?
Click to expand...

My dad would of got it first, believe me :rolleyes: I cant stand the smell :yuck: just awful
 
Given that I'm on basal-bolus, my regular basal dose would give me a hypo soon after the crash - assuming I'll have to do a lot of physical work to get a shelter, etc during the first hours after the crash. So I'd either die from hypo there or find some carbs, over treat my hypo and give dka a quick start :)
Sorry for the grim version ;)
 
We maybe type 1's, but our bodies could react in opposite directions, some going downhill fast and others lasting for a much longer time and hopefully surviving, but the probable complications ? could be awful :eek:

RRB
 
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