Pancreatic Punch

Type I Diabetes is usually a juvenile onset. You don't produce enough insulin, you see, so your body reacts poorly, overreacting with a burst of signals to the delinquent cells, leading to further complications. Your cells starve in a sea of plenty, unable to absorb the sugars from your blood, like a starving man paralyzed in a bakery store room. As you can imagine, this is frustrating to your internal chemistry.

My friend developed Type I after a punch in the back ruptured his pancreas. The damage to his pancreas resulted in a leak of pancreatic lipase. His organ dissolved itself, bubbling with disintegrating fat, ultimately calcifying into a saponified white chalk. His islets of langerhans, the most scenic cell pattern extant, failed in their function, and production of insulin dropped off.

We fix Type I with injections of insulin. This used to be costly, the insulin harvested from humans or pigs, until we learned how to convince bacteria to make it for us. You inject the insulin with meals, or twice a day. The insulin opens the door, lets the sugar in, and your body stops its frenetic response. My friend had his insulin stolen once. In Las Vegas, the capitol city of excess, he was pickpocketed. He didn't notice until reaching for his shot. He stumbled into the hotel that night, disheveled and sweaty, reeking with the sickly sweet stench of ketones. His liver was breaking apart fat to feed his starving cells. His cells, starving in the midst of overabundance.

We didn't appreciate the metaphor.