College of Pharmacy students recently participated in a challenge intended to help them understand the challenges of living with diabetes. Just as each diabetes patient may be given a different regime to follow, each participating student received one of three different scenarios in this week-long challenge sponsored by the College of Pharmacy’s chapter of APhA-ASP’s Operation Diabetes. In all of the scenarios, the students were instructed to track their carb intake, test their blood glucose levels, and inject “insulin” to correct their levels, as all diabetic patients must do. (The "insulin" was only air, and it was injected subcutaneously instead of into the bloodstream.)
In the first scenario, the students were asked to calculate how much “insulin” they needed to inject based on how many carbohydrates they ate for their bolus dose (insulin to carb ratio) as well as test their blood sugar in the morning and at every meal.
In the second scenario, the students were asked to limit the number of carbohydrates they consumed at each meal and to avoid snacking between meals, in addition to testing blood sugar and injecting “insulin." This was a difficult regime to follow, according to first-year pharmacy student Rachel Grolmus. She said she was unable to eat her normal foods and that going out to eat was not easy. She spent more time grocery shopping and reading food labels during the challenge, and ate a lot of carrots, salads, and cheese.
In the last scenario, the students were asked to follow a very strict schedule of times of injecting their “insulin” and eating their meals. For these participants, being so consistent was problematic when each day’s responsibilities were so varied. Between going to classes, practices, meetings, etc., adhering to a consistent schedule for student Monica Schmidt was sometimes impossible. In a rush to test in the middle of practice one day, Monica received an error message on her glucose reader.
The students also found there were some unexpected challenges in following one of the above diabetes regimes. Testing and injecting throughout the day produces biological waste. For Andrea Klepper, finding a place to dispose of her used insulin syringes, pen needles, and lancets was often problematic. She had to resort to carrying around her used equipment in her backpack until she reached the College of Pharmacy building, where there is an appropriate sharps-disposal container in the first floor restrooms and, during the challenge, one in the student lounge.
For Rachel, one unexpected result occurred from the repeated finger pricks for glucose testing and injections of the fake insulin. She experienced bruising on her stomach and fingers, and said that it hurt to type.
Overall, the students shared that participating in this week-long challenge will hopefully make them better pharmacists. The students said that following the above regimes required all day vigilance, and by participating they have gained empathy and understanding for the huge lifestyle changes that are required for a newly diagnosed diabetic. One student suggested that this challenge will now prompt them to work with patients to make little changes over time to increase adherence, instead of large demanding changes.