I am not a doctor, nor an expert in Diabetes. My wife has been a (diagnosed) Type 2 for the last 20 years and I’ve spent the last three years reading a lot about diabetes, diet, and obesity. Here is my take on the matter of T2DM.
Diabetes is an occlusive artery disease. The blood flow through the smallest arteries gradually, over years, become so impaired that cells in that part of the body start to fail. This typically shows up in the kidneys, eyes, and feet of the T2DM sufferer. Over 200 body parts, usually feet, are amputated a day in the U.S. because of T2DM. This is all well understood and not in dispute. The fact that high glycation of the blood (high blood glucose, or high blood sugar) is a major factor in the arterial disease is not in dispute.
The causes and treatment of T2DM are hotly in dispute. I agree with Dr Tim Noakes, Dr Jason Fung, Dr Robert Lusting, engineer Ivor Cummins, and many, many others that high insulin levels lead to Insulin Resistance, metabolic disorder, type 2 diabetes, weight gain, obesity, heart disease, and (probably) alzheimers. The main cause of high insulin levels are carbohydrates in the diet. Too many carbs, or carbs eaten too often, keep insulin levels high, and the cumulative effect over years are all the maladies described above. Strict control of carb intake (less than 50 grams per day, perhaps as little as 20 grams) should be required of every T2DM patient.
The American Diabetes Association (ADA) and others don’t see it that way. They recommend that T2DM patients have a ‘moderate’ amount of carbs that is about 300 grams per day, as long as the patients inject themselves with enough insulin to compensate. I believe that just adds to the hyperinsulinemia the T2DM patient already had, and encourages them to eat even more carbs.
The debate continues, and if you or a loved one has T2DM, then you should search for the names listed above to see more.
What does this mean for emergencies, disasters, and long term SHTF?
The most immediate danger for a T2DM person on medication and injecting insulin is having a low blood sugar emergency. This is when there has been too much insulin injected for the amount of carbs eaten. An early sign is the shakes, but that can quickly lead to combative behavior then unconsciousness if they are not given glucose quickly. If untreated they can go into a coma and die. Low blood sugar could happen because of unplanned, intense physical activity, or a long endurance activity (think bugging out in the middle of the night) without adequate amount of carbs.
The next level of danger may come from a long trek. The T2DM patient may be unused to long hikes, and blisters or injuries, combined with poor blood flow to the feet, may lead to serious infections which could be life (and limb) threatening within days.
Injected insulin usually has to be refrigerated, as the efficacy decreases quickly when stored at room temperature or higher. So whatever insulin a T2DM patient has on hand may only last a few weeks without refrigeration.
Most of the Long Term Storage (LTS) foods available commercially are very high in carbohydrates. Even un-ground wheat, a favorite of many preppers, has a profound affect on blood sugar when ground into flour and baked into something like bread. For a long term SHTF scenario, it may come down to a choice of avoiding starvation by eating what is available (carbs) and accepting the T2DM consequences. I have as many non-carb LTS foods in my preps as I can manage, but it’s not easy. For example, I like sardines, but my wife does not.
The best long-term preparation that can be made is to control the carb intake now and reduce the reduce the blood sugar levels to the point where diabetes meds are no longer needed. While not a cure, the effects of T2DM can be reduced and reversed for many people. Address that disaster first, before a natural (or man made) disaster makes it even worse.
That’s my opinion.