Sir, – Unlike Dr Anna Clarke (January 19th), I thought Brian O’Connell’s piece, “Is Ireland failing its heroin addicts?” (Life & Culture, January 9th) was commendable.
If Dr Clarke thinks the comments in the article were intended to sully the image of diabetics, then she has clearly misunderstood. The whole point of the analogy is that no one thinks any less of people unfortunate enough to suffer from diabetes. The philosophy described by Dr Christopher Luke and Dr João Goulão is based on the principle that addiction is a disease, and drug addicts should be treated with the same level of sympathy and support as sufferers of other diseases. Whether or not one agrees with that philosophy, it was quite clear than no one was trying to cast aspersions on people with diabetes.
I am also surprised that Dr Clarke implied that people with diabetes often need to administer insulin in public because “insulin must be taken as an injection at the specified times or risk ill-health, hospitalisation or worse”. While it is true that people with Type 1 diabetes require insulin to survive, even a delay of several hours would not place them at immediate risk. The most common emergency situation encountered by diabetics is hypoglycaemia, or low blood sugar, which is actually caused by insulin treatment rather than the underlying diabetes. If diabetics fail to administer insulin, they will suffer hyperglycaemia, or high blood sugar.
While hyperglycaemia is also very harmful, it takes hours to develop and days to reach a level that poses an immediate threat. I fully agree that there is no reason for diabetics to be ashamed of their need to inject insulin, but the same is true of various other “activities of daily living” that most of us only undertake in private. – Yours, etc,