During the first week of protests sparked by the killing of George Floyd in Minneapolis, a video of a 20-year-old woman begging a police officer for her insulin moments after her arrest in Cincinnati went went viral on Twitter. As Alexis Wilkins recounted later in a phone interview, she and several friends were getting a ride home with a fellow protester when a police officer put a palm on the car to stop the driver. The young women were ordered to get out of the car and sit on the curb. Wilkins soon realized that her bag containing the supplies necessary to manage her Type 1 diabetes was still lying on the floor by the passenger’s seat. Having experienced an adrenaline rush after the protest, she had eaten a quick snack to bring her blood sugar back up, which would in turn need to be lowered again with a dose of insulin.
To her relief, Wilkins’s bag was eventually retrieved, and she was able to prevent dangerous blood sugar levels while in custody. In the end, she told me, she was separated from her life-sustaining supplies for around a half hour, during which time she was terrified that the bag would be lost in the shuffle. If that happened, she would have missed two critical doses of medication, as well as a necessary battery change for her insulin pump, which was slated to run out of juice later that evening. Wilkins could have quickly faced a serious medical emergency.
Given the stakes, Wilkins’s terror was entirely rational. The harrowing scene highlights the special danger that draconian policing poses for people with diabetes, whose health depends on access to medical supplies including insulin, snacks, pumps, syringes, glucose testing strips or cell phone apps, on a near-constant basis, without interruption. Their vulnerability to state violence is shared by others with disabilities and chronic medical conditions, who may be less able to weather police encounters or even brief periods of detention. As Matthew Segal, the legal director of ACLU Massachusetts, stressed, “A decent chunk of ‘use of force’ cases involved people who needed to work who were in some kind of physical or mental health crisis…who ended up getting hurt or killed…. It’s very common for the police to deal very harshly with people who simply need help.” Indeed, research suggests that up to half of people killed by police have a disability, and that it is relatively common for diabetics in crisis to be injured or killed by police.
In fact, a landmark Supreme Court case on the use of force in policing involved Dethorne Graham, a Black man with diabetes. In 1984, Graham began having an insulin reaction, and asked a friend for a ride to a convenience store to get some juice to raise his blood sugar. When Graham walked into the store, he saw how long the line was and quickly walked back out again to go somewhere else. A nearby officer judged this behavior as suspicious, so he followed Graham and his friend and pulled them over. Without confirming that nothing was amiss at the store, the officer detained Graham at the curb. A scuffle ensued, in which an officer allegedly slammed Graham’s head on the roof of his friend’s car. By the time he was finally released, Graham had fainted and incurred shoulder and head injuries, multiple scratches, and a broken foot.
Graham’s suit against the officer eventually made it to the Supreme Court, whose ruling set a precedent that many cops think of as their “First Amendment.” It established a standard for assessing police’s use of force by a so-called “objective reasonableness” test. The test asks whether a reasonable person in the accused officer’s position would have done the same thing. As Segal explains, this precedent has tended to center the police’s point of view, rather than that of the victims of their actions. “It has led to a body of case law that is just extraordinarily, extraordinarily deferential to police…. If you see everything from the perspective of a police officer, then suddenly a horrible beating of a man just trying to get orange juice is just a reasonable mistake…. I think that Graham vs. Connor is the origin of a sociology that says whatever the officers did, we’re going to tell the entire story from their perspective.”
And from the perspective of far too many officers, the perfectly reasonable actions of someone with diabetes—like asking for a bag to remain in eyeshot or quickly leaving a store with a long line—might be considered suspect. When a diabetic’s blood sugar is askew, they tend to behave erratically—reacting more aggressively than usual, tripping over their words or struggling to process commands. And in Graham’s case, his race certainly put him at significantly more risk.
As Segal put it, “It becomes far less ‘reasonable’ what the officer did if you accept the proposition that Black people tell the truth.’” Wilkins, too, was shaken to imagine how her close call might have played out if she weren’t white: “I’m incredibly lucky that, as traumatic as it was, it could have been worse and I’m glad that it wasn’t. Because I know it is for people of color every single day.”
The dangers of these police encounters snap into even sharper focus when you consider who is most likely to suffer from serious diabetes complications in the first place. Black Americans are 60 percent more likely to be diagnosed with diabetes than whites, and twice as likely to die of it. Black Americans are also more likely to have low incomes and unstable housing, both of which make diabetes even more challenging to manage.
Theo Henderson, an African American with Type 2 diabetes living in a park in Chinatown in Los Angeles, told me that all of these things frequently intersect: Being unhoused exacerbates his diabetes symptoms by making it very difficult to eat a nutritious diet, and also leaves him vulnerable to aggressive policing. In the past few years, he estimates that he’s lost medications around eight different times to street sweeps, when cleanup teams and police officers clear out homeless encampments and discard residents’ possessions.
Losing one’s medication and diabetes supplies so frequently makes a challenging chronic disease nearly impossible to manage. “They just take all your stuff and dump it in the trash…. Now you’re dealing with a traumatic experience, trying to figure out how to restructure your life: Whom do you call to get those resources, or to try to get an appointment if you’re diabetic? Doctors aren’t just twiddling their thumbs.… You may walk in like I’ve done a couple of times and they’ll say they don’t have availability. And you may need the medication to keep you going, but maybe you’re so demoralized that, you know, you just give up.”
And when diabetes patients are held in police custody or filtered into jails and prisons, the situation can quickly deteriorate further. According to the American Diabetes Association, diabetes care is often denied to people in short-term custody. And management of the condition is often subpar in incarceration settings: Last year, an investigation found a dozen deaths from diabetic ketoacidosis—a serious complication triggered when a lack of insulin drives glucose levels dangerously high—in Georgia prisons and jails, presumably because of shoddy care management.
The impact of these challenges was described to me by a man named Bob Carder, a Type 1 diabetic who recounted several harrowing days he spent in an Ohio jail sometime around 2009, when he was 24 years old. After being picked up one Friday evening for an old warrant related to an allegedly unpaid speeding ticket, Carder recalled the guards’ taking away his supplies during processing. They told him they’d administer his drugs as they deemed necessary. But over the course of the weekend, he received only a few units of insulin per day, far less than his typical allotment.
“Anything in jail, if you make a request, if they even hear you, it takes hours. I mean, six, seven, eight hours sometimes… and they don’t care. If you make noise, if you knock on the door, they’ll just start doing things like, ‘You guys won’t get food tonight,’ or ‘We’re just going to turn the TV off,’ and then the rest of the people in your cell hate you, because you just got the TV shut off, even though you’re trying not to die.”
Eventually, Carder says, his blood sugar rose so high that he was dragging himself across the floor to make it to the toilet to vomit. His cellmates were so alarmed that they too began begging for medical attention. On the following Monday, Carder was rushed to the hospital, where he suffered a heart attack in the waiting room. Three days later, he woke up in the hospital, handcuffed to his bed.
In the end, Carder probably cheated death by just a few hours—all over a speeding ticket. Looking back, I asked, what does he think the police and guards he dealt with were thinking? Why did they spend days ignoring and rejecting his pleas?
“They don’t see me as an individual. They see me as a number,” he said. “To be boxed up, and shipped out…. I don’t think the majority of them that I’ve dealt with wake up and go, ‘How am I going to ruin somebody’s life today?’ But at the same time, they’re also not thinking, ‘How do I make sure I don’t ruin somebody’s life today?’”