Diabetes in the Prison System: From False DUIs to Even Death

Slurred speech. Poor coordination. Disorientation. Fruity breath odor. All are symptoms shared by both alcohol use and diabetes mellitus. While impaired driving, regardless of the cause, remains a safety concern, people with diabetes are frequently misidentified as being under the influence – rather than experiencing a medical emergency – preventing them from receiving the urgent care they need.

Diabetes is a chronic condition affecting more than 37 million Americans, with an estimated 8.4 million relying on insulin. Simply put, diabetes hinders the body’s ability to regulate blood sugar. This inability can lead to hypoglycemia, dangerously low blood sugar, as well as hyperglycemia, excessively high blood sugar, sometimes unexpectedly. These fluctuations can result from anything like missed meals to even just stress, and abnormal blood sugar levels can mimic signs of intoxication.

When blood sugar drops too low, symptoms can include confusion, slurred speech, difficulty concentrating, dizziness, and even loss of consciousness. In severe cases, hypoglycemia can cause seizures or a coma. To a police officer, a driver experiencing hypoglycemia may appear visibly impaired, struggling to speak clearly or follow directions.

When blood sugar levels are too high, it can lead to dehydration, fatigue, and disorientation. In cases of Diabetes Ketoacidosis (DKA), the body produces excess ketones, which can cause the person's breath to have a fruity or acetone-like odor – similar to alcohol. A driver experiencing DKA may appear confused or slow to respond, symptoms which can be mistaken for signs of intoxication.

Even when breathalyzer tests show no alcohol, people with diabetes may still arrested under suspicion of drug impairment use based on symptoms alone. Once in custody, detainees are often denied timely medical care, putting them at risk of severe health complications or even death.

In 2023, Louis Jung Jr., a 50-year old man with Type 1 diabetes, was detained at a correctional facility in Philadelphia as a pretrial detainee, meaning he had not yet been tried or convicted of a crime (AP News). Despite his diagnosed condition, prison staff failed to provide him with insulin or monitor his blood sugar levels for six days. Jung tragically died from DKA while still in custody.

Also in 2023, 63-year-old Keith Bach, who had Type 1 Diabetes was arrested on suspicion of vandalism and taken into custody at San Diego Central Jail (NBC San Diego). Despite repeatedly informing deputies of his condition and the depletion of his insulin pump, Bach's urgent requests for insulin were ignored. His wife even visited the jail to plead for them to administer the insulin, and fellow inmates told the deputies to address the alarm signaling the depletion of his insulin pump. Three days later, Bach died from DKA. In a report published nearly a year after his death, the medical examiner ruled his death a homicide by neglect.

Earlier in 2022, 28-year-old Matthew Shelton turned himself into Harris County Jail on a DWI charge (ABC News). Despite bringing his prescribed insulin, Shelton did not receive it, and five days later, he died from DKA.

These tragic cases highlight a critical and often overlooked issue: the failure to recognize and address medical emergencies in people with diabetes, particularly within the prison system. Misunderstood symptoms, such as confusion or disorientation, are frequently mistaken for intoxication, leading to wrongful arrests and neglect of essential medical care. The results can be fatal, as evidenced by recent cases where individuals with diabetes died from complications like diabetic ketoacidosis after being denied proper treatment while in custody. These cases show the urgent need for better training, awareness, and healthcare protocols to ensure that people with diabetes receive the timely medical attention they deserve.