Monday, December 31, 2007

Meet Mrs. Johanssen (Part 3)

Let's talk medicine.

Mrs. Johanssen has a short monologue on the MTV Daria website in which her condition is spelled out, so there is no mistake that she claims to have hypoglycemia. "So let's get started before my blood sugar drops to dangerous levels," she says, by way of introducing the webpages that follow, then adds, "Where are those damn diabetic macaroons?"

Which brings us to a little problem.

Diabetes is a condition in which a person has too much glucose (sugar) in the bloodstream because the body is not producing the hormone known as insulin, which converts sugars and other substances into energy. (This information comes from the American Diabetes Association website.) In other words, a diabetic Mrs. Johanssen should have too much sugar in her bloodstream. The most common form of adult diabetes is Type 2, commonly seen in overweight persons who do little exercise and eat too much sugary food. A general overview of that illness can be gained at this link.

An excess of glucose in the bloodstream is called hyperglycemia (that word links to the ADA webpage explaining the condition). That's hyper-glycemia, the prefix hyper- meaning too much. Note that one consequence of hyperglycemia is ketoacidosis, a symptom of which is shortness of breath. Ketoacidosis is dangerous in the extreme; a person's life is at risk when this develops. Did Daria and Jane miss something when Mrs. Johanssen fainted on them?

However, Mrs. Johanssen repeatedly claims she has hypo-glycemia, which means too little sugar is in her bloodstream. How is this possible? Is she mistaken, is she lying, did the script writers get it all wrong, or what?

Maybe she's right. There is actually a situation in which a person can have Type 2 diabetes but still have hypoglycemia, and that is as a result of taking insulin injections to combat the diabetes. If Mrs. Johanssen is giving herself insulin shots, but her insulin level is sometimes too high, then too much of the bloodstream's glucose is metabolized for energy. This condition is not uncommon, as revealed on this webpage from the National Diabetes Information Clearinghouse. Examine the list of symptoms of hypoglycemia: hunger, shakiness, perspiration, dizziness, possible loss of consciousness. See also this webpage from the Hypoglycemia Support Foundation, about changes in personality (outbursts of temper, mood swings, etc.). That's Mrs. Johanssen, isn't it?

If Mrs. Johanssen is giving herself too much insulin, she could be hypoglycemic. She might be doing this by accident, misreading the instructions, or she might be doing it on purpose because she fears the effects of diabetes or wants to eat more sweets, or the doctor might have prescribed too high a dosage. Since she is aware of the condition, however, it is far more likely that her body is creating a little insulin on its own but unreliably, so her insulin levels fluctuate even with a steady dosage of the same. Remember what she said in "Cafe Disaffecto" about chocolate: "Doctor says I'm not supposed to have too much of it, but he wouldn't mind if it's for a good cause." The second part of that statement is in doubt, but the first part might be true. Eating small amounts of sweets can cure hypoglycemia in the short run. Mrs. Johanssen's problem is that her resistance to sweets and fatty foods is very low, and her blood-sugar issues are screwing with her personality and impulse control. She can't easily stop.

It all makes sense. Daria and Jane did exactly the right thing in not selling Mrs. Johanssen all 24 bars of chocolate, though she could have had one and not been in any serious trouble. If she had eaten too much chocolate, she would have overcome her medication and possibly gone into diabetic shock, or else given herself even more insulin and gone into hypoglycemic shock. She's toast either way.

If anyone knows enough to correct my medical stuff here, feel free to do in the Comments. One last note on Mrs. Johanssen, then on to someone else. UU wants to hear about Ted, so we'll do him after Mrs. J.


E. A. Smith said...

One of my ex-girlfriends was a diabetic, and she could have as many problems with too little blood sugar as too much. It amazes me that any diabetic person can keep it straight; it must be a full-time job, regulating manually what the body is supposed to do automatically.

UU said...

As far as I know, it's a very good explanation from a medical point of view, I think that's just what the creators imagined when they described Mrs Johanssen.

Thank you for Ted DeWitt-Clinton! (Yep, I insist on capital 'W'! :))