Editor’s Note: It is an extremely personal decision to protest, and Beyond Type 1 neither endorses nor opposes any person living with diabetes’ participation. This guide is to help those who choose to protest do so as safely as possible.

Protesting is one of many ways to create change and is a right of all Americans under the First Amendment. But if you have diabetes, there are extra things to consider, particularly amidst COVID-19.

Having diabetes – Type 1 or Type 2 – presents challenges in daily life already; adding a challenging environment with risk of exposure to a virus makes things more complicated. Because of that, you may choose to lend your voice to the things you care about from home, which is also impactful. 

However, if you are heading out to protest, here’s what you need to know.

Be Prepared

Step 1: Make sure you are healthy enough and prepared to participate. Consider the state of your health over the last few days and weeks. The best circumstances under which to attend a protest are when your blood sugars have been stable, you have been eating hearty and nutritious meals, you are well-hydrated, your immune system is strong, and your mental health is fortified. 

Step 2: Pack a bag. In addition to the standard items suggested for all protesters, like extra masks/face coverings, cash, your health insurance card, permanent markers, water, and snacks, there are extra things to consider if you have diabetes. Remember that you may get stuck away from home for a longer period of time than planned.

• Double down on water. While heavy, staying hydrated can keep your blood sugar levels more manageable and can prevent other health issues. When volunteers or street medics offer more water, accept their offer. 
• Bring a variety of snacks, with a combination of carbohydrates and protein, and glucagon (nasal or injectable kit). It is helpful to have both fast-acting glucose, like glucose tabs or gels, to raise your blood sugar quickly if you experience a low, as well as more substantial snacks to consume periodically to keep your blood sugar stable. Ensure that the people you’re going with know how to use glucagon, including what personal signs of a low blood sugar you experience that they can look out for. 
• Pack extra blood sugar monitoring supplies. Even if you have a continuous glucose monitor (CGM), it is possible for your sensor to fail or become inaccurate due to heat causing your adhesive to loosen or jostling from being in a crowd. With either your CGM or glucose monitor, make sure you are checking your levels often. If you have a closed-loop system and can utilize an ‘exercise’ setting to keep your blood sugar levels slightly higher (typically around 160 mg/dL), do so.
• Include a back-up insulin delivery method. If you wear an insulin pump, bring insulin pens (with extra pen needles) or vials and syringes. If you utilize injections, make sure you have more supplies than you typically need. Consider packing in a small cooler system/insulated bag to keep your insulin cool. 
• Write down your medical information on index cards kept in the outer pocket of your bag. This should include your medical background information (all medical issues you live with), your medications, and the contact information for your healthcare provider and emergency contact.
• We are still living in a pandemic, so pack extra face masks, hand sanitizer, and disinfecting wipes. If you accept water or snacks from volunteers, ensure you sanitize surfaces, like the opening of a water bottle. COVID-19 is challenging, but made more challenging by diabetes management. Minimize your risks to stay safe. 

Step 3: Wear protective articles of clothing + a medical alert item. Wear a mask or face covering, long pants, comfortable closed-toed shoes, a long sleeve shirt, a hat and/or sunglasses, plus a medical alert item, like a bracelet or necklace.

• If you do not have a medical alert item, write your alerts on your arm using permanent marker. This could something like “insulin-dependent, type 1 diabetes.” Your alerts should be as clear as possible, helping a person completely unfamiliar with diabetes be more aware of your health background.
• Protective clothing – long sleeves, sunglasses, hat, etc. – shields you from the sun, and will also provide a barrier for your skin in case tear gas is deployed. A primary component of tear gas is capsaicin, a chemical compound derived from chili peppers. As tear gas (made from fine particles) is absorbed by your skin, it can produce extensive amounts of inflammation. This can lead to health issues in anyone, but can lead to issues with blood sugar, extra pain response, and dehydration for people with diabetes. 

Step 4: Have a buddy and communicate. No one should go to a protest alone if possible, but particularly no one with an underlying health condition. Ensure you attend a protest with someone you trust, who knows you have diabetes, and can help look out for the signs of low or high blood sugar. Ask them to remind you to drink water and eat. Create a plan for where and when to meet if you get separated. Be clear about your limits and make sure you are in agreement about your boundaries. For example, if you are attending with someone who is willing to be arrested and you are not, you will no longer have your buddy system intact, which could lead to a safety issue.

Step 5: Take care of yourself when you get home. Chances are you just walked a long distance and tensions were high. Hydrate and eat once you get back home or to a safe place. Your blood sugar may drop or rise in unexpected ways due to stress and exertion. Keep an eye on your blood sugar levels as much as possible. If you have a CGM with follow capabilities, ask a friend or family member to make sure their alerts are loud, particularly while you sleep.

Know Your Rights

Attending a protest carries the risk of being detained or arrested. Because of this, ensure you know your rights before you attend. Be aware that while everyone in the US has the same rights theoretically, being undocumented, a person of color, or belonging to any marginalized group – including living with diabetes – alters how you may need to approach interactions with members of law enforcement. 

The following is summarized from the American Diabetes Association’s Inappropriate Law Enforcement Response to Individuals with Diabetes.

1. If you get arrested, clearly and calmly state to the police officer that you have diabetes. If you are concerned about or nearing a medical episode – such as a low or high blood sugar event – while detained, communicate the circumstances to the officer. By law, if an officer has visible cues (such as clear signs of a low or high blood sugar) or has been given notice of a person’s medical condition, they must abide by the resulting rights that provides.
2. You have a right to be able to take care of your health and receive medical assistance if and as needed. The Fourteenth Amendment grants the right of pretrial detainees (anyone who has been detained, arrested, or jailed) to adequate medical care.
3. Under the Fourth Amendment, a police officer is not allowed to search or confiscate your belongings without a warrant or without probable cause. If a police officer believes they have probable cause, they must inform you of what they are searching, as well as what they are seizing. Consensual seizures are not prohibited by the Fourth Amendment, so you must state that you do not consent for your belongings to be seized. This all becomes more murky if the police officer can make a case that a severe crime was being committed, an immediate threat is being posed to the officer or public, or if you are resisting or otherwise evading arrest. Stay calm, be clear, and follow directions as much as possible.

Overall, if you are considering or attending a protest, safety comes first. Be prepared. Be careful. Know your rights.

Lala Jackson

Lala is a communications strategist who has lived with Type 1 diabetes since 1997. She worked across med-tech, business incubation, library tech, and wellness before landing in the T1D non-profit space in 2016. A bit of a nomad, she grew up primarily bouncing between Hawaii and Washington state and graduated from the University of Miami. You can usually find her reading, preferably on a beach.