0/5⭐️🎧 If a life threatening, chronic illness is going to be in a novel, there is an irrefutable responsibility on the author and editors to ensure that the illness and any medical crises on page are depicted accurately and with care. Period. This book had the most reckless misinformation regarding type one diabetes and hypoglycemic treatment that I have EVER read. I am disgusted. I am unsure if it was a typo or simply a misunderstanding but it should have been caught.

I will be direct quoting from the text:

“ ‘I found this on the shore.’ She dug a hand into the pocket of her leather jacket—hastily thrown over silky black pajamas—and pulled out something that made my heart stop. An insulin pump.”

“ ‘She’s probably hypoglycaemic right now. She’s been down here far too long’.”

“Their quick actions saved Catalina’s life—the paramedics got there just in time to administer insulin.”

1. Insulin pumps use short-acting insulin. Meaning that the life of the insulin working in the body is only around 2-4 hours, depending on the person. Without insulin infusion, the type one diabetic begins to have HYPERGLYCEMIA and will eventually begin to go into life threatening Diabetic Ketoacidosis. This is a medical emergency that requires hospitalization/insulin treatment. I was so worried about Catalina being off her pump, I kept thinking “how long has it been? How does the time working differently in the underworld translate for her missing meds? Is she dead?”

2. HYPERglycemia = high blood sugar

3. HYPOglycemia = low blood sugar

4. Catalina might not have eaten for a while, but her freaking body can’t make insulin!!! So she would have been high or going into DKA.

5. This is the MOST GLARING issue of the plot point, IF A DIABETIC IS HYPOGLYCEMIC AND IS GIVEN INSULIN, THEY WILL SEIZE AND/OR DIE. The brain runs on glucose. In NO REALITY IS INSULIN EVER A TREATMENT TO A LOW.

From my understanding, this book is marketed to Young Adult/New Adult readers. While type one can happen at any age and is a lifelong illness, it typically is diagnosed during childhood/teen years. To put this misinformation in a book for a group of people that have a high likelihood of encountering a type one diabetic is so dangerous. Especially considering all of the misinformation and stigma towards diabetes that already exists.

Disability representation is so important in media and type one is hard to find, particularly in ways that are not harmful or too generalized. I have had this disease for three decades, and the on page misinformation is one of my biggest nightmares. I hope against all hope that I don’t have a severe low and someone gives me insulin. It would be a death sentence.

If a type one diabetic is experiencing low blood sugar and is conscious: full sugar juice, hard candy, glucose tablets are the treatment.

If unconscious: call EMS. Do not feed unconscious person. DO NOT GIVE INSULIN. Verify blood sugar if possible. Use a glucagon emergency kit if possible.

Below I have listed resources from the American Diabetes Association regarding Type One, hypo and hyper glycemia.

https://diabetes.org/about-diabetes/type-1

https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/symptoms-treatment

https://diabetes.org/living-with-diabetes/treatment-care/hyperglycemia

I’m sure that the intent was not to harm here, but I am in shock about how this was missed and published.

I received this eARC from NetGalley and St. Martin’s Press in exchange for my honest review.

4.5/5⭐️ 2/5🌶️🎧 This was a perfect palate cleanser for my horrendous book hangover. Fun, whimsical, romantic. The cliffhanger and plot twists were a little on the nose but it is very on brand for this level of whimsy, so I’m not mad about it. I’m excited to finish this series when book five comes out. Also, the spice is slightly turned up in a way that felt more realistic to the story compared to the off-page in the previous book, so I am glad that the author took that avenue this time.