‘I don’t wanna live anymore.’ A Type 1 diabetic’s struggles inside Otay Mesa Detention Center

Alone, in a gray cell the size of a parking space, under a bright light, Hanne Engan sobbed.

Days earlier, the 24-year-old from Norway and her husband, a U.S. citizen, were planning where to celebrate one of the couple’s last appointments for Engan’s green card application. 

But in November, she waited, locked inside the Otay Mesa Detention Center.

Engan, a Type 1 diabetic who relies on life-saving insulin, knew it was only a matter of time before her blood sugar might spike again, before the blurred vision, severe dizziness and splitting headaches might come roaring back, before dehydration turned her tongue to sandpaper. 

She told inewsource, “I knew it was possible that I wouldn’t make it out.”

Medical experts who spoke to inewsource said the care Engan described for her Type 1 diabetes was at times substandard and potentially life-threatening — and that it raises questions about the overall level of care at the Otay Mesa Detention Center.

An inewsource investigation of court records and interviews with 10 former Otay Mesa detainees identified dozens of immigrants who have described chronic conditions, deteriorating health or inadequate care.

In the first 13 months of Trump’s second term, Otay Mesa averaged two or three calls for ambulances a week. That’s up from an average of two calls a week under Biden’s entire four-year term.

Otay Mesa is one of eight immigration detention centers in California that have swelled with immigrants amid a national crackdown.

Calls for ambulances peaked at the facility during former President Joe Biden’s last year in office, and dipped slightly under Trump, from 151 to 141. The detained population nearly tripled from about 500 in 2021 to more than 1,400 in 2025. It has since decreased to about 1,170.

Using a California Public Records Act request, inewsource obtained and reviewed more than 100 recent 911 calls seeking assistance from Cal Fire ambulances at Otay Mesa. 

Most calls reported detainees seizing, injuring themselves, suffering chest pain or struggling to breathe. In addition, they included:

• Four calls for stroke-like symptoms.
• Three calls for pregnancy-related emergencies — one after a miscarriage and two for abdominal pain that required advanced life support ambulances.
• Eight calls that revealed mental distress, including one for a “cardiac arrest” in which the caller describes a “possible hanging,” another for a man who “self-mutilated” and another for a woman who was “acting erratically” and “saying she wants to kill herself.”

Seizures made up nearly 1 in 5 ambulance calls from Otay Mesa during Trump’s second term.

Medical experts say that trend could point toward poor management of medication for chronic conditions that can cause seizures — conditions that, like diabetes, require precisely dosed and timed treatment. Seizures can be caused by extremely high or extremely low blood sugar or by a host of other factors unrelated to diabetes.

Minneapolis emergency physician William Weber, the medical director at the Medical Justice Alliance, a nonprofit that advocates for improved prison health care, said the percentage of seizures in ambulance calls at Otay Mesa is “many times higher than would be expected in the general population.”

“It raises concerns that seizures are happening so frequently,” he said.

Immigration and Customs Enforcement declined multiple interview requests but said in an emailed statement that “comprehensive medical care” in detention is a “longstanding practice.” 

An ICE spokesperson did not respond to specific medical cases inewsource detailed in a six-page letter but said detainees receive medical, dental and mental health services as well as access to medical appointments and 24-hour emergency care.

ICE called it “the best healthcare that many aliens have received in their entire lives.”

CoreCivic, the private prison company that manages Otay Mesa and its medical team, also declined requests for an interview. In a statement, spokesperson Ryan Gustin said that they follow federal detention guidelines and are monitored for compliance by the government.

“The safety, health and well-being of the individuals entrusted to our care is our top priority,” he said. 

Doctors said any lapse in insulin therapy could be catastrophic for diabetic patients.

“We’re taught that if you’re Type 1 diabetic, you’ll die without insulin pretty quickly,” said Katherine McKenzie, a professor at the Yale School of Medicine and director of the Yale Center for Asylum Medicine.

In at least one case, Otay Mesa staff had to call for an advanced life support ambulance for a diabetic patient whose blood sugar was too high, records show.

‘Wouldn’t want to be sick’ there

Engan told inewsource that inadequate care at Otay Mesa for her Type 1 diabetes left her suffering chaotic episodes of high blood sugar — far above what doctors say is appropriate and safe. 

The goal of treatment is to keep one’s blood sugar from getting too high or too low, which can involve precisely timed insulin injections, usually timed to meals, as well as managing diet, exercise, stress and other factors that affect blood sugar levels. 

But in detention at Otay Mesa, Engan said the treatment routines she had spent years fine-tuning were largely ignored. She said she went without insulin for two days after her arrest by ICE.

She said she was held in an ICE holding facility downtown before being brought to Otay Mesa, where she first received insulin the night of her arrival.

CoreCivic spokesperson Brian Todd told inewsource that part of that timeline is out of the detention center’s control.

“It is important to note that CoreCivic’s responsibility for an individual’s care begins upon their arrival at our facility,” he said.

When Engan did start receiving insulin and blood sugar checks, she said they weren’t timed with meals despite her pleas to staff. She said she skipped meals, believing it was better to go hungry than to risk a hyperglycemic episode. She said that the meals at the facility were not adequate for diabetes because they were high in carbohydrates.

Responding to a seven-page letter detailing inewsource’s reporting, Todd said in a statement that all detainees are screened by a nurse for chronic illnesses, medications and other needs upon arrival and that nurses make sure “their needs are addressed immediately.”

He said meals for diabetics are prepared in accordance with American Diabetes Association guidelines and that “patient compliance” with medications, appointments and meals can be a challenge for the facility as it is “in the community.”

But the conditions described by Engan exemplify the difficulties in treating patients with chronic conditions, who often need regular or specialized care, inside detention settings.

McKenzie, the Yale professor who reviewed court petitions and summaries of inewsource interviews with former detainees at Otay Mesa Detention Center, said the facility is “just not well-equipped to care for people who are chronically ill or acutely ill.”

“I wouldn’t want to be sick in Otay Mesa by any means,” she said.

Weber, the Minneapolis physician, said the care Engan described at Otay Mesa was “like a handbook of what not to do with a Type 1 diabetic.” 

‘I don’t wanna live anymore’

Engan messaged her husband from a tablet given to her by detention staff. 

“Being isolated is hell,” she wrote. 

She needed insulin to stave off the worst symptoms.

But she didn’t know when she would get it.

Engan had spent the previous days pleading for insulin injections with her meals, begging to see a doctor and writing grievance reports explaining her condition. The nurses she saw told her she couldn’t change her treatment plan without seeing a doctor. A day after Engan finally did — three days into her detention — she said she was moved into the cell by herself.

She was in what CoreCivic calls “medical housing units,” single cells used in some cases for medical observation and treatment.

The company said immigrants there still have access to recreation and “basic necessities” and said its use of the cells “reflects our commitment to appropriate clinical oversight.”

Engan called it solitary confinement.

She said she was held in the cell for 24 hours a day some days, that she was allowed to shower only once in the five days she was there and that she couldn’t socialize with other detained immigrants. Her meals arrived through a slot in a locked door. 

She said her cell had a bed, a steel toilet, a small table attached to the wall and a television that didn’t work. 

Engan said that on her second day in the cell, her treatment improved slightly. The nurse overseeing her cell had started timing her insulin to meals and letting her choose her own dose. But it came at a cost, Engan said: Her five days in the cell were “really horrible.”

She texted her husband that she could hear people detained next to her. 

“A girl in a cell close to me is actually going insane, screaming her lungs out and banging on the door, screaming that this is abuse,” Engan texted her husband. 

Joshua Daguman spent days calling family, lawyers and media outlets — anyone who could help get his wife out of detention. He knew the delicacy of her condition.

The couple had married about a year earlier after meeting while playing volleyball at Mission Beach.

When Engan’s student visa expired, neither imagined she would end up where she did. 

“How is your mental health? How are you feeling?” Daguman wrote her. “This too shall pass my love please hang in there.”

Engan responded within minutes. 

“I feel like I don’t wanna live anymore.” 

Engan was released four days later after she’d spent a total of nine days in detention. When she returned home, she listened to a voicemail left on her phone the day before she was moved to the isolation cell. 

In it, an ICE agent trying to reach Engan’s family said that detention staff had listed her “as Type 2 diabetes and she’s Type 1” but that “the proper action was already put into place.”

Engan interpreted the voicemail as the detention staff admitting to mislabeling her condition.

That notation was made despite what Engan said was multiple sick calls, grievance reports and interactions with medical staff in which she said she was Type 1, which requires a higher level of care. 

“They were just careless, I guess,” Engan said. “Or incompetent.”

She is still waiting on a final decision for her green card application.

Todd, with CoreCivic, said diabetics receive blood sugar testing, insulin and medications “when indicated” but he did not address why insulin administration was not timed to meals.

Marc Stern, a correctional physician and former assistant secretary of health for Washington state prisons, said Engan’s story raises questions about how the Otay Mesa medical staff handles care for all its patients.

“Providing minimally acceptable care for diabetes in detention is not rocket science,” Stern said.

“But it does require having medical staff who have a basic understanding of diabetes and that the health care system does what’s required.”