The Diabetes Divide – by Olly Double
Some things bring us together, others force us apart. As the parent of two children affected by the condition, Type 1 diabetes is one of the things that forces me slightly apart from other people. It’s not that they’re unsympathetic, it’s just that they can never truly understand what it is that we deal with on a daily basis. It’s the diabetes divide – the lack of knowledge that stands between us and them.
Which brings me to the American drama series Touch, currently showing on Sky. There are not many programmes that we sit down together as a family to watch, but this is one that we’re all happy with – my wife Jacqui, my two sons Joe (15) and Tom (13), and me. The basic premise is that Kiefer Sutherland is the father of a boy with autism who never speaks but is in touch with a kind of network of numbers which is hooked up to some kind of cosmic plan. Each week, Kiefer has to blindly follow the numbers his son gives him, leading him through a series of adventures that inevitably leads to some kind of happy ending.
Stand back from it for any length of time and you realise it’s a corny-as-hell premise, but it’s so well put together that you don’t mind. The narrative weaves and twists cleverly as characters from across the globe are seen in a series of intriguing situations, and as the episode progresses we start to see how these diverse individuals are connected and brought together in a way that’s likely to warm the cockles of even the chilliest heart. It’s a show that’s driven more by harmony than conflict, and it’s based on the beautiful dream that maybe if we tried hard enough we could all come together and bring peace to the world – even if it is aired on Rupert Murdoch’s channel.
But this week’s episode contained an incident which rankled more than just a bit. Having followed the trail of numbers to an illegal poker den, Kiefer finds himself having to track down a professor of maths. Sneaking into the prof’s office, he finds the mysterious mathematician lying on the floor, obviously having collapsed while trying to make a call on his smart phone. Kiefer picks up the phone, and dials the number that the prof’s been trying to call. He gets through to the prof’s friend, who tells him that the prof is diabetic.
Clearly the prof’s having the kind of hypo we fear Joe and Tom being struck down by, the kind that sends you into unconsciousness. What an interesting storyline – let’s see how they deal with it.
It’s a panicky situation. Kiefer’s crouching by the guy’s inert body, and even though the friend’s sitting in a field in Australia without a shirt on and caked in mud – don’t ask – he instantly knows what to do.
‘All right. There’s a small refrigerator behind his desk. On the second shelf there are syringes loaded with insulin.’
What?? Insulin? Clearly the prof’s hypoglycaemic. If you inject him with insulin, you’re likely to kill him! Our muddy, shirtless friend has clearly had his brain fried by the Australian sun. Is that what the story’s going to be? The prof’s trusted friend – who knows enough about his condition to know the precise shelf where the insulin’s kept – is going to be responsible for his mate’s death because he’s forgotten how to treat a hypo.
Now Kiefer’s grabbed the insulin syringe and says, ‘OK, I’ve got it. Where do I inject it?’
‘The arm, the bum – doesn’t matter,’ says shirtless.
Kiefer injects the prof in the arm and starts nervously shaking him. ‘Come on, stay with me,’ he breathes. A few tense seconds pass, the prof’s eyes roll dramatically, and he’s back with us.
Soon the prof’s back on his feet, and in next to no time he’s recruited Kiefer to join him in another illegal game of poker without so much as a blood glucose test.
Wow, this series really is set in a fantastical world! Where do we start with this?
Well, first of all you treat hypos with carbohydrate, not insulin. Or if the person’s unconscious, as the prof was, you inject them with glucagon. As I just said, get that wrong and you’re likely to kill them.
But let’s give them the benefit of the doubt and assume that ‘insulin’ was a slip of the tongue. Come to think of it, the syringe did look more like a glucagon injection. So Kiefer manages the intramuscular injection, and the prof comes round. How does he feel so well so soon? I’m not diabetic myself, but having seen how Joe and Tom are after a major hypo, I know you feel groggy and awful for a good couple of hours. The last thing you’d want to do is take a trip to an illegal gambling den for a quick game of poker. And if you did do that, surely you’d want to test your blood sugars before the game, knowing how nervous tension can affect your levels?
Or maybe it wasn’t a hypo. Maybe the prof had been struck down by hyperglycaemia? Unlikely that he’d be in work feeling perfectly well, and then suddenly keel over, but OK, let’s go with that. So Kiefer injects him with insulin – but it’s going to take him more than a few seconds to start feeling well again. Surely, he’d be more likely to say, ‘Take me to hospital,’ than, ‘Hey, you know what – I fancy trying to win a hundred thousand dollars from a bunch of mobsters.’
How long did the programme makers spend researching diabetes? 10 seconds? Surely even a quick glance at Wikipedia would have told them better than that?
So that’s how a programme about people coming together made me feel further apart. People who don’t have diabetes in their life simply don’t have the faintest idea what it’s like to deal with it day by day. Friends, colleagues and even relatives will sometimes ask, ‘How are Joe and Tom getting on with their diabetes at the moment? Is it under control?’
How do you answer that?
‘Well, yes it is under control in the sense that they manage to get their blood sugars within that elusively narrow range between four and seven mmol/L for maybe seventy or eighty per cent of the time, and their HbA1c levels were pretty good when they checked them at their last clinic appointment, but there are times every day when their blood glucose is too high or too low, and they have to prick their fingers and squeeze a drop of blood out to test with their monitors several times a day, and they can’t eat anything without carefully trying to work out how much carbohydrate it contains and dialling up the appropriate amount of insulin on their insulin pumps, and if they do anything energetic they’ve either got to have a snack before they start or reduce the basal insulin that they’re pump’s delivering, and the last thing Jacqui and I do before we go to bed is test the boys’ blood sugars, and our sleep is disrupted when we have to wake up in the middle of the night and test their blood sugars, and diabetes forces you to have an obsessive interest in food and exercise and insulin, and the fears of what might happen long term constantly nag away at the back of your mind…’
Try giving them that answer and you’ll see them glaze over pretty quickly.
So it’s galling when a programme decides to deal with a condition like diabetes, and instead of helping to show people what it’s really like, they actually reinforce dangerous misconceptions. It’s made me start wondering about how inaccurate their portrayal of autism is. I expect people who have kids with autism – including some of my friends – would probably sit and watch Touch and feel just as misunderstood as we do.
If the people who make films and the TV programmes really did their homework, they could start to show how conditions like diabetes really affect people’s lives, and that would help to bring us all closer together.
But for now, people who aren’t directly involved with diabetes simply can’t understand it – I know, because I used to be one of them.