Diabetes Self-Management Blog

Kate pressed the Accu-Chek needle into her forefinger. The digital meter read up to 282. Her norm was around 90. Jesus, she was off the charts.

She dug into her purse and came out with her kit…She took out a syringe and the bottle of Humulin…She lifted the syringe and pressed it into the insulin, forcing out the air: 18 units…

—The Blue Zone

Eighteen units to bring her blood glucose down to…what? Minus something-or-other?

“It would take me two units,” my friend Liz said. “Maybe two and a half.”

Even zaftig, Type 2, insulin-resistant me would only need 12 units to end up at 90 mg/dl, and Kate was a slim, trim, athletic Type 1. Should author Andrew Gross have named his protagonist Sunny Von Bulow instead?

I’ll get to Humulin in a paragraph or so, but first: 282 mg/dl is “off the charts”? I can show you “off the charts,” and it ain’t no sissy 282!

Now, Humulin is either Regular or NPH insulin (and it’s so 1990s!). The book notes that Kate does two injections a day, but it only mentions Humulin and not what kind, although the fact that she uses Humulin to correct a high would indicate that it is Regular. Regular doesn’t last all that long. Her blood glucose may be somewhat normal part of the time, but what is she the rest of the day? Off the charts?

Today’s regimen, for those of you who don’t know, is a long-acting insulin for a baseline and a rapid-acting insulin to handle any food that you eat and for correcting high blood glucose. Even before rapid-acting insulins were released in 1996, people generally took a combination of NPH and Regular.

The poor woman must not have had very good diabetes self-management education. She leaves for work without giving herself insulin. She skips dinner. She goes all day with just a few bites of salad.

Kate is tough, too. She goes several days (she doesn’t know how many, and neither do I) without taking her insulin and is neither in the hospital nor dead. What a woman!

“Kate’s diabetes was intended to show a character strength,” Gross responded after I e-mailed him about the errors and added, “I have received one or two [comments] from diabetes sufferers before, both critical and positive about Kate’s achievements despite the disease.”

I believe Kate could display character strength and been an achiever while properly managing her diabetes—in which case she could also have acted as an inspiration to people with diabetes and readers could have learned more about diabetes from her.

Geez, no wonder people harbor misconceptions about diabetes—they’re getting misinformation from the media. And that’s all media, from newspapers, to television, to magazines, novels, and movies. In addition, they believe everything they read (or hear) from people who are just as perfect as you and me (which is to say, imperfect). Maybe it’s a case where people don’t know that they don’t know something and innocently repeat myths or outdated information.

(As an aside, it reminds me of the time I worked for an advertising agency and we did a commercial for a drug rehab center. “How did you get that woman to talk about her drug addition?” one person asked my colleague and me one day.

“It’s television,” my colleague responded. “It’s not real.”)

Even worse, however, was a recent column by Peter Gott, M.D., who writes for the Newspaper Enterprise Association. In response to a reader who complained that his doctor refused to issue a prescription for a blood glucose meter, Gott sided with the doctor, basically saying that not everybody needed to check their blood glucose, especially if they’re managing with diet and exercise.

I disagree. Knowing your blood glucose levels can help you determine how different foods and exercise affect your numbers. And, because Type 2 diabetes tends to be progressive, with intensified treatment needed over time, it’s a way to determine when changes in treatment need to take place.

Besides, why discourage somebody who wants to be proactive in managing his diabetes? Just imagine a doctor—read by who knows how many people, by the way—telling somebody he shouldn’t optimize his care.

But I digress.

I’m a firm believer in including diabetes in all manner of media. A novel? Why not? Millions of people have diabetes. Why can’t a character in a work of fiction have diabetes just as a matter of course? After all, we’re in all walks of life in the real world.

But the diabetes information needs to be correct. Think of how many people authors could educate while they entertain.

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Comments
  1. Dear Jan. Keep up the good work in bringing diabetic reality to the masses. Dr. Gott comments are surrealistic as much as Salvador Dali. On Monday I went to Safeway to meet a Diabetic educator that told me without any doubt that if I went on the Atkins diet I would end up with ketosis because the body burnt fat, eventually need to be hospitalized with and infusion of bicarbonate to counter act the low pH in my body. I told her that Atkins seem to live a long and healthy life. She said that he was not a diabetic. Flying pink elephants. I turned the conversation around to another topic not diet since she was well indoctrinated in the usual CDA, ADA: “You must eat a minimum of 55% of your intake as carbs and God will strike you down if you dont.”

    Posted by CalgaryDiabetic |
  2. A related pet peeve of mine is when the media doesn’t clarify which type of diabetes they’re talking about. It’s almost always type 2, which those of us who are familiar with both types can tell from the context, but the Average Joe reading or listening to the story can come away with information they assume applies to type 1 as well, when it doesn’t, as in the references to dietary causes in this story from Minnesota Public Radio:
    http://news.minnesota.publicradio.org/features/2003/11/25_gundersond_diabetesprevent/
    Drives me CRAZY!
    (type 1 for 10 years now)

    Posted by chrissie |
  3. Thanks for the article. I feel the same frustration with fiction, but also with the non-fiction sources, and advertisements. It is beginning to sound as though diabetes is exclusively a weight induced disease. It is not, millions of us deal with diabetes no matter what the scale says. There is beginning to be a stigma attached to diabetes that it is controllable by simply loosing weight. I understand that in many cases it is, but I am getting really tired of seeing weight loss commercials using references to controlling their diabetes with weight loss. I think the general population believes that all, or most, diabetes is that way, especially if you happen to be a little over weight.

    Posted by jeannene |
  4. One of mt pet media depiction peeves is the meter commercials “use our meter because it hurts less”. I’ve NEVER used my meter to make myself bleed for the blood sample. I always use my lancet device. Now, if someone came up with a device that used the strip to poke and slurp a sample at the same time instead of juggling 2 devices, THAT would be progress!

    Posted by Ephrenia |
  5. 282? And I thought I was excessively high when my readings were in the 180 to 200 range! I’m still a bit confused as to what “a seriously high glucose reading” is!?!? I know the suggested norm is 70 to 120. But what about the higher 100 readings? Are we fooling ourselves?

    Posted by JiminPcola |
  6. All diabetics are emissaries for the treatment of the disease. Almost everyone I know, knows someone who is diabetic. Yet ignorance abounds.Let’s face it, the idea of self-administered injections and things like insulin pumps sound just plain gros or scary (was to me!)to many people with a low confront of bodies. And look around you at the out of shape Americans with happenstance bodies. They are showing you how low their confront is of their bodies. So they are not normally going to go the extra half step to understand diabetes unless they meet someone up close and they see the face of it.

    For the past year and a half I’ve been a type 1 and I just recently went on a pump. None of it is scary or gross, and honestly, I’ve had greater challenges in my life (love your neighbor being one of them, especially the neighbor with the dog that barks all night).

    So when I meet someone, if it is appropriate, I let them know I am diabetic in an upbeat way and answer their questions. Almost always they have some wrongheaded notion as to my plight and I give them the truth. I like to think encounters like that are viral and eventually word gets around.

    The author you mention sounds like a lazy writer. Coming up with an element in a character’s life that shows what they are made of…and not really getting inside what that is?? Lazy.

    Peter Mead

    Posted by Peter Mead |
  7. Jan,
    Your comments fell in line with my pet peeve, and that’s a certain doctor who appears on a female’s daytime talk show. He nonchalantly (and arrogant in my opinion) tells folks if they lose weight they can “reverse” their diabetes. To any of us with the big d, we are intelligent enough to know that weight loss helps us manage diabetes, not “get rid of it.” This is dangerous of him to say, especially for any newbies or those looking for a way to believe they no longer have diabetes, which he has in fact implied. The arrogance galls me, and with a nation wide audience, imagine the harm it can do. Burns me!!!
    I guess one good thing that comes out of it is that I get so mad I turn off the tv and go do some situps!!
    Take care,
    Sandipeach

    Posted by Sandipeach |

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