Number 21 – Casualty!

As discussed in Number 12 – Does it Hurt? People with diabetes are subjected to a plethora of misconceptions about the disease, its origins and its treatment. It doesn’t help, therefore, to have prime time television dramas that include ludicrous storylines that only serve to further confuse and obfuscate the realities of living with diabetes and likely problems encountered.

I used to think that dramas were well-researched – particularly by the BBC – and that all that medical jargon that flows from the mouths of all our favourite medics on Casualty would possess a high degree of accuracy if compared to ‘real life’. Sadly, that notion has been undermined severely since I became more acquainted with the world of hospitals, medicine, and diabetes in particular.

It seems that the potential hazards of living with diabetes, coupled with a scriptwriter’s inadequate knowledge and research, or ‘artistic license’ to twist the truth, provide a rich vein of dramatic storylines. On one particular episode we were presented with the tale of a young girl caught up in some sort of bizarre boating accident. The girl was diabetic, Type 1, and had unfortunately been parted from her insulin in the course of the accident and it now lay attracting the attention of the deep water fish of some fictitious lake.

So what, you might think, diabetes is a common enough ailment and insulin is readily available in every pharmacists and hospital in the country. Ah! Not ‘Bentillin’, unfortunately, this is a uniquely formulated insulin that has no history of animal origin or testing, and is only available at Jacob’s Chemist in Penzance! From this point the storyline becomes ever more ludicrous, with the girl rapidly descending into diabetic ketoacidosis (DKA) and heading for coma. This, despite the fact that she probably hasn’t eaten anything since the accident so has no food digesting to boost her blood sugars. Of course, the reason must be that ‘Bentillin’ is a single-speed insulin – it must be, since this is the only insulin she (and her father) will accept, and therefore her blood sugar levels are being rapidly driven up by her liver with no insulin on board to cope with it. Oh dear! Why am I trying to rationalise this? The scriptwriter clearly didn’t!

There follows a moral dispute between the doctors and the girl’s father over whether they should administer ‘ordinary’ insulin, with a young doctor eventually taking it upon himself to administer this and she rapidly (instantly!) recovers! Becky kindly provided a transcript of the storyline in this post.

OK, it’s a TV soap-drama and most of the detail will have passed completely over the head of most people watching. Without the complete invention of something that doesn’t exist (Bentillin), however, there would have been no storyline at all. Joe Public, would have been left with the impression, however, that the story was fact-based and that there exists a chemist in Penzance that is the only provider of an insulin suitable for animal rights diabetics. Sadly, we have yet to see a diabetic storyline in any drama that matches reality – there is usually some dramatic device that leaps completely away from reality and invalidates the whole storyline. Neighbours, Eastenders, Home and Away, Coronation Street – all have had diabetic storylines that are either mangled versions of the truth, or conveniently forgotten once the focus has moved away.

This led me to the conclusion that Jacob’s had somehow perfected a blend of insulin and clotted-cream ice cream in some sort of cottage-industry medical facility, and wished to retain the monopoly by refusing to share the secrets of the process with the wider community – illustrating once again that the often ludicrous topics raised on the forum are rich pickings for poetic inspiration!

Post link: http://www.diabetessupport.co.uk/boards/showthread.php?t=6566

Number 13 - How long diabetic?

Diabetes, as far as we know, has been known about for thousands of years, but it is only in the last hundred years that it has been understood what it actually is, how it can affect the body, and how it can be treated. A hundred years ago someone with diabetes would either live a shortened life, eventually going blind, having kidney failure, limbs amputated, a heart attack or stroke or falling into a diabetic coma. This would have been the case for what we now call ‘Type 2’ diabetes. There were, of course, far more acute cases, usually in the young, where the patient would become quickly emaciated and probably die within months – what we now know as ‘Type 1’ diabetes. Usually, those with Type 1 would not live long enough to develop the longer term complications exhibited by Type 2s.

Then, in 1922 Drs Banting and Best isolated the ‘missing link’ that could finally be used as a treatment for diabetes – insulin. It was seen at the time as a miracle cure, although now, nearly eighty years on from that discovery, we know that it is a treatment for the symptoms and not a cure. There have been many developments over the years, with new techniques, new insulins, oral treatments for some types, advances in testing equipment etc. – all these have made the daily control of blood sugar levels tighter and more manageable, and the advances continue apace.

Having only being diagnosed a couple of years myself, I have been very interested to hear the experiences of those members who have lived with the disease for many years – even decades in many cases. This post shows what a huge range of experience we have on the forum, ranging from days, weeks and months to over half a century since diagnosis. Interestingly for the forum, it is not always the case that these long-term diagnosed people have the greatest knowledge. Often, they have grown up with diabetes and stuck to what they have always known, whether by accident or design, and it is fascinating to see how things that would be commonplace knowledge to more recently diagnosed people is a complete mystery to them. Through no fault of their own, it's likely that their doctors may have had the misguided belief that they ‘already know it all’ and have not sought to educate them on the latest advances.

It is only thanks to the medium of the internet that this information is now becoming widely available to all, and through forums like ours, experiences can be exchanged like never before. Many people with over 30 years of diabetes had never met another diabetic and it is great to see these experienced people join in our community, often transforming their lives in the process.

Post link: http://www.diabetessupport.co.uk/boards/showthread.php?t=4554