Earlier this month, BBC show The Syndicate was criticised for its misleading portrayal of diabetes treatment, but it is not the first (or inevitably, last) example of dodgy diabetes representation.
Be it in television or Hollywood blockbusters, there have been many occasions in which inaccurate diabetes research or poor explanations have added needless confusion to scenes.
We’ve researched some of the more puzzling storylines and scenes that got diabetes wrong, and how they could have been improved.
The most recent diabetes blunder comes courtesy of Kay Mellor’s popular drama, The Syndicate.
In the last episode of series three, diabetic character Amy was suffering hypoglycemia (low blood glucose levels). A chap called Spencer then administers her insulin, which is going to reduce her levels further and could bring on a coma.
Naturally, following contact from leading diabetes charity JDRF, the BBC issued a statement: “We regret if we have given the impression to some viewers that low blood sugar should be treated with insulin.”
It was Mellor’s explanation of the incident that provided the most perplexity, though. In a statement to Mirror TV, issued on behalf of Mellor and Rollem Productions, a bizarre amount of distance was put between Mellor and her duty to properly convey diabetes on screen.
“First of all can I just say, although I researched and spoke to people who were diabetic, the drama is purely fictional. And like any dramatist I have to take dramatic license sometimes to make the story work.
“Also we have no idea what the chemist said to Spencer or what he did as a consequence. We come up on him untying the yacht and sailing out to sea then administrating the insulin, but we have no idea how much time has passed.”
What? So, instead of actually specifying the correct treatment for a hypo, it’s up to the audience who may not be well versed in diabetes management to make up their own conclusion? The show may be “purely fictional”, but medical credibility is essential if you bring medical conditions into your show in the first place.
What should have been done? The show could have either had Amy’s hypo treated with glucose, or specify that a certain amount of time had passed before the insulin was administered. Failure to do so will have surely left a lot of people thinking that insulin can be used to treat a hypo.
That’s My Boy
Rarely is diabetes used for comedic purposes in TV or films, but writer David Caspe gave it a go in 2012 “comedy”, That’s My Boy.
“It’s insulin, you d***,” says Andy Samberg to his father, Adam Sandler. “I’m a diabetic ‘cause you let me eat cake and lollipops for breakfast every day. I weighed 400 pounds by the time I was 12. You know how hard it was to take that weight off?”
There’s a lot going on in that passage of dialogue. One thing that needed clarifying, though, was which diabetes type Samberg’s character developed.
It appears as though Caspe meant to refer to type 2 diabetes, which can be brought on at an early age, even as young as 12, but this certainly isn’t a laughing matter, anyway.
If it was type 1, then the line implies that eating lots of high-calorie, sugary food will give you type 1 diabetes, which is incorrect – as type 1 is an autoimmune disease.
What should have been done? Ideally, the line is rejected outright in the screenwriting process, as it’s not exactly a zinger, anyway.
Hansel and Gretel: Witch Hunters
This 2013 action-horror film is a bit of a shambles, at least in relation to diabetes.
After being force-fed candy as a child, Hansel (played by Jeremy Renner) contracts the “sugar sickness”, which requires him to regularly inject insulin.
However, this is a gross oversimplification of how diabetes is caused. As previously mentioned, type 1 doesn’t develop through overeating sweets, but while a high-sugar diet can increase the risk of type 2, a number of other risk factors, such as genetic predisposition, can be to blame and are not highlighted in the film.
Things get worse, though. Later on, Hansel becomes incredibly weak, which we are led to believe is due to high blood sugar. Thankfully, a shot of insulin later, and our protagonist is back to feeling himself again, despite rapid-acting insulin typically working after 10-20 minutes.
This sequence is particularly remarkable because diabetic ketoacidosis, a dangerous short-term complication from high blood sugar, usually takes days to develop. Having high blood sugar for a few hours, or even a whole day, will make you feel bad, but not to the point where you’re collapsing in a stairway.
Moreover, Hansel doesn’t test his blood to confirm his blood sugar levels – admittedly, the delay in waiting for a reading might have restricted the film’s pace – but being on the verge of collapse so suddenly is much more likely to be due to hypoglycemia.
Of course, this surely can’t be the case, or Hansel wouldn’t have injected insulin.
Another point worth broaching is that insulin was discovered in 1922. While the film doesn’t stress which year it is set in, Hansel and Gretel was popularised in the 1800s, which may explain why there are no blood glucose meters around, but not why insulin is.
What should have been done? There was no need for Hansel’s baffling “collapse” moment, or the generalisation that eating too many sweets causes diabetes – regardless of other factors and diabetes type being referenced.
Nicolas Cage’s character, Cameron Poe, may be on a prison transport plane in which the prisoners are set to be released, but such is his good heart, should he have really been there at all?
Choosing not to escape, he helps his diabetic cell mate, O’Dell, who has had all his insulin and needles destroyed during a hijacking.
O’Dell is acting like somebody suffering a massive hypo. He’s sweating and panicked, but repeatedly claims how desperately he needs his insulin shot.
Turns out, O’Dell has missed his injection, and according to the film, is facing a life or death situation if he does not inject immediately.
As mentioned above, diabetic ketoacidosis does not develop instantly following a missed injection, and while O’Dell’s blood glucose levels would inevitably rise, the film’s suggestion that imminent death was due from this missed dose was erroneous.
Furthermore, if O’Dell’s blood sugar had been low prior to his scheduled dose, this would only reduce his levels further, and make things a whole lot worse.
What should have been done? This was an unfortunate portrayal of diabetes, especially as Con Air became quite a popular, well-liked film. The intention was admirable, one tends to believe, to include diabetes as a plot device, but it would have been more convincing if it had been days rather than hours since O’Dell’s last injection.
Which films or TV shows have you seen diabetes poorly represented in? Alternatively, have you seen diabetes portrayed in an accurate, commendable way? Let us know in the comments section below.
Picture credits: www.hitfix.com, www.mirror.co.uk, www.eonline.com, www.youtube.com