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Negative Stereotypes About Type One Diabetes

Diabetes is a chronic illness that’s making its presence known with now over 29 million

Americans living with it daily. Type one occurs, mostly in young adolescents, when islet cells in

the pancreatic region are attacked through what is believed to be a strain of an unusual virus. The

virus then diminishes the pancreatic cells ability to produce insulin at a consistent, normal rate.

Without this ability, the individual who is diagnosed must care for themselves by checking their

blood glucose levels and making necessary adjustments based on the data. Synthetic man made

insulin has to be injected either through an insulin pump, a syringe or an insulin pen. The amount

of insulin is determined by 2 rations. The insulin to carb ratio and the correction ratio.

The insulin to carb ratio is determined by the number of units of insulin needed to

accommodate a certain number of carbohydrates. As a type one myself, my insulin to carb ratio

is 1:7, which means for every 7 carbohydrates, one unit of insulin is required. A simple math

equation is done before each meal time to add the amount of carbohydrates in the meal, and

dividing it by the ratio. There is no science to determine this ratio, it’s simply a trial and error

basis. These ratios vary for each individual and can require adjustments. The correction ratio is

required when the blood glucose level is above range. A target number is selected, for example

during the day, my target glucose is 120 and overnight the target is 150. When the blood glucose

is above target, it is subtracted by the target number, then divided by the ratio. For example, if

someone’s blood glucose is 250, their target is 120, and correction ratio is 1:30, you would

subtract 250-120 which gives you 130, then divide by 30 which leaves you with a total of 4.33

units of insulin to be injected.

When a blood sugar is to low, also called hypoglycemia, there is a surplus of insulin in the

body and not enough carbohydrates to cover for it. Symptoms include dizziness, hunger,
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Negative Stereotypes About Type One Diabetes
weakness or fatigue, shaking and impaired vision. In order to treat, fast acting sugar has to be

consumed immediately. Most common treatments are glucose tabs, glucose shots or juice boxes.

If a low blood sugar is left untreated, it will result in the individual falling unconscious, having a

seizure, and most likely result in death. There is a tool called glucagon, a large syringe filled with

sugar that stimulates the liver to release all of the glucose built up inside. The glucagon is only to

be administered if the type one diabetic is having a seizure.

On the other hand, when the blood sugar becomes too high, or hyperglycemia occurs, there

was more carbohydrates consumed and not enough insulin to cover. Symptoms are extreme

thirst, frequent urination, nausea and blurred vision. To treat this, a correction must be done with

insulin and the correction factor. If left untreated, the individual will begin to lose circulation in

limbs and will eventually result in amputation. The individual could also enter into DKA, or

diabetic ketoacidosis. DKA happens when the body becomes so desperate for something to

breakdown the sugar, that is begins attacking and eating at the fat cells. This can get to the point

of the individual to become fatigued, and lose consciousness.

There is no current science behind the diagnosis of type one. Symptoms mimic the flu, and

individuals are often misdiagnosed. During my diagnosis, I developed a fever and virus during

March, and after that continued running under the weather. I had ear infections, was drinking

water by the gallons, and had severe chronic exhaustion. It wasn’t until my 8th trip to my primary

care doctor that sparked something in them to check my blood sugar. Medical researchers have

no known cause or cure for type one diabetes. It is believed that a virus causes the cells in the

body to attack the pancreas, but nothing is confirmed yet. Insulin is considered a therapy remedy

for treatment, but no cure will be found until a functioning pancreas can produce insulin without

getting rejected by the body.

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Negative Stereotypes About Type One Diabetes
One of the largest obstacles in regards to living with type one diabetes is the stigma. There are

multiple types of diabetes. There is type one, as we know, type two, gestational and prediabetes.

Type two diabetes occurs when a person consumes more carbohydrates than the body can

handle. The pancreas begins to slow and additional insulin has to be taken to aid the pancreas.

This type can be brought about by genetics, lifestyle and diet, it can be cured with proper

management of diet and exercise. Gestational diabetes occurs when a woman is pregnant, she

becomes diabetic for the duration of her pregnancy, once the baby is born the woman returns to

normal. Gestational diabetes can be very dangerous for the fetus and the mother. Prediabetes is

when someone has an unhealthy lifestyle and is at risk for developing type two or gestational

diabetes.

“I have learned that most patients and their families want, not only to acquire information

regarding their diseases and treatment options, but also to be understood by those caring for

them, to have their social circumstances recognized, their cultural values respected, their fears

and anxieties, aspirations and dreams acknowledged. Through a fusion of clinical information

and mutual understanding, they strive to develop a helpful— even healthful— perspective on

their medical conditions, on the predicaments these conditions create, on the meaning of their

lives now altered, perhaps permanently, by illness” (Feudtner, 2003). This quote coincides with

the diagnosis and stigma of living with type one diabetes as a chronic illness. Not only do

patients yearn for strong, accurate and affordable medical care, but they need their social

standards justified and validated. Without that validation and the continuing negative stigma, the

chance of a diabetic not caring for themselves properly skyrockets.

The stigma associated with diabetes is that they are all overweight, lazy individuals who self-

inflict the chronic illness on themselves. One of the biggest perpetrators of this stigma is the
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Negative Stereotypes About Type One Diabetes
mass media, and media outlets such as T.V., social media and magazines. Satire and negative

connotations are used to create humor about those living with diabetes, which takes away the

credibility of the difficult work that they endure every day.

One of the largest fitness corporations, Cross Fit, tweeted a picture of a bottle of Coca-Cola

this past June (reference tweet in appendix A), with the caption “Open Diabetes” This triggered a

feud between individuals living with type one, medical professionals and employees of CrossFit.

By posting this online, as a fitness website, they proposed the assumption that those who drink

Coca Cola are unhealthy and will become diabetic if they continue on this lifestyle. Medical care

professionals grew angry from the broadness of the words get diabetes, without classifying

which type and how they would eventually become diabetic from soda. People living with type

one became angry because all of the stress, pressure and overall health that they have to deal

with and manage everyday suddenly becomes less credible and more of a joke to society.

Family Guy as well as Parks and Recreation are shows in which use diabetes as a main source

of humor very frequently. There is one episode of Family Guy in particular in which a small

overweight, and very out of shape boy is named “Diabeto” and is shown shoveling food down

his throat and being so overweight that he is unable to walk. The scene begins when he yells to

his mother to see if he can have a sugary, unhealthy snack. She tells him no and orders him to

roll back into the kitchen. This implies that he lived a very unhealthy, inactive lifestyle that

resulted in his lack of ability to walk as well as bring a dark humor to child obesity and type two

diabetics.

Parks and Recreation, a show that is a spin-off of The Office, uses diabetes frequently when

explaining that their town is the 2nd most obese in America. They go as far as to prove

throughout the series that they all love a local breakfast shop, and show an episode where they
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boycott the local government at the thought of installing a new salad shop. There would never be

a case this offensive, and diabetics, of each form, work hard to maintain their health and would

never “boycott” something that would benefit them. It continues to promote that link of diabetes

= obesity and unhealthy, which is completely false.

Hollywood can be overdramatized in each aspect, so some diabetics don’t get upset over the

shows that have incorrect portrayal. One of the most devastating moments was when the Center

for Disease Control and Prevention listed a list of statistics in regards to facts about those living

with diabetes. However, they never specified the different types of diabetes nor did they

differentiate that data. Due to the status and expectation that is demanded of the Center of

Disease Control and Prevention, this seemed unprofessional, uneducated and unethical.

Health campaigns are a major market for pharmacist and using mass media as a form to

relate information back to consumers and viewers. Pharmacists and scientist will consistently

release ads, commercials and short clips online when a new product becomes available. These

ads can be useful, but again cause confusion and a negative connotation with different illnesses.

All of the commercials for diabetes products refer to the people starring in them as diabetics, and

again do not classify the different types of diabetes. There has been research done that referring

to someone as a diabetic may instill negative emotions about being “sick” so to speak.

“The term "diabetic" has been used freely to describe people with diabetes. But the word

"diabetic" should be used as an adjective, not as a noun. It is acceptable when discussing

conditions of diabetes, such as diabetic ketoacidosis, or diabetic nephropathy, neuropathy, and

retinopathy. "Diabetic" describes the condition, not the person. Although "diabetic" is also,

technically, a noun, it should not be used as such when referring to a person with diabetes. Using

"diabetic" as a noun unfairly labels people with diabetes, and it implies that all patients with
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diabetes are the same. As a noun, it has a negative connotation and is seldom used in a positive

tone. I have never heard a health care provider say with joy, "I specialize in treating diabetics. I

find my job rewarding and would not want to do anything else." Instead I hear, "I have this

diabetic, Mr. Jones. His A1C is 9.3%. Go fix him."”(Peters 2012). This quote exemplifies the

importance of making sure the label diabetic doesn’t continue to trigger this negative

connotation.

This ties in several theories throughout health communication. Patient- provider relationships,

social support, health campaigns and health literacy are the key aspects to hone in on when

analyzing the portrayal of diabetes in the media.

Health literacy is an overall factor that can be applied to nearly every concept. It is defined as

one’s ability to understand medical terms or the knowledge of healthcare as a broad topic. In

today’s society, most health campaigns and conversations regarding health are required to be

presented at a 5th grade reading level, since that is the national average for understanding the

terminology that they are presented with. Medical staff clearly have a deeper understanding of

the terminology, and illness, which is why their explanations to patients are so crucial in how the

patient will manage themselves.

When individuals living with type one diabetes feel unappreciated, or mocked from the

media’s portrayal, and the nation’s lack of understanding, they may feel less inclined to want to

take care of themselves which could lead to burnout. There are so many campaigns that are

beginning to help alleviate this possibility. One of the biggest concepts is when it is tied into

patient provider relationships. The provider and the family of the diabetic are truly the only ones

who fully understand the situation that the patient is in. If the patient is struggling, it’s up to the
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provider to relate to the best of their ability to the patient, and not only explain their form of

diabetes, but the other forms as well and link the connection of how the rest of the nation makes

mistakes in judgement calls about people living with the various forms.

This ties into support groups. Recently, many camp grounds have opened up to offer camping

incentive programs to kids living with type one diabetes. The duration of the camp stay involves

games, meal time when everyone takes their insulin together, and information sessions on the

diabetic stereotypes, and what we can do to break those stereotypes. These camps are set up to

create leaders for the kids attending and help normalize their experience by having them check

blood sugars and administering insulin together. They also give leadership skills by allowing the

kids to brainstorm new ideas for health campaigns, and ways to help educate society to break the

stigma. Having a social support network is empowering and inspiring for those living with

diabetes to really try to manage their health and use their friend network as a system to lean on

during difficult times.

Health Campaigns are currently being used and are part of the infiltration of the stigma of

type one diabetics in society. There is a diabetes health campaign commercial in which a woman

discloses her diabetic nerve pain and explains how she used a new type of medicine to treat it.

What wasn’t explained was how for gestational diabetics, the nerve pain can have links to the

baby and issues directly with the pregnancy. For type two’s it could be a matter of blood sugar

management and the less controlled it is, the more likely an amputation is to occur. For type one

diabetics it could be a result of a patterned history of high blood sugars. Health campaigns of this

nature indicate to uneducated viewers that all diabetics have nerve pain, and continues the stigma

that there’s a slim difference between the various types of diabetes.

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Overall, individuals living with diabetes, whether its type one, type two or gestational, deal

with a great amount of frustration for uneducated assumptions and negative connotations that

people assume coincide with being diabetic.

With today’s progressing society, the social networking we use, and health campaigns, we

can work together to end this stigma and allow for equal and just representation of chronic illness

in the media. I hope to see the Center for Disease Control and Prevention work closer with

Hollywood producers to ensure that the facts being spewed out to them during shows are

accurate, and non-judgmental.

Health campaigns should continue to spread the word about new remedies, medicines and

treatments, however they should differentiate what strain of diabetes, or chronic illness they

have, to ensure that the viewers will understand the difference, and the stigma will begin to fade

out.

As someone who lives with type one diabetes, one of the most serious illnesses, I can first

hand confirm that with the questions I’ve been asked, we need to help reeducate our society and

use the media outlet that is causing so much damage to do so much good and reinstate that

education. There is so little education, a national reading level of 5th grade that viewers and

consumers from these advertisements, usually end up believing things that repetitively occur. ,

We also need to continue funding camps and social support groups for adults living with type

one. By implementing these changes, we can have a more educated public and more empowered,

leaders living with diabetes to take initiative on new programs.

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Negative Stereotypes About Type One Diabetes

References

Feudtner, C. (2003). Bittersweet. Chapel Hill: The University of North Carolina Press.

Retrieved from http://ebookcentral.proq uest.com/lib/bryant/detail.action?docID=41327

Fox, C. (2005). Vital diabetes : Your essential reference for diabetes management in primary

care (3rd ed. ed.). London: Class Pub.

Hanas, R. (2004). Type 1 diabetes in children, adolescents and young adults : How to become

an expert on your own diabetes (2nd ed. ed.). London: Class.

Miller, T. A., & DiMatteo, M. R. (2013). Importance of family/social support and impact on

adherence to diabetic therapy. Diabetes, Metabolic Syndrome and Obesity: Targets and

Therapy, 6, 421–426. http://doi.org/10.2147/DMSO.S36368

Peters, K. R., PharmD. (2012). "Diabetic" and "noncompliant diabetic": Terms that need to

disappear. Clinical Diabetes, 30(3), 89-91. Retrieved from

http://bryant.idm.oclc.org/login?url=http://search.proquest.com/docview/1033046274?accountid

=36823

Turner, H. (2009). Oxford handbook of endocrinology and diabetes (2nd ed. ed., Oxford

medical handbooks). Oxford: Oxford University Press.

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Negative Stereotypes About Type One Diabetes

Appendix A

Above is a screenshot of the tweet sent out by the CEO of CrossFit, which instills a stigma that
too much soda can cause diabetes, and does not specify which variation of diabetes, nor how
soda can affect it. Nick Jonas, current celebrity, who is also a type one diabetic, took it upon
himself to stand up for the diabetic community.
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Appendix B

The photo above is from Deviant Art, and depicts the famous scene in family guy where the
obese child asks for cookies, then is told no and to roll back into the kitchen by his mother. This
sets up a stereotype that diabetics are too lazy to walk, always crave sugar and eat unhealthy all
the time, as well as have a basic lifestyle of food and little physical activity. The scene ends with
Diabeto shoving an abundance of pies into his mouth at once.