A Letter to the Writers

In my current class, I had to write a paper on an issue important to me. I wrote about the misrepresentation of T1D in the media platform of television. I wasn't going to share it but what's the point of writing a letter wanting a change and not sharing it? So here it is, I hope you all enjoy! 

To Whom It May Concern:

          My name is Hannah Giffin and I am writing to you regarding an ongoing issue in the media which needs to be addressed; the misrepresentation of Type 1 Diabetes and Diabetes in general. As a writer for a television network who creates the scripts for television shows, you make influential decisions about what goes into the scripts and what is said on television. What many don’t understand is that the misrepresentation of diabetes can be a leading cause of depression and extreme mental health issues in diabetics. In this letter, I will present you with compelling information that will show the effects of diabetes “jokes” in the media and their impact on people living with the disease. I know that there is also a lot to be said on behalf of Type 2 Diabetics and how this affects them, however I will be shining a light on Type 1.

            Type 1 Diabetes is a disease that many don’t even know about. They hear “diabetes” and immediately think of Type 2 without even knowing it. According to the American Diabetes Association (ADA), “In type 1 diabetes, the body does not produce insulin. The body breaks down the sugars and starches you eat into a simple sugar called glucose, which it uses for energy. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body.” Regarding Type 2, the ADA states, “If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. Over time it isn't able to keep up and can't make enough insulin to keep your blood glucose at normal levels.” As you can see, they are in fact different. With Type 1 diabetes, the organ called the pancreas does not create insulin at all, while with Type 2, the patient has built up a resistance to the insulin their body produces. Type 2 Diabetes can be caused by obesity. With obesity, fatty tissue releases fat molecules into the blood, which leads to resistance to insulin. In a recent interview, Taylor Lookofsky, an associate therapist who is also a Type 1 Diabetic, told me, “As a Type 1 Diabetic, many people assume that I cannot eat sugar or that sugar is bad for me and many people say ‘you can’t have sugar’ or ‘isn’t sugar bad for you?’ These interactions can be very frustrating at times because being a Type 1 Diabetic doesn’t mean I cannot eat certain things, being a Type 1 means I have to be a little more cautious.” (2018)

            Now that you have some background on the difference between Type 1 and Type 2 Diabetes, I will tell you a little bit about what these jokes are doing to your audiences. In episode 4 of the second season of Fuller House, juvenile diabetes (another name for Type 1 Diabetes) was referenced as candy was being handed out at Halloween. Juvenile diabetes is another name for Type 1 Diabetes, which means that the Halloween candy would not cause juvenile diabetes. If candy was consumed all day, every day, for years, it is possible one could develop Type 2, but the assumption or inference that it could cause juvenile or Type 1 Diabetes is incorrect. In an episode of Big Bang Theory, Penny is talking to a customer and says, “well as a waitress, sales was a big part of my job, and believe me I convinced a lot of very large customers who should not be eating cheese cake to have more cheese cake and one of those ‘chubbsters’ had an insulin pump.” Insulin pumps are used for Type 1 Diabetics, while Type 2 Diabetics take medication in the form of pills to increase their sensitivity to the insulin their bodies produce. Type 1 Diabetics are able to eat anything they please as long as they give the correct dose of insulin. My doctor told me that my disease is not defined by my diet, but by my lifestyle. No person, diabetic or otherwise, should eat cake for three meals of the day, but I can have a slice at the birthday party. In the show EastEnders, Kim Fox said, “If the kids don’t give themselves diabetes, it’s not a good party is it?” As explained regarding the previous two examples, no amount of sugar will cause Type 1 Diabetes. One of the biggest issues in writing for the media is not specifying which type of Diabetes is being referenced. I have a list of at least eight more examples, but I think I have sufficiently stated my point. The bottom line is Type 1 Diabetes has absolutely nothing to do with sugar, eating too much, or body weight. When I was diagnosed at 11 years-old, I weighed under 70 pounds, but the day I returned to school, I was called fat and have been picked on ever since for my disease and weight. Dealing with diagnosis alone for any Diabetic, Type 1 or 2, is hard. Dr. Jen Nash said in the Book ‘Diabetes and Wellbeing’, “Many people struggling with the diagnosis of diabetes oscillate between a number of stages for many years, getting stuck at denial, or between anger, bargaining and depression, perhaps with small acceptances along the way.” (2013). Depression and diabetes is real and stems from misrepresentation and misunderstanding. The Journal of Pediatric Nursing conducted a screening of adolescents with Type 1 Diabetes and “After 4 months, a total of 142 adolescents with T1D were screened, 12% scored above the cut-off score requiring referrals including 8 adolescents with suicidal ideation.” (2014). I conducted a survey of 32 of my friends who have Type 1 Diabetes and out of the 32, 24 reported having depression in a moderate to severe form. Conor Warme, a 22-year-old who has been living with Type 1 Diabetes for over 18 years and has struggled with depression over this disease, told me that misrepresentation “was a big contributor to my depression for years. To this day I'm still trying to break the bad habits I formed when it got really bad because of it. My parents always used to tell me how when I was first diagnosed I cut myself off because I felt so different. That made me a lonely person and paved the way for my depression. A big reason I did that is because I didn't feel like people would understand it since it was and is so poorly talked about and educated upon.”

            I understand you may think that the jokes are okay to use because you’re talking about Type 2 Diabetes and you would never want to make fun of a disease caused by organ failure, not by obesity or sugar; but how can we stop the confusion? In the past, after every mishandled reference to diabetes in the media, there is uproar. Writers and producers get backlash from angry viewers when they feel attacked. There are often apologies issued, but the damage is done. Let’s solve this together so both writers and Type 1 diabetics are no longer hurt.

Let’s revisit Penny from Big Bang Theory referencing a “chubby” man wearing an insulin pump. An insulin pump is like a portable IV of insulin; Insulin pumps deliver rapid- or short-acting insulin 24 hours a day through a catheter placed under the skin. They are used for Type 1 Diabetics as an alternative to giving a shot of insulin every time they want to eat something.

      

     

      Above, Figure 2, is a photo of what an insulin pump looks like and how it works. In severe cases of Type 2 Diabetes, an insulin pump may be recommended, but they are primarily used as a treatment for Type 1 Diabetes. Jokes like Penny’s demonstrate that writers are uninformed about the issue. I don’t see how any disease could be a punch line, Type 1 and Type 2 included, because this is someone’s life. You are making fun of someone and diseases from which they suffer. My father, who is also a Type 1 Diabetic, gave me a statement about jokes in the media, “People are ignorant and so is the media. There has never been a distinguishing campaign between Type 1 and Type 2. Jokes are made and no one realizes that the two are completely different. It is unfair and isolates a Type 1 and makes them feel unrecognized and misunderstood.” We need to make a change for the well being of the youth and adults with this disease. This issue is very personal, and important to me; when Fuller House made the comment about Danny leaving pamphlets about Diabetes for trick or treaters, I contacted the creator of the show and he apologized and promised me they would be more careful in the future, I have attached a screenshot of said response.  (Figure 3)

            I hope this letter has educated you for the better. My goal is to shine light on the misrepresentation and misunderstanding of Type 1 Diabetes and the difference between Type 1 and Type 2. A disease, Diabetes or not, should never be the brunt of a joke. If this joke were about something like cancer, I suspect you would never use it for a laugh in your show. Please respect those who suffer every day, being made fun of in the media. My suggestion is to remove these types of jokes all together; there are many jokes in the world that are much more funny than my disease. Together, we can help each other to benefit from this misunderstanding and emerge with a positive experience. We can all still laugh, just not at the expense of people living with a disease.

Thank you very much for reading this. I hope you will have a change of heart when you go for the next punch line.

Sincerely,

Hannah Giffin

Citations

• “Type 1 Diabetes.” American Diabetes Association, www.diabetes.org/diabetes-basics/type-1/.

• “Type 2.” American Diabetes Association, www.diabetes.org/diabetes-basics/type-2/?loc=util-header_type2.
• Atkinson, Eisenbarth, & Michels. (2014). Type 1 diabetes. The Lancet, 383(9911), 69-82. Found through ASU Library

• “Grabinoski, M. (2017). 003–Screening for Depression in Adolescents with Type 1 Diabetes Mellitus. Journal of Pediatric Nursing, 34(C), 102.”

• Lookofsky, Taylor (2018, May 24) Personal Interview;

• Nash, J., & Ebrary, Inc. (2013). Diabetes and wellbeing managing the psychological and emotional challenges of diabetes types 1 and 2. Chichester, West Sussex, U.K.: Wiley-Blackwell.
• Survey Monkey, (2018) I conducted a survey through this website to receive anonymous answers.