Media, the fear factor and a call to action in diabetes

“Going blind. Getting your leg cut off. Kidneys packing up. Dying of a heart attack. The implications of being diagnosed with diabetes are shocking. Yet it seems many of us keep ignoring the alarm bells, with rates of diabetes soaring across the globe.”

These were the headlines that the lovely Renza wrote about in her blog Diabetogenic earlier in the week.  “Starting an article about diabetes with a shopping list of scary complications is alarmist and pointless. There is no context offered, no explanation of what they mean, no statistics and no concern shown for those of us living with diabetes every day. It’s damaging, inconsiderate and irresponsible reporting.”said Renza. And I have to agree.

I did not read the original article at the time. I did not want to. I could tell just from reading Renza’s blog that I would be distressed and upset, even angry, if I clicked the link and had a look. But somehow, the article has taunted me the past couple of days. Yesterday showing up in my Twitter stream on SMH Lifestyle where I did give in, click the link, skim the article and quickly ran away back to the safety of my Twitter feed without really taking it all in. Other than that headline.

Late last night my lovely PR person sent me the link, saying it would be a good one to have a look at. “Ok universe” I screamed. I am supposed to read this and do something about it. So, I read it and now I also write, like Renza, in response.

The article states a lot of facts. A lot of things I agree with wholeheartedly. Diabetes is big. It is growing.  It is scary and (take it from me) it is very expensive.  However, in total support of Renza’s angle on this, the fear factor approach is not helpful. I know this to be true from personal experience. As a 12 year old I was told at diagnosis that I was a ticking time bomb. I was told that I would most likely end up with stuffed kidneys, go blind, quite likely lose a limb, especially if I ever dared to go barefoot, and would, most heartbreaking of all (and incorrect) never have a healthy baby.

So what do you think I did? Took notice and lived the life of a nun, a perfect diabetic (whatever that is)? Nope. At 14 I thought what the hell, if I am going down I am going down with a bang. I stopped self care. I did all the things I was told not to do, for a long time. I think this is a common story.

We know that people with diabetes (all types) have a high level of distress and depression. We know that a lot of this is due to the daily strain of managing a sometimes unmanagable condition coupled with worry and fear about the future and diabetes complications. Here at Diabetes Counselling Online we work closely with many people looking at the wellbeing of people living with diabetes. The Diabetes MILES study showed that 33 per cent of people with diabetes worry about the future and the possibility of serious complications. And as per Renza’s article, the authors say it is “consistently the foremost concern of people with diabetes”. I can confirm from a personal perspective of having spoken with literally thousands of people with diabetes and their families over the past 12 years, that this is definitely the case.

So what does a headline like that do to all the people out there who already live with diabetes?

There is a call out at the moment reminds Renza “for the Government to adopt a coordinated national diabetes strategy and fund programs to address the issues.” I would strongly add to this that there needs to be far more focus and resources sunk into mental health resources and services for people with diabetes to address these levels of distress among our community.
Professor Greg Johnson, chief executive of Diabetes Australia raises many important facts in the article such as ”sedentary lifestyles, easy access to processed food, weight gain and a multicultural society which includes people from high-risk genetic backgrounds, such as indigenous, Chinese, Indian and the Pacific islands are raising our numbers of people being diagnosed with type 2 diabetes.” This is a real concern and one that needs to heard and addressed in various ways.

Professor Johnson also raises a point that many people out there would not know, there’s no doubt weight gain is a big driver, but it doesn’t explain it all. ”There are thousands of people with type-2 diabetes who are a healthy weight and have a pretty healthy lifestyle.”  he says. This may come as a shock to many who stigmatise people with type 2 diabetes as being fat and lazy. Again another community attitude and one often in the media that is a big driver of distress and guilt.

The concerns raised about children developing type 2 diabetes and the increased risks of complications for this group of young people is a growing problem and a tragedy of our times. I remember some years back discussing this problem as it slowly started to happen and knowing it would grow. Again this is something we can do something about. Education is key, not headlines which scare people into hopelessness.

The idea of a “hard-hitting approach” raised by Mike Daube, a professor of health policy at Curtin University, is not a bad one. However there needs to be sensitivity about how this is tackled and I have no problem with campaigns tackling things like sugary drinks with hard hitting messages and a bit of shock, as long as there are clear messages about the risks to health, obesity and type 2 diabetes, without the usual murky messages about “sugar” causing every type of diabetes.

Fear factor style public health campaigns may work for other health concerns such as smoking and alcohol consumption or drink driving. But we are talking about trying to do two things here as far as I can see – reach the broader community and people who are at risk of type 2 diabetes to try and prevent them developing it; and reach people living with diabetes to try and prevent them developing complications. People choose to drink and smoke. No person ever chose to have diabetes. This is where general fear factor campaigns may do more damage than good. I also commend the article for defining the types of diabetes at the end. This is often not included and is a positive move.

And finally we fully support the call for a nationally co-ordinated plan on diabetes in Australia. Diabetes Australia has released its National Diabetes Strategy and Action Plan, focusing on early detection, management and prevention. This is a must read. Please have a look and join the call for this approach so that we can ensure not just better action on prevention which is vital, but better support, services and quality of life for those of us already living with diabetes in all its forms.

Helen Edwards

 

6 Comments

  1. Mel on August 9, 2013 at 4:38 pm

    I abhor the scare tactics campaigns, particularly around illnesses. The more things change, the more they stay the same though. We expect the media to be sensationalist but who remembers the $1m DA advertising campaign featuring billboards of amputated limbs and close ups of eyes being held open with metal clamps and other stuff, to remind us “Don’t ignore diabetes”. Then hps wonder why people with diabetes often suffer from depression, grrr.

    • Helen-Edwards on August 12, 2013 at 7:51 am

      so true Mel, it is a very tricky thing to find a balance with isn’t it…

  2. Renza Scibilia on August 12, 2013 at 11:59 am

    Thanks for the shout out, Helen. And thanks for also providing commentary on this issue.

    • Helen-Edwards on August 12, 2013 at 12:12 pm

      you are more than welcome, great article from you and this one would not leave me alone! 🙂

  3. Ian Graham on August 12, 2013 at 7:42 pm

    The black dog can be a companion to any medical condition. Especially one that is labelled as being an inexorable downward path to …. (you’ve said it upstairs). When it is then combined with another condition that normally is only partially reversable and usually ultimately fatal, that reverses much of the improvements you have made to your diabetes, the black dog tends to get you by the throat.

    Thankfully, my GP recognized the symptoms and took steps to alleviate them. My tumour has since more or less miraculously been killed and resected, and my diabetes is now back under control, although I am still on the ‘happy pills’.

    It’s a difficult line to follow with an education program trying to get people to notice what you are trying to say and get themselves checked for any signs of diabetes, without scaring the living daylights out of them and then giving them the heebie-jeebies if they are diagnosed. Keep the education going, but keep the threats out of it!

    As you’ve said elsewhere “… remember that diabetes is not a leading cause of blindness, kidney disease, stroke and limb amputation – it is unmanaged diabetes that is. Well managed diabetes is the leading cause of nothing!”

  4. Helen-Edwards on August 13, 2013 at 9:46 am

    thanks for sharing your story and wise words Ian, it is so true and it is a difficult balance for all of us, people with diabetes, family members and loved ones and diabetes health care professionals – at the end of the day I think we all want the same thing – healthy, happy lives 🙂 And totally agree re threats – leave them out!

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