A new PBS documentary sounds the alarm about a public health emergency that was here before coronavirus and will need America’s attention after we push though the COVID-19 outbreak: the diabetes epidemic.
“Blood Sugar Rising — America’s Hidden Diabetes Epidemic,” a new 2-hour film narrated by actress S. Epatha Merkerson and released on PBS stations on April 15th, asks, “Why isn’t there a war against diabetes?” It demonstrates why we need to fight that war.
What makes this film different from other recent documentaries on the rising rate of diabetes — like “A Touch of Sugar” or HBO’s “The Weight of the Nation: Obesity and Type 2 Diabetes” — is that “Blood Sugar Rising” has the backing of the nationwide PBS platform. Millions of Americans will hear its stark warning that “it is now predicted that half of the U.S. population will have either diabetes or pre-diabetes by 2025.”
The film also stands out because it is very ambitious, covering a lot of territory in about 2 hours. It showcases compelling stories of people wrestling with diabetes management and trying to fend off complications, fighting social and economic problems that contribute to the epidemic, and working on new technology to bring hope to our D-community.
I learned about this film from a relative who is committed to diabetes education and is working to bring audiences to “Blood Sugar Rising.” I told her I would candidly share my views about it with the diabetes community. My verdict: thumbs up. Tell your non-diabetic friends and family to watch it.
Threaded throughout are messages that diabetes educators and activists have been conveying for quite some time, but too few people understand:
- It’s really bleepin’ difficult for people with diabetes (PWDs) to manage this disease, but if we don’t work at it, we’re going to suffer serious, possibly deadly consequences.
- It’s not our fault (neither type 1 nor type 2 diabetes). Stop the victim-shaming!
- America needs to do something about the socioeconomic problems that contribute to the rise of diabetes and its complications, including the lack of access to healthy food and the outrageously high cost of insulin.
Judith Vecchione, the film’s executive producer and an executive at WGBH in Boston, tells me she is very passionate about informing Americans about the realities of diabetes. She wants to “start a conversation” about what this country should do about it.
Vecchione has vivid memories of her grandfather coping with type 2 diabetes. When she started to see TV ads for diabetes products in early 2010s, she grew more intrigued about a disease that the general public didn’t understand very well. Eventually, she teamed up with writer-director David Alvarado and producer Jason Sussberg of Structure Films, and they took more than 2 years to make an ambitious documentary.
Regular readers of DiabetesMine will be familiar with some of the advocates and experts in “Blood Sugar Rising.” They include diaTribe editor Kelly Close and D-dad Ed Damiano, the developer of the “bionic pancreas” project, which the film uses to exemplify the race for new automated insulin systems. But the most memorable segments are the personal stories of lesser-known folks like Monteil Lee.
We watch Lee, an aspiring rapper with type 2 diabetes from the San Francisco Bay Area, trying hard to prevent an infected toe from getting amputated. He says he had difficulty managing his diabetes after diagnosis, as he grew up in a sugar-saturated environment and liked eating sweets and candy — not that this directly causes type 2 diabetes, of course, but it can be related to developing the condition.
The point is, Lee struggled to change his eating habits to keep his blood sugar in check. The film shows him trying to stay off his foot and follow his eating regimen with the encouragement of his supportive physician, Dr. Dean Schillinger of University of California, San Francisco, who also appears in “Blood Sugar Rising” as an eloquent diabetes activist.
Equally poignant is the depiction of Nicole, a T1D who has experienced a “list of complications’’ — including kidney failure. “I skipped insulin injections and ate whatever I wanted, pretending that I wasn’t a diabetic,” she tells viewers. While the film doesn’t clarify that some PWDs who take good care of themselves also develop complications, Nicole’s story is a valuable lesson about the price of diabetes denial.
“Blood Sugar Rising” also deftly covers the way our economic and healthcare systems, food insecurity, and poverty are contributing to the increase of type 2 diabetes in many communities, especially among people of color.
We meet Karen Young-Washington, an African American woman from the Bronx whose brother died of diabetes complications in 2010. She brings children to a local New York “Garden of Happiness” that she helped to start. There, she teaches kids about healthy food and where it comes from, and how good nutritional habits can help prevent T2D, which is sweeping their community.
“This is a tale of two cities,” she tells us. “Here in the Bronx, we are surrounded by unhealthy food. We have bodegas — racks of cookies, candies, cakes, and sodas. Go into more affluent neighborhoods, walk into a store, and there are vegetables [and] healthy food options.”
As the cameras pan the grocery shelves in both “cities,” it becomes clear why diabetes disproportionately impacts African Americans, Latinos, and other minorities. That’s a setup for the point made by Dr. Anthony Hatch of Wesleyan University: “Our genes do not exist in a vacuum. They only do what they do in a given environment. We’ve got to turn back and look carefully at the environments we live in, how they are structured to create inequality.”
On the other hand, rural communities are also being ravaged by diabetes. In another segment, we watch Laura Grueser, a health worker in Meigs County, Ohio, counseling and cajoling white neighbors with T2D. She shops and dines with them as she coaches them, gently and sweetly, on how to reduce and maintain level blood sugars and lose weight.
“Here in our little neck of the woods,” Grueser explains, “we show love to each other with food… We don’t get together unless there’s food. And usually it’s not really good choices. It’s a heavily diabetic area… and one of the reasons is the lack of natural food.”
The documentary also doesn’t shy away from addressing the dangerously and ridiculously high price of insulin. It tells the tragic story of Alec Smith, a T1D who died when he aged out of his parents’ insurance plan, couldn’t afford insulin, and tried to ration it. His parents, Nicole Smith-Holt and James Holt Jr., have garnered a lot of media attention as advocates fighting to make insulin more affordable, but Alec’s story can’t be told too many times.
In “Blood Sugar Rising,” Big Pharma executives get a chance to explain why they’re not responsible for tragedies like the one that devastated the Smith-Holt family. The film briefly touches on the complicated insulin pricing system and the role of Pharmacy Benefit Managers (PBMs) in propping up the medication’s cost.
But in the end, insulin manufacturers don’t come off very well, as the documentary shows activists preparing “Insulin4All” T-shirts and the Smith-Holts speaking out at a rally against big insulin maker Eli Lilly.
You can see portraits of some people featured in the film on this PBS link, the TV viewing schedule can be found here, and you can purchase the film on DVD. PBS has also launched an online campaign, “Portraits of an Epidemic,” which urges PWDs to share their photos and a sentence about their experience. You can also follow their new hashtag #BloodSugarPBS.
All in all, “Blood Sugar Rising” doesn’t answer the important question articulated by Kelly Close: “Why isn’t there a war on diabetes?” But it sure comes across that executive producer Vecchione clearly believes that war is necessary.
“As we consider the world after the coronavirus, we as a country need to do a much better job in taking on diabetes,” Vecchione told me. “We need more research, more education, more access to healthy food, more understanding of the role of poverty and race.”
Let’s hope America agrees with her.
Dan Fleshler is a writer and media strategist in New York City. In 2013, he started a blog called The Insulin Chronicles to share mysteries encountered and lessons he’s learned from living with type 1 diabetes since 1962.
Over the last two decades, his op-eds and feature stories have appeared in the New York Times, Village Voice, Forward, New York Jewish Week, Ha’Aretz, Reform Judaism magazine and elsewhere.