What Netflix's Purple Hearts Got Right (And Sort of Wrong) About Type 1 Diabetes

I simply completed watching Netflix’s smash hit movie Purple Hearts. If you’re not conversant in it but, it’s a romance centered on Cassie, a younger girl who’s six months into her sort 1 diabetes prognosis. While at its core this movie is a love story, Cassie’s diabetes and her unbelievable battle with healthcare in America is the primary plot of the movie.

People within the diabetes neighborhood are saying it’s one of the perfect representations of diabetes in Hollywood historical past. So, did it reside as much as the hype?

If you intend on watching it, be forewarned, SPOILERS are arising!

WHAT THE FILM GOT RIGHT

For diabetes accuracy, this film excels! It describes what life is actually like for Americans with sort 1 diabetes proper now, significantly for lower-income people or these with part-time or freelance jobs. These had been the highlights:

The state of healthcare in America. This might be an important facet of the movie.

The film reveals what too many of us already know: that the price of insulin in America is astronomically excessive. Cassie must pay $300 for long-acting and $220 for short-acting insulins with out insurance coverage. $500-plus monthly is typical within the United States, if not decrease than common.
Because she will’t pay for all of the insulin she wants, Cassie finally ends up rationing insulin, a probably lethal technique that’s all too frequent within the U.S.
The pharmacy couldn’t refill her prescription early except she paid out of pocket, because the cashier acknowledged her “insurance wasn’t renewed.” While this time period isn’t one thing I’ve personally heard earlier than, the frustration and exasperation with an impossible-to-understand system could be very correct.
Cassie resides with enormous medical debt and being compelled to decide on between paying hire and shopping for insulin. The stress from her medical debt retains her up at night time — a lot in order that she’s keen to interrupt the regulation to get higher healthcare to afford insulin.

What life with sort 1 diabetes is actually like. Finally, a movie will get this largely proper!

This is the perfect Hollywood depiction of sort 1 diabetes that I ever bear in mind seeing. It sounds easy, however Cassie checks her blood glucose with a finger poke, squeezes out the blood to placed on a take a look at strip, and provides herself insulin — precisely what we actually do! So many motion pictures get this basic stuff fully fallacious.
While some of the scenes appeared overacted and exaggerated, it’s accomplished to make sense for these not residing with diabetes watching the movie. In basic, Cassie’s excessive and low signs are correct. She’s drained with blurry imaginative and prescient when she realizes she wants a correction. She’s wobbly and disoriented when her blood sugar is dropping.
She units an annoying alarm to verify she remembers to manage insulin. We know what it’s like once you overlook!
The film additionally will get a ton of tiny particulars proper. The approach Cassie turns the insulin vial the wrong way up and flicks the bubbles out of the needle. How she bends her leg and rests her arm on her knee to get the “meat” in her tricep to make it simpler to inject into her arm. I realized that trick once I was a child and have used it SO many instances in my life! If you’ve accomplished this earlier than, you recognize precisely what I’m speaking about.
She retains all of her diabetes stuff in her purse. If you regarded in my purse proper now, you’d discover a unfastened syringe and a backup bottle of insulin with perhaps 20 models left in it. Oh, and a juice field, fruit snacks, and a VERY previous granola bar that I’m certain have been there for 3 years. If you recognize, you recognize.
How excited she is to go on an insulin pump and steady glucose monitor (CGM) after struggling for thus lengthy with out the perfect instruments! Many of us bear in mind how thrilling it was to lastly win approval from insurance coverage for these costly however important units. Her joyful dance says all of it!
Keeping her pump in her again pocket and giving a fast correction bolus like we’ve all accomplished 100 instances.
Going low within the center of the night time after sudden exercise, and in addition seeing zero models of insulin on board (IOB) on her pump display screen when she couldn’t bear in mind the final time she ate. They undoubtedly received this one proper!

The know-how.

While her Medtronic pump and Guardian CGM aren’t the latest variations (the pump appears to be a 670G), they’re correct. The movie reveals real looking insertions of each the infusion and sensor websites.
You hear Cassie’s CGM alarm and also you see the studying: 68 mg/dL with a triple down arrow. I believe I can safely say that we’ve all had this expertise, the place your glucose simply drops so shortly that your CGM can’t even sustain. You’re fantastic one second after which all of a sudden you are feeling SUPER low and are stumbling round. This illustration is one hundred pc genuine.

The diabetes lingo. So many different motion pictures and TV reveals get this so extremely fallacious. Cassie spoke like an actual particular person with diabetes.

“Reserve,” the backup insulin vial that has a little bit bit left simply in case
“Short-acting” and “long-acting” insulins
“Go, Big Pharma,” stated in a sarcastic tone

The relationships. Cassie is surrounded by well-meaning individuals who attempt to be supportive however don’t actually perceive what she’s going via. Many folks with sort 1 know precisely what that is like.

Cassie’s mom is supportive and understands how severe the situation is. She asks Cassie to maneuver again dwelling so she will help shoulder the burden. However, she doesn’t perceive simply HOW costly Cassie’s insulin is — at one level she offers her daughter $80, not realizing that it’s not even near what she wants. Even although Mom has the perfect of intentions, she doesn’t fully perceive what it’s like for her daughter.
The pharmacy cashier doesn’t actually appear to know that if Cassie can’t get insulin, she may die. She doesn’t help or present any sources for Cassie to get the insulin she wants. This is a standard story we hear in the neighborhood typically. There are sources for those who can not afford their insulin.
Cassie’s mates and husband give her area to do diabetes issues, however don’t actually perceive or know learn how to assist.
I really like that because the romance progresses, Luke begins to know Cassie’s diabetes higher. When he hears her alarms, he runs to seize the glucose gel and shortly learns that T1D could be scary. It’s an correct relationship state of affairs.

WHAT WASN’T SO ACCURATE

As real looking because the movie’s depiction of diabetes was, it’s nonetheless a film, and there have been moments that felt excessive. I’ve a brother who’s a director and editor (he additionally has sort 1!), so I can recognize that motion pictures have to exaggerate to get the purpose throughout and to intensify the drama. A gentle low blood sugar that you just repair with just a few glucose tabs isn’t precisely thrilling. One instance: The filmmakers had Cassie use an enormous syringe, with a needle that was MUCH bigger than any needle I’ve ever seen used for insulin.

More importantly, Cassie’s signs (or lack thereof) felt exaggerated to me. She’s rationing her insulin so we all know she’s going to be excessive. But the depth of her signs — labored respiratory, stumbling, sweating, and exhaustion – make it appear to be she’s experiencing diabetic ketoacidosis (DKA). She injects some insulin, and the following day she appears wholesome once more. That’s simply not how that works.

She additionally rebounded in a short time from that 68 mg/dL triple down arrow to make out along with her husband. I believe she’s about to search out out that bodily exercise after hypoglycemia normally brings extra lows. 😉

MISSED DIABETES OPPORTUNITIES

As good because the film’s depiction of diabetes was, I felt it may have accomplished a good higher job. Here’s what I want Purple Hearts had proven:

I needed to see extra of these little administration moments highlighting how exhausting and all-encompassing T1D is. We are at all times wanting, checking, and adjusting: briefly checking your CGM graph, mindlessly touching your pump or sensor web site, or barely adjusting your pump in your waistband once you sit down. (My brother disagreed. He was glad that the movie centered extra on character growth and their relationships.)
Cassie was by no means proven bolusing for meals or managing her blood sugar round meals. This might need been accomplished on function, to keep away from the stigma round meals and diabetes. But I believe it was a missed alternative to point out the truth of how central meals is to our situation, and the way tense diabetes makes each meal.
Cassie’s insulin pump is sort of by no means seen. While I typically attempt to disguise my insulin pump, you may nonetheless see the define underneath my garments, and once I’m round shut mates or household, I don’t trouble tucking the tubing away. There aren’t many of these moments within the movie, and with some of the wardrobe decisions, it might have been robust to cover her pump. I really feel this doesn’t precisely signify how intrusive and omnipresent a tubed pump is.
The movie contains a dialog about Cassie and Luke having youngsters. They are sitting across the desk within the yard and Luke’s sister says how nice he’d be with youngsters. There is a clumsy pause, and Cassie says nothing. This would have been a pleasant second to say one thing about sort 1 diabetes and being pregnant. Again, one other misplaced second.

I believe Purple Hearts did a terrific job portraying life with sort 1 diabetes, each for folks from the diabetes neighborhood and for viewers simply studying in regards to the situation. I hope this film helps the world higher perceive what many Americans are going through each day.