On Top of My Game: Living with Diabetes.

Prospect Media Inc and Northwood Entertainment, producers. New York, NY 10001, Prospect Media Inc, 1990, VIIS, 46 min, $150.

The major theme of this videotape is to give the viewer a very personal and realistic look at what living with diabetes is like. The actors are evidently people who have diabetes in real life and who must continuously deal with the disease. The audience for this videotape could be health care professionals or patients. The theme is demonstrated effectively and shows many aspects of dealing with diabetes.

The focus of this videotape is living with diabetes. The videotape is totally patient oriented, but health care professionals, as well as students of health care fields, could benefit from viewing it. The format consists totally of commentary by the patients: a 16-year-old boy, a 31-year-old married attorney, a 60-year-old parent, and 30-year-old female twins who have children, among others. The patients discuss their respective challenges for survival, and most present moving, honest success stories. Seeing how diabetes affects a person, from the perspectives of a child, a parent, and a spouse, gives the viewer great insight and sensitivity into dealing with this disease.

The patient comments and scenarios are extraordinarily effective. A good example of this is when the 31-year-old lawyer is shown in a courtroom scene in which he approaches the judge to ask that he be excused momentarily so that he may take his medication. The judge allows it over the objection of the opposing attorney. Although it is obviously a staged scene, the actual judge and public defender do appear in the credits. The point that one can survive with this disease, as long as coworkers understand what the person with diabetes needs to allow himself or herself to function as a contributing worker, is well demonstrated.

The videotape comes across as honest and realistic. Although some of the stories reveal struggles within each patient's family, the individual coping strategies are well documented, and some great success stories are demonstrated. As previously stated, there is no technical narrative. This is perhaps where the videotape could have been enhanced. It would have been beneficial if the videotape had used a medical expert to explain what the goal of the videotape is and to summarize what is being discussed by the patients. In addition, medical graphics might also have enhanced some of the patients' scenarios. For patients, however, this patientto-patient approach might be more effective than a more medical approach.

The information found in this videotape is both valid and contemporary, and it deals with all levels of coping with, and treatments for, diabetes. The ways in which patients cope with diabetes are discussed comprehensively, but the actual disease itself could have been better clarified with some medical or graphic narrative. The production quality of the videotape, for the most part, is good, as is the use of sound and lighting. The effective use of cutaways to support comments from the patients is also excellent.

A brief discussion guide that accompanies the videotape supports the use of the videotape for patient and health professional education. I feel one outstanding use for this videotape would be in a class on psychosocial aspects of disability. This videotape reveals very powerful coping strategies and conflicts that families deal with when a member has a chronic condition. It is an excellent patient education source.

Entry-level physical therapy students, as well as all health care professionals dealing with diabetes, would find this vide& tape an essential learning guide. I recommend this videotape, particularly for its honest and motivating look at what the person with diabetes is dealing with in his or her daily life.

Barbara S Oremland, PT Lyndhurst, Ohio