Tom Hanks Has Diabetes: Could His “Cast Away” Character Have Survived? | The Survival Doctorby James Hubbard, MD, MPH

Reading that Tom Hanks now has type 2 diabetes made me think: What if his character in Cast Away had the same disease? You know, the movie where his plane goes down and he spends four years stranded alone on an island? In such a scenario, could he survive type 2 diabetes?

What do you think?

Type 1 Vs. Type 2 Diabetes

Just to make sure we all have the same knowledge base here, you need to know the difference between type 1 diabetes and type 2.

In type 1, your pancreas produces no insulin. When you ingest sugars, insulin is required to get them from the bloodstream into your cells for energy. Without the sugar in your cells, no matter how much food you ingest, you starve. In type 1, supplemental insulin is required to maintain life. There is no substitute.

Type 2 diabetes is a different disease. You may have a normal amount of insulin, but your body has trouble using it. To compensate, you produce more insulin. Medications can help your cells better use the insulin, but with time, your pancreas may be overwhelmed enough that it just gives up making it. Then, the type 2 diabetic essentially becomes a type 1.

Even in people whose blood sugar is pretty well controlled with medication or insulin, either type takes a toll on the blood vessels, heart, eyes, kidneys—virtually all your organs. In fact, the increased risk of death people with type 2 diabetes have is due more to these problems than to dying specifically of a high blood sugar. (Caveat: A minority of people with type 2 are genetically more prone to die directly from high sugars.)

Tom Hanks on an Island With Diabetes
Tom Hanks Has Diabetes: Could His “Cast Away” Character Have Survived? | The Survival Doctor

Tom Hanks’ character got plenty of regular exercise on the island, that’s for sure.

So, back to the island scenario. Assuming Tom Hanks finds enough food to keep him from starving, and assuming he’s overweight when he crashes onto the island (about 60 percent of people with type 2 diabetes are), studies have shown that even a 2-5 percent reduction in weight could significantly decrease his sugar levels.

At a 5-10 percent decrease, the risk of complications of the kidneys, eyes, blood vessels, etc. start decreasing. More weight loss than that (presumably until you get to your ideal weight) decreases your risk even further. Regular exercise helps significantly and independently also.

In fact, about 10 percent of people with type 2 diabetes can get off medicine completely with proper diet and exercise.  But, you have to stick to the regimen. An off-and-on diet won’t cut it—a problem Mr. Hanks would not have on his island.

For the other 90 percent, a good diet, ideal weight, and regular exercise may not get you off medications completely, but it may decrease the amount you require. And it certainly can decrease the ravages diabetes wreaks on your body.

So How Would He Fare?

As I suggested earlier, an island-locked Tom Hanks is more likely to become ill, even die, from complications such as organ damage than from a high sugar. So, when he comes home, out of his diabetes meds for four years, his organs certainly may be damaged, but the amount is unpredictable—from no more damage than if he were at home (remember 10 percent are able to get off their meds with proper diet and exercise) to more but not immediately life-threatening damage. Or he could never make it home due to dying directly from the sugar being too high. (Without medication, there’s a less than 10 percent chance of that.)

What About Type 1 Diabetes?

When people with type 1 diabetes ask me what they can do if they run out of insulin, I don’t have a good answer. I do have a post on suggested storage techniques to make what insulin you have remain potent. Another hope I have is that maybe, probably, if there were a long-term shortage, some bright, enterprising people would start purifying, titrating, and bottling insulin from animal pancreases. For years, it was commercially made from pigs.

But What If It Never Became Diabetes?

The best thing Tom Hanks’ character could have done is to have started his diet and exercise program well before he ever crashed into the island.

In real life, according to what I’ve read, Mr. Hanks and his doctor knew for quite a while that his blood glucose levels were “borderline.” That’s what’s known as prediabetes.

Many people with prediabetes go on to have full-blown diabetes, but just a moderate amount of diet and exercise can often prevent this from happening.

Even if you start the diet and exercise after you get diabetes, the earlier you start, the more likely you are to be to be among those 10 percent of people who don’t need meds.

What If the Island Had Herbs?

If the island were to grow American ginseng, Tom Hanks’ character might have an even better outcome—if he’s read this post about supplements that could help if you run out of medicine.

What about cinnamon? The studies are mixed on whether and how much it helps. If you try it in real life, be sure to monitor your sugar levels carefully since, if it does help, you might have to back off on your prescription medication. It’s best to let your doctor know before you try any new supplements or treatments.

Even so, nothing takes the place of diet and exercise.


What about you? What have you found that helps? Have you or anyone you know stuck with a good diet and exercise program? How much did it help?


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