Lies About Diabetes

"Only Overweight People Get It" and 7 Other Lies About Diabetes
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For a disease that strikes close to two million Americans a year and affects more than 20 million, diabetes is surprisingly misunderstood. And this lack of understanding is having tragic consequences; according to projections by the Centers for Disease Control (CDC), as many as one in three American adults could have diabetes by 2050. So how do we get the facts straight? Let's start with correcting the most common mistakes. Here are eight common beliefs about diabetes that are just plain wrong.

Lie: Only Overweight People Get Diabetes

Truth: Most experts now believe that diabetes is primarily genetic in origin, and it can happen to anyone at any weight. In addition to family history, risk factors include ethnicity and age. Diabetes occurs when cells become resistant to the action of insulin, a hormone secreted by the pancreas. The pancreas can't make enough insulin to keep up, causing sugar to build up in your bloodstream. Eating unhealthy food or being overweight can lead to insulin resistance and trigger the onset of diabetes, says Eliot LeBow, a licensed clinical social worker (LCSW) health and wellness advisor for the American Diabetes Association. But diabetes doesn't require that particular trigger to develop. "People who are very thin get type 2 diabetes as well as people who are carrying extra weight," says LeBow. Meanwhile, most overweight people never develop type 2 diabetes.

Lie: You Get Diabetes From Eating Too Much Sugar

Truth: It's not that simple. A candy habit itself doesn't cause diabetes, experts say. If you're thin, exercise regularly, and eat a generally healthy diet (in other words, if your diabetes risk is low), then the occasional M&Ms binge isn't something to worry about. But many people who eat a lot of sugar are overweight, and that does increase your risk for type 2 diabetes. And once you're significantly overweight or obese, your cells can become resistant to insulin, so that when you eat candy or other sweets your body can't process the sugar efficiently.

Sugary drinks like soda pop, however, do pose a diabetes risk, according to recent studies, though experts don't yet know whether the culprit is the highly concentrated sugars in these drinks or the empty calories. The American Heart Association now recommends limiting your intake of sugary drinks to 450 calories per week.

Lie: Diabetes Isn't That Serious

Truth: This is the most dangerous misconception of all, experts say. According to the American Diabetes Association, type 2 diabetes kills more people each year than breast cancer and AIDS combined. And two out of three people with diabetes die from heart disease or stroke. The good news, though, is that diabetes is a manageable condition, and with good blood sugar control you can hold off diabetes complications or prevent them entirely. Keep on top of your heart health by getting regular blood pressure and lipid screenings and any other tests recommended by your doctor. If your blood pressure, cholesterol, or lipid levels are above the normal range, or your HDL (good cholesterol) is too low, talk to your doctor about the best treatment options, which may include going on medications to lower your blood pressure and cholesterol.

Lie: If You Lose Weight and Eat Right, Diabetes Will Be "Cured"

Truth: Losing weight, changing your diet, and exercising more are definitely the first steps to controlling your diabetes, because these actions decrease insulin resistance, making your body's cells respond better to insulin. And if you have mild or prediabetes, taking these steps might in fact cause your diabetes to go "dormant," says diabetes educator Eliot LeBow. But that doesn't mean your diabetes is "cured" and you can stop worrying -- it can come back at any time, given an opportunity. "And that's really important to know," says LeBow, "because it keeps you focused on monitoring where that diabetes is at."

Lie: Once You Have Diabetes, You're Going to Have Serious Health Problems

Truth: There's no question that diabetes can lead to a host of health problems. In addition to heart disease and stroke, diabetes can damage your vision and cause circulation and nerve problems that can damage your feet. However, if you keep a tight rein on your blood sugar and don't allow it to spike and drop, you can prevent these types of damage. Keeping glucose levels, blood pressure, and cholesterol on target also helps prevent heart attack and stroke, the two diabetes complications most likely to be fatal.

Lie: You Can't Eat Carbs If You Have Diabetes

Truth: Counting carbohydrates is important for people with diabetes, yes, but that doesn't mean eliminating them altogether. In fact, avoiding carbs can be unsafe for diabetics, says Jessica Crandall of the Academy of Nutrition and Dietetics. The brain needs carbohydrates, which it converts to glucose, as its energy source. The best plan: Figure out with your doctor how many 15-gram servings of carbohydrates you can eat a day. For many people with diabetes, it works out to about four times a day. It's best to prioritize carbs from whole grains, fruits, and vegetables and limit carbs from refined or processed sugar. Try to follow a set meal schedule, and eat approximately the same amount of carbs with each meal. The best trick is to choose carbs containing fiber (an orange rather than orange juice) and pair carbohydrates with protein (peanut butter with an apple, sardines with crackers). Both these strategies keep blood sugar from spiking.

Lie: Going on Insulin Means You've Failed

Truth: Because of the misplaced stigma about insulin therapy, many people with type 2 diabetes hold off taking insulin for far too long, when doing so would actually be the true sign of success. The goal when you have diabetes is tight blood sugar control, because high blood sugar is what leads to symptoms and long-term complications like vision loss, heart disease, and loss of circulation in the legs and feet. And if you aren't able to keep your blood sugar stable with diet and exercise alone, or with diet, exercise and oral diabetes medications, then you're doing your health a big favor by starting insulin. Diabetes is a progressive disease, and over time most people with diabetes will need to take insulin.

Lie: You Have to Eat a Special Diet If You Have Diabetes

Truth: One of the most common misconceptions about diabetes, this is also one of the furthest from reality. And experts worry about this myth, because it prevents people from seeking treatment for diabetes because they fear giving up their favorite foods. Here's the reality: The recommended diet for someone with prediabetes or diabetes is pretty much the same diet experts recommend for everyone. It features healthy fats like olive oil, plenty of vegetables (and some fruit), whole grains, lean meat, and nonfat dairy products. In fact, it's almost identical to the "Mediterranean" diet you've heard so much about.

But -- and it's a big but -- you'll need to monitor the amount of carbs you eat at one time to avoid glucose overload. (Furthermore, sugar allowances vary depending on the stage of your diabetes.) According to the American Diabetes Association, sweets aren't off-limits for most people with type 2 diabetes. If you have dessert, take away another high-carbohydrate food, such as bread with dinner. Same with alcohol: If you must have a drink, stick to a small glass of beer or wine, and cut carbohydrates from your meal to balance things out. Portion control is important -- a small slice of cake and no seconds, one small beer but no more Oktoberfest.

It's also not true that people with diabetes have to eat less. Actually, you want to eat regularly throughout the day -- at least three meals and several snacks -- to prevent blood sugar spikes and drops. Experts recommend eating at least every four hours, and that includes having a bedtime snack with staying power (like a handful of nuts or whole-wheat toast with peanut butter) to tide you over until morning.

Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio

over 4 years, said...

The first lie that only overweight people get diabetes did surprise me and verified it was correct. But nearly all who become insulin resistant also develop the other metabolic syndrome risk factors to include an enlarged waist in terms of proportion to the body. So the real deciding factor is not that you are overweight, but whether you are carrying a gut. Also to say most experts now believe that diabetes is primarily genetic in origin is a stretch and not helpful. Experts believe that the susceptibility to developing type II diabetes is genetic, but diet is the reason we become insulin resistant and develop type II diabetes. There needs to be some clarification is the sugar and soda pop reference. Bottom line: you get diabetes from eating too much sugar. Chronic consumption of "fructose is known to induce hepatic insulin resistance" and "has been implicated in the epidemics of"¦type 2 diabetes"¦"(ref "Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal, Nutrition & Metabolism, 2008). And yes, sugar consumption is the leading dietary cause of type 2 diabetes (ref: The relationship of Sugar to Population-level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data," Basu, Yoffe, Hills & Lustig, PLOS one, Jul 2013). Lastly, the reason the American Heart Association now recommends limiting sugary drinks is because sugar is known to induce hypertension, increase triglycerides, lower HDL, and worsen the LDL size distribution"”all factors in CHD & CVD. The sections on the seriousness of type 2 diabetes and eating carbs are gratefully spot on. But the next section sends the wrong message. You should change your diet if you are developing diabetes. To say otherwise is to put people at further risk. My doctor and nutritionist radically changed my diet to reverse my metabolic syndrome, and to return my serum lipid profile and my blood sugar / 1ac to normal, it is possible and I have done it without drugs. It is not about portion control. It is about eliminating certain foods, eliminating all added sugars and white (refined) carbs, and limiting carbs at every meal. I had my last can of coke, my last glass of orange juice, my last Yoplait yogurt, and my last small slice of cake 40 months ago. And the results: I slashed my triglycerides 60%, my total cholesterol plummeted to 148 and dropped my 1ac to 5.4. Yes, I'm no longer pre-diabetic (but not cured), and I eat my red meat, eggs and cheese, and drink my wine (limit "“ 2 glasses a day). And no I don't eat a Mediterranean diet. Bottom-line: there is a lot of bad nutritional science out there.

over 4 years, said...

Thanks, CA-Claire. That was a fasting glucose test, and I didn't have sugar with my coffee that morning (or any coffee for that matter! When I fast, I fast!) My doc is not a "lecturer," but a "discussant!" In any event, I'll continue to work on limiting sugar intake and probably have another reading, including a hemoglobin A1c test, in six months or so.

over 4 years, said...

Right now a fasting glucose reading of 100-120 is considered to be pre-diabetes. 80-99 is 'normal'. The problem with glucose testing is it is specific moment in time. Maybe yesterday you binged on carbs, or forgot and had your coffee with sugar before the test. If your Doctor starts to lecture you, ask that they run a hemoglobin A1c test, which shows your glucose levels over the past 90 days (life cycle of a red blood cell). As long as you are under 6.5, you are OK.

over 4 years, said...

It clarified some information for me. I just had my annual physical and the doc said "Watch the sugar!" I looked at the numbers and my sugar is at 100 (I'm not sure 100 what!), and that's high normal I guess. So I'm watching the sugar!

over 4 years, said...

I finally found out why my doctor said I don't need to worry much about my diabetes after losing 100 lbs., because I was now pre-diabetic. Now I know that my diabetes is just lurking in the background, and I still need to take care of myself to avoid horrible complications. Thanks for the info, and may all your A1C values be under 6!

over 4 years, said...

looked liked a good article, but I'm not going to wade thru 8 pages of ads to read it!

over 4 years, said...

The information on preventing type II Diabetes helped me. My mother has type II. She doesn't take good care of herself. She would never take advice from me. I might get my dad to listen.

over 4 years, said...

I found the contents of this article to be very informative and steeped in practicality. Need to share with close friends and family.

over 4 years, said...

Thyroid medication, antidepressants, and some blood pressure medications affect both blood sugar (raises them) and cholesterol. Statins may also raise blood sugar levels, while lowering cholesterol. Medications are a delicate balance, and need to be watched carefully. Doctors will rant and rave, but will not take into account the side effects of the medications you are on. Be sure to read and pay attention to the information that comes with each of your prescriptions so that you can intelligently discuss medication side effects and efficacy with your Dr. AND your Pharmacist (who is more knowledgeable about the drugs than the Dr.).

over 4 years, said...

Talk to your own doctor but I recently saw a program that indicated cholesterol lowering medications (statins) may lead to increased glucose levels (Type II diabetes). I was on a statin and had a 108 glucose reading in March. I stopped taking my statin and my latest glucose reading was 85...but my cholesterol levels have increased. I drink homemade cocoa in the mornings: 2 cups 1% milk, 1+ T cocoa, 1 t cinnamon and 1+ t agave. Cinnamon is supposed to be good for diabetes. I have added Agave to my diet as it purportedly low glycemically as compared to sugar. I do not drink soda. The doctor on the program I saw said that particularly for women, he does not prescribe statins except for maybe 1% of his patients. He said statins do not prevent heart attacks but may be useful if you have had a heart attack. Again, I would discuss with your own doctor but feel this is important enough to mention as I think it bears looking into.