As I said in a previous post- November is American Diabetes Month. As important as it is to bring awareness to facts, and information it is sometimes just as important to bring awareness to myths and address stigmas around a topic.
Myth #1- If you take insulin you have type 1 diabetes.
As I said in my previous post- both individuals who are Type 1 or Type 2 (even those who have gestational diabetes) can use insulin as a means to help control blood sugars
Myth # 2- If you have Type 2 Diabetes and you need insulin you are non-compliant.
Unfortunately there are still a lot of negative connotations that come along with insulin therapy. Are there some cases that if individuals had been more compliant with diet an exercise could insulin maybe have been avoided or the lack of need prolonged? YES! But there are also cases when people do what they are told, and the disease itself progresses rapidly, and they make less insulin over a shorter period of time. Whether you are a friend or a health care provider it’s not ok to make snap judgements about someone’s control just because they are on insulin.
Myth # 3 – Diabetes is not really a problem
Any healthcare provider is aware that Diabetes is VERY prevalent in fact ~ 25.8 million people have diabetes according to the American Diabetes association. Diabetes is not this little thing hiding in a corner. It is upon us and in the past 10 years so much research has been done, and is in the process of being done that really highlights risk factors for developing this disease.
Myth # 4 – Only overweight and obese people can get diabetes
Myth #5 – Having a poor diet and inactive lifestyle will cause you to have diabetes.
The Facts: There are modifiable and unmodifiable risk factors. Modifiable risk factors are things that a person can change, and improve upon like: physical activity, diet, smoking, drinking, weight
Then the UNmodifiable risk factors (things people cannot change, but also play a very significant role in developing diabetes or other diseases): age, gender, ethnicity (populations most at risk for diabetes are: Native Americans, African Americans, Asian Americans, and Hispanics), family medical history/genetics (it is now well known, and the American Diabetes Association supports this – diabetes both 1 & 2, but moreso 2- are VERY MUCH tied to family history)
The modifiable and unmodifiable risk factors in various combinations are like the recipe for developing diabetes (or other chronic diseases).
Many of my patients have multiple modifiable and unmodifiable risk factors at play. And this is explained to them. It’s never just one thing that causes someone to have diabetes.
Many tmes these individuals have a variety of risk factors at play for many years, and are finally diagnosed after some type of trigger such as a stress (emotional, or physical), change, etc.
Diabetes is no longer a disease that discriminates- it is a chronic illness. And while poor diet, and lack of exercise play huge roles in diabetes or its development- there are other very important factors at play – so it’s important that as healthcare providers and well just being a decent human – that you do not make presumptions.
Myth # 6 – Diabetes is curable/Can go away
Unfortunately not yet. But it can be controlled. However, many people mistake achieving a great level of control as their diabetes going away entirely. Not correct. When individuals have great exercise/food habbits and are able to get off medicines – if one or both of those habbits faulters the higher blood sugars typically crop up.
Another popular question/thought is weight loss “getting rid of” diabetes. This is a really common promotion for bariatric surgeries, that these surgeries will allow for a “remission” of diabetes. Remission does NOT mean cure. Weight loss helps the issue of insulin resistance, and may decrease peoples’ needs for insulin/diabetes pills but that does not mean that the issues of blood sugar control are gone completely.
Another thing to remember is that there is a greater body of evidence showing that there are poor outcomes with bariatric surgery (in terms of weight re-gain, and complications) than there is evidence supporting the long term effectiveness of bariatric surgery (to clarify bariatric surgery means: lap band/gastric band or sleeve/gastric bypass etc).
Myth # 7 – When you have diabetes you have to give up foods you love
Not correct. Managing diabetes really boils down to leading a healthy lifestyle. I consider myself healthy, I eat fruit and veggies multiple times a day, I exercise about 4 times per week, but I LOVE FOOD (and beer), and dining out. But I try to be 90-95% of the time and do my own cooking, and eating at home, and exercise – so I can indulge those other times. That is my idea of a healthy lifestyle.
In terms of diabetes education regarding is really important. It is important to know which foods influence your blood sugars (carbohydrates), and which foods do not (meats, eggs, cheese, fats, most vegetables), and balance them out at each meal.
The only thing I encourage my patients to cut out is drinking your carbs/calories – for several reasons 1) these beverages are very concentrated forms of sweet, and very small amounts will elevate the blood sugar very significantly 2) there is no point in consuming your calories in liquid form (hah! said the dietitian who loves beer) 3) the carbohydrates in these drinks all come from sugar, and do not provide the body fuel/energy in the way that carbohydrates that come from food do.
These beverages include: regular pop, fruit juices, flavored/sweetened teas, sports drinks, fruit punches, lemonades, kool aids, and/or adding sugar or honey to a beverage (i.e. adding sugar to coffee, coffee is not a carb, but sugar is!). There is a solid base of research that shows that decreasing and eliminating sugar sweetened beverages is beneficial to health/weight in general!
Additionally taking insulin or diabetes pills is not a free pass to eat whatever, whenever.
Myth # 8 – If you have diabetes – you will have complications!
Not correct. When diabetes is managed properly many individuals are able to lead healthy lives and avoid complications. Complications tend to arise when the blood sugars are consistently uncontrolled. What starts to happen is the high level of blood sugar starts to affect other areas, such is the vessels in the eyes, how the kidneys work, and the smaller vessels in the hands and feet. When blood vessels are damaged in the eye – that is called Diabetic Retinopathy- it is the only one of the diabetes complications that can be reversed with corrective surgery. When the kidneys are over worked and protein starts to spill out in the urine – this is called Diabetic Nephropathy – and can ultimately lead to Chronic Kidney Disease, and even dialysis. Once kidney damage is done the damage is there- but progression can be slowed with dietary changes and better blood sugar control, and blood pressure control. When the nerves are damamged in the hands and feet- and people lose sensation in those areas, or complain of a burning sensation/tingling/numbness- that is known as Diabetic Neuropathy. Neuropathy is typically what precipitates many diabetes related amputations. As if you do not have sensation in your feet and you get a cut- and don’t feel it/pay attention to it- and it get’s infected and the infection spreads – doctors sometimes recommend amputation as a means to stop the infection from spreading.
Speaking of complications – here is a myth inside a myth. Having diabetes does not mean that a woman cannot have a happy, and healthy pregnancy and a happy, healthy baby.
Myth # 9 – Regardless of what my blood sugars are telling me if I feel ok, than I am ok.
So so so so NOT TRUE. And I see this all too often. Just because you feel fine does not mean all is well. Hypertension or high blood pressure is known the silent killer – but I think diabetes is the same. Many people do not feel “symptomatic” of high blood sugars until they are over 250 (but sometimes if people are used to this they develop a new, higher, threshold that causes them to be symptomatic)… which is not good.
This is why blood glucose monitoring is important and targets have been established to help guide people in to better control of their blood sugars, and reduce risks for complications.
Myth # 10 – Your physician is the one in charge of your diabetes/health
No offense to any doctors out there. But no. You are the one who is ultimately you/the patient is the one who is managing the care on a daily basis. You are the one who decides to take or not take medications, to eat or not eat certain foods.
Physicians, Nurses, Pharmacists, Dietitians, and other health care providers are there to do just that: provide care, and provide information for the patient to utilize. I don’t go home with my patients and count their carbs, or throw away their pop. At the end of the day no one knows you better than you know yourself, and you have to advocate for yourself, and work with a physician and diabetes educator to establish a plan of care that will work for you.
As you can see diabetes is serious, but it is something that is also manageable. It’s always good to know your risk factors for any disease stated, and start making changes for the better sooner rather than later. These days an ounce of prevention is worth well more than a pound of cure.