Happy National Diabetes Month!…only one month late
November is National Diabetes month, and despite that it is now December – I started this post in November….. and you guessed it…. work has been busy. BUT I HAVE AN ANNOUNCEMENT! I have accepted a NEW JOB! I am so excited, I will be leaving the wild world of managing 20 employees, and I will be working as an outpatient diabetes educator. I.AM.PUMPED.
One of the reasons I became a diabetes educator, and chose to specialize in this area is because diabetes is such a fascinating and complex disease, involving many different aspects of metabolism, and hormonal balances or rather imbalances. There are a lot of myths that surround diabetes – and I am here right now, in this post to dispel those, and talk about some facts.
Myth #1- Only “large” people get diabetes
So here is the low down. YES. Central adiposity, (carrying weight in your midsection), is a huge risk factor for insulin resistance, ergo, diabetes. THAT IS NOT THE ONLY RISK FACTOR, things like ethnicity, and family history (to name a few) are also risk factors.
Remember risk does not mean “definite” – risks are either modifiable (things you can change: weight, activity level, diet, smoking), or unmodifiable (age, ethnicity, family history) – unmodifiable risk factors are factors you have no power to change- so if you find you have some unmodifiable risk factors – it is time to start addressing some of the modifiable risk factors, and making lifestyle changes to reduce risks.
I will tell you, in practice I have seen plenty of people who have a “normal” weight for height, and are diagnosed with type 2 diabetes. One thing I have seen regardless of a person’s weight is – more times than not – my clients have at least one relative with diabetes, and/or are from an ethnic background that has a higher prevalence of diabetes associated with it.
Myth #2 – “If you eat t00 many sweets and candy – you will get diabetes”…
This is something that drives me crazy when people take it seriously. Remember- diet is a modifiable risk factor – there is not enough evidence at all that poor diet is causative of diabetes. A poor diet can and will make existing diabetes much worse, but it has not been successfully shown to be a solely causative factor.
Myth #3- “If you’re on insulin – you failed at managing your diabetes”
Completely untrue! Diabetes is a progressive disease, type 1 involves insulin deficiency/no insulin production. Type 2 diabetes is characterized by insulin resistnace and possibly later on a combination of insulin resistance and insulin deficiency. It may start this way, it may progress into this, however an individual requiring insulin does not suggest failure at managing their blood sugars.
Myth #4- There are only two types of diabetes
Nope. And please do not refer to them as Insulin dependent or non-insulin dependent.
Type 1 Diabetes: Is an autoimmune disease in which the body’s beta cells are damaged and no longer produce insulin to sustain the body’s needs. Because it is an autoimmune disease those who have Type 1 diabetes are typically prone to developing other autoimmune disease in their lives like rheumatoid arthritis, thyroid diseases celiac disease etc. Because people with type 1 diabetes do not make enough insulin to meet their body’s needs – they depend on insulin injections to live
Type 2 Diabetes: This is characterized by insulin resistance and (possibly) eventually insulin deficiency, as the disease progresses. It can be controlled with diet, & exercise, pills, and insulin, or any combination of the above methods.
Gestational Diabetes: The best explanation is that it is a type of diabetes that occurs in pregnancy as the body is experiencing increased insulin resistance and changes in hormones. It typically goes away after the baby is delivered, however it does put the mother at risk for having diabetes later in life, and in future pregnancies
Pre-diabetes: This is a “grey area” that occurs when someone does not meet the American Diabetes Association defined criteria of having diabetes, but their blood work shows higher than normal blood glucose levels. With lifestyle modification once pre-diabetes is diagnosed the goal is to have patients aim for normal blood glucose levels, and work intensively with their eating and exercise habbits.
LADA- Latent Autoimmune Diabetes in Adults: I have seen at least three of these cases, and they are fascinating. This type of diabetes is also sometimes refered to as Type 1.5, or “evolving type”. At the time of diagnosis it may seem as if someone has very characteristic symtpoms of type 2 diabetes however the pancreas, in a matter of months stops producing insulin, and the body relies on insulin injections.
MODY- Mature Onset Diabetes of the Young: This is a form(s) of diabetes (there are several MODY types) that is caused by genetic mutations in a number of different genes. Depending on the gene that has been mutated – there will be varying characteristics of the form the diabetes takes on. People who have MODY type will have different characteristics than just that of type 1 or type 2, or have a combination of characteristics. An example being someone with type 1 characteristics – requiring insulin – but does not test positive for antibodies.
Our bodies use glucose as fuel, and energy – whether it is readily available or we are dipping into stored forms. Regardless insulin serves as a “key” that unlocks the cell door – to allow glucose into our cells – where it will be used as energy.
As I hope I have highlighted in what is hopefully not a “too long” post is that diabetes is a very complext disease, and despite living in the time we do – there are still a lot of ridiculous myths regarding diabetes, and general lack of understanding. What is also fascinating is how understanding carbohydrate metabolism and diabetes have also provided me with a better understanding of how to fuel my body during my long runs.