by Katelyn Castro
Diabetes. Sugar. Insulin. Shots. You’ve probably heard of diabetes before, but unless you or someone close to you has diabetes, the media may have warped your perception of the disease. About one in ten Americans has diabetes, yet there are still many stereotypes surrounding the disease.
Even as a nutrition student, I didn’t really understand the serious and complex management of diabetes until two years ago. Working at a camp with kids and counselors with type 1 diabetes taught me more about the disease than I could have learned from any textbook. No one with diabetes wants be defined by their disease, but I’m confident that they do want others to understand what it’s like to be in their shoes.
Since November was National Diabetes Month, now is the perfect time to raise awareness and end the stigma surrounding diabetes. I reached out to friends who have diabetes or have siblings with diabetes, and reflected on my own experiences to get a better idea of the misconceptions out there. Below are some common myths about diabetes from a collection of personal experiences, stories, and conversations. Let’s get the facts straight:
1. Myth: If you take insulin, it means your diabetes is poorly controlled.
Fact: Insulin keeps people with type 1 diabetes alive. While most people have a working pancreas that makes the insulin you need to take up energy and keep blood glucose levels under control, those with type 1 diabetes do not. People with type 1 diabetes need insulin regularly through a pump or injections. About 5% of the population living with diabetes has type 1 diabetes.
People with type 2 diabetes, the more common type of diabetes, may not need insulin at first. Unlike type 1 diabetes, type 2 is progressive so the body gradually becomes resistant to insulin and can’t use it properly. A healthy diet, exercise, and medication can keep blood glucose levels in check in the early stages, but insulin may be needed eventually. In either type of diabetes, taking insulin to control blood glucose levels is critical for your health.
2. Myth: Eating too much sugar causes diabetes.
Fact: Unfortunately, it’s not that simple. Type 1 diabetes is an autoimmune disease caused by a combination of genetic and environmental factors, including exposure to viruses or bacteria. Researchers are still trying to figure how these factors interact, but eating too much sugar is clearly not the cause.
Although eating too many sweets is not healthy for anyone, it’s not the direct cause of type 2 diabetes either. But, excess calories from any food can lead to obesity, which is a major risk factor for type 2 diabetes. When someone with prediabetes or another predisposition is overeating, the pancreas can’t keep up with the high demand of food and can’t use insulin effectively. In this way, eating too much (of any food) can increase risk of type 2 diabetes.
3. Myth: Only overweight and unhealthy people have diabetes.
Fact: Most people with type 1 diabetes are a healthy weight. When children and young adults are first diagnosed with type 1 diabetes, they may actually be underweight because they can’t take up the energy they need without enough insulin.
Although obesity is one risk factor for type 2 diabetes, genetics, ethnicity, age, and lifestyle factors also play a role. In fact, most people who are overweight never develop type 2 diabetes, and many people with type 2 diabetes are at a healthy weight or only moderately overweight. A family history of diabetes and personal history of gestational diabetes can increase risk of type 2 diabetes. Age (forty-five and older), ethnicity (African Americans, Hispanics, and Asian-Americans), and physical inactivity can also increase risk. Experts recommend people with one or more risk factors have their blood glucose levels checked every three years.
4. Myth: Diabetes is like an allergy to sugar. If you avoid it, you’re diabetes will be under control.
Fact: Everybody needs carbohydrates in their diet for energy, even people with diabetes. Simple carbohydrates, like sugar, may actually be crucial when people with diabetes have low blood sugar (hypoglycemia). Low blood glucose can cause weakness, irritability, and severe cases can cause seizures. High blood glucose can make people nauseous and drowsy, and untreated cases can lead to a coma. The key to managing diabetes is not to avoid sugar, but to keep blood sugar levels in a safe range.
Although lifestyle factors and medication can reverse type 2 diabetes in the early stages, there is currently no cure for type 1 diabetes. For people with type 1 diabetes, checking blood glucose levels, calculating carbohydrates, and adjusting insulin is a full-time job. Careful management can prevent complications related to diabetes later in life, such as kidney disease, heart disease, and neuropathy.
5. Myth: You have to follow a special diet if you have diabetes.
Fact: There’s no reason that people with diabetes need to follow a restricted diet. Like everyone else, people with diabetes can benefit from a healthy diet high in fruits, vegetables, whole grains, lean protein and healthy fats, and low in saturated and trans fats. Whether you have diabetes or not, sweets and desserts can be enjoyed in moderation.
Those with type 2 diabetes may have to pay closer attention to portion sizes of starchy foods to keep carbohydrates consistent throughout the day. Aiming for 45 to 60 grams of carbohydrates for each meal is usually a good start. Those with type 1 diabetes typically have more flexibility because they can adjust their insulin depending on the amount of carbohydrates they eat.
6. Myth: Playing sports and exercising can be dangerous if you have diabetes.
Fact: Gary Hall, an Olympic swimmer, and Jackie Robinson, a former baseball star, are two of many athletes who lived with type 1 diabetes. Need I say more? Exercise is just as important for people with diabetes as it is for anyone else. For people with type 2 diabetes, exercise may have extra benefits: improving blood sugar control, aiding in weight loss, and lowering blood pressure and blood cholesterol levels.
As long as those with diabetes pay attention to how they feel and keep an eye on their blood sugar levels during exercise, there is no need to feel limited. Staying hydrated, eating beforehand, and keeping snacks close-by can help people with diabetes stay safe during exercise. The sky is the limit! While diabetes is a serious and complicated disease that affects all aspects of life, it should never limit or discourage anyone from reaching his or her goals.
Katelyn Castro is a first-year student in the DI/MS Nutrition Program at the Friedman School. She is passionate about teaching nutrition to kids and has spent the past two summers working with kids with type 1 diabetes at the Barton Center.