Seven misconceptions about diabetes

St. Joseph’s/Candler Center for Diabetes Management registered dietitian debunks common myths about this common chronic disease

What do you think when someone says they have diabetes? That they can never have sugar or that eventually they are going to lose part of their leg?

Diabetes is a condition in which the body doesn’t make or use insulin correctly. The most common types of diabetes are type 1 and type 2. Type 1 diabetes is an autoimmune disease where essentially the body makes little or no insulin due to an autoimmune reaction that destroys the insulin-producing cells in the pancreas, explains Gabriella Zeigler, registered dietitian for the St. Joseph’s/Candler Center for Diabetes Management.

In type 2 diabetes, your body still makes insulin but for whatever reason – and there are many – not to the degree that is adequately controlling blood sugar. You may not be making enough insulin or it may not be binding properly or your liver is making too much blood sugar or you are digesting your food too quickly, Zeigler says.

“I also like to stress that genetic factors and family history play a huge role in diabetes diagnoses,” Zeigler adds.

Related Article: Is diabetes genetic?

The effects of diabetes vary person to person but there are some common misconceptions that should be cleared up.

“I see misconceptions on the disease side itself and misconceptions on the diet part too,” Zeigler says. “I try to let patients with diabetes know that it’s not really what we eat, but how we eat and then making adjustments so you don’t have to never eat your favorite foods ever again.”

Here are some common misconceptions surrounding diabetes:

Misconception 1: It’s my fault I have this disease

As mentioned, there are many reasons why people develop diabetes and a lot are out of your control.

“A lot of times it really is predisposition and family genetics,” Zeigler says. “It’s not always because you ate too much sugar for too long. It could also be your liver isn’t working properly or your insulin isn’t binding properly. There are multiple reasons why our blood sugars could be high, not just that we eat poorly.”

Misconception 2: If you are overweight or obese, you will eventually develop type 2 diabetes

Yes, being overweight or obese is a risk factor for developing diabetes, but there are other risk factors such as family history, ethnicity and age that also play a role. You shouldn’t disregard the other risk factors. In fact, most overweight people never develop type 2 diabetes, according to the American Diabetes Association. However, exercise is important for anyone who faces other risk factors of diabetes, and it’s especially important for people diagnosed with diabetes to exercise regularly.

“Diabetes is not always tied to weight,” Zeigler says. “Just because we weigh a certain amount or a BMI (body mass index) gives us a certain number, that does not dictate how well our organs are functioning. You can be completely healthy in a bigger body.”

On the flip side, if you are diagnosed with diabetes and then lose weight, there’s no guarantee you won’t have diabetes anymore or your blood sugar will be perfect, Zeigler adds. Having a healthy weight is good for a lot of reasons and many disease preventions, but as mentioned, your weight and diet may not be the reason behind your diabetes diagnosis.

Related Article: Can skinny people get diabetes?

Misconception 3: Eating too much sugar causes diabetes

A lot of sugar is not good for anyone. However, if you want to avoid diabetes that doesn’t mean you have to totally eliminate sugar from your diet.

Focus on reducing the amount of sugar you consume. Maybe you start by drinking less sugary drinks, whether it’s natural sugar or added sugar, such as soda, sweet tea and juices. Or, instead of the large chocolate bar, opt for a bite-sized one instead.

But, don’t punish yourself if you do have that candy bar every now and then.

“If you have an off day, it’s an off day. You are only human,” Zeigler says. “It’s not going to immediately raise your A1C. I always stress to people your A1C is a three-month average. If you have that one bad day, move one.”

Misconception 4: If you have diabetes, you shouldn’t eat carbohydrate-rich foods, such as bread, potatoes and pasta

People with diabetes do need to watch their carbohydrate intake; however, it doesn’t have to be totally eliminated. In fact, Zeigler thinks that’s the wrong decision to make.

“I don’t think there’s anything positive about cutting out an entire food group,” she says. “Carbohydrates are you body’s main source of energy. In the day’s length of time, you want to make sure you are giving your body enough energy.”

So, yes, it’s OK to have starchy foods, but Zeigler advises dosing those carbs throughout the day. If, for example, we have a particular patient who needs 200 grams of carbs per day, it’s far better to spread out those 200 grams throughout the day by having around 50 grams at meals and around 20 grams at snacks rather than taking in 100 grams at one meal and then 100 grams at another.

Zeigler also recommends making sure your plate is balanced with protein, whole grains and lots of vegetables. Protein and whole grain, high fiber foods help slow digestion, including that of the carbs you eat, Zeigler says.

Misconception 5: People with diabetes can’t eat sweets or chocolate

Managing your diabetes involves certain lifestyle practices including exercise and a healthy diet. If eaten as part of a healthy meal plan and combined with exercise, sweets and desserts can be eaten by people with diabetes. But, keep moderation in mind.

“Have the sweet thing because if someone tells us we can’t have something, we are going to want it more. It’s just human nature,” Zeigler says. “Let’s say you only allow yourself to have ice cream on Saturdays, and you love ice cream. Come Saturday, you’re more likely to overeat the ice cream and order more than necessary because you’re thinking, ‘I can’t have this again for a whole week.’”

Misconception 6: If you have type 2 diabetes and your doctor says you need to start using insulin, it means you are failing to take care of your diabetes

First, tons of people with diabetes never even touch insulin, Zeigler says. There are so many other great medications and options for habit adjustment that your healthcare team can prescribe or recommend.

But, if you do end up needing insulin and you were trying everything you could, it doesn’t mean that you’ve failed.

“Sometimes the body needs a little bit of help,” Zeigler says. “I think because diabetes is so closely tied to diet and exercise that it’s easy to forget that it’s still a chronic disease and your body needs help when it has a disease.”

Misconception 7: People with diabetes are going to lose a limb, such as a foot or part of their leg

It’s a valid concern and one Zeigler hears often, but the two do not automatically go hand in hand. It’s all about controlling your diabetes.

Diabetes does not attack your feet. However, diabetes is linked to peripheral neuropathy, which occurs when there’s damage or disease to the nerves. If, for example, you get a cut on the bottom of your foot and don’t notice it or feel it because of nerve damage, then it may not heal properly or as quickly, especially if your blood sugars are uncontrolled.

“If you have uncontrolled diabetes and your blood sugars are really high, then the healing process is slower,” Zeigler says.

That doesn’t automatically mean you are going to lose your foot, but it does put an emphasis on controlling your diabetes diagnose with proper diet, exercise and taking any medications your physician prescribes.

Related Article: Peripheral neuropathy: Understanding diabetes effects on your feet

The St. Joseph’s/Candler Center for Diabetes Management is an American Diabetes Association certified program. It offers individual diabetes management counseling programs on topics including exercise, carb counting and diet, as well as preventing complications with diabetes.

A doctor’s referral is required for insurance reimbursement; however, the staff can help with referrals. For more information, call 912-819-6146 or visit our website. 

St. Joseph’s/Candler Center for Diabetes Management registered dietitian debunks common myths about this common chronic disease