To help push back against these misperceptions, SELF talked to experts about the most common diabetes myths that they hear, along with the truth behind the myths as well.
1. Myth: People should be embarrassed about having diabetes.
You may feel embarrassed about having diabetes, but there are so many reasons for why having this medical condition (or any other) shouldn’t be shameful. For starters, diabetes is incredibly common. More than 34 million people living in the U.S. have the condition, according to the Centres for Disease Control and Prevention. That’s around 1 in 10 people. But even if it were a less common condition, the shame and stigma surrounding diabetes still wouldn’t be justified.
There are numerous reasons for why diabetes is often so stigmatized, including anti-fat bias, racism (diabetes is more likely to affect people of colour than white people), and our cultural obsession with wellness, among others. But having diabetes doesn’t mean you are somehow less than a person without the condition in any way.
If you have type 1 diabetes, then your pancreas doesn’t make enough insulin, a hormone that helps your body take sugar from your blood to use as energy. People with type 2 diabetes typically produce some insulin but aren’t able to use the hormone effectively, meaning they're insulin-resistant, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Type 1 diabetes typically tends to develop much earlier than type 2 diabetes.
Experts aren’t sure what exactly causes the insulin issues that give rise to type 1 diabetes, but they generally believe it happens when your immune system mistakenly attacks healthy cells in your body. Type 2 diabetes is the result of a mix of genetic and lifestyle factors. Having a first-degree relative with diabetes—like your mother or father—increases your risk of developing both forms of diabetes, according to Jorge Moreno, M.D., an internal medicine physician with Yale Medicine who is also board-certified in obesity medicine. Either form can be stigmatized largely because people may not understand diabetes and assume only lifestyle factors are involved, according to Wendell Malalis, M.D., endocrinologist at Northwestern Medicine Regional Medical Group. “People may feel like [diabetes] was all their fault,” he tells SELF.
Since lifestyle factors aren’t involved in developing type 1 diabetes, there’s no way to reduce your risk of developing the condition. Staying physically active and not being a weight that is medically classified as overweight or obese can decrease a person’s risk of developing type 2 diabetes by helping the body become more sensitive to insulin. But having any real control over these kinds of lifestyle factors is so much easier said than done. For instance, the way you eat and exercise can depend on where you live, your schedule, food accessibility, and how your family raised you to think about and behave around food and fitness. If you’re a single parent who works long hours, for example, you may not be able to cook many fresh meals (which can be more expensive and take longer to prepare) and exercise often. It’s also very much worth noting that weight doesn’t exist in a vacuum—no matter how you eat or move your body, factors like your hormones, sleep, and, yes, genetics can have a big impact on your weight. All of that is to say that it’s unfair and inaccurate to blame or judge anyone for having a condition like diabetes.
That said, if you have a family history of type 2 diabetes and want to lower your type 2 diabetes risk (or feel more in control of your type 2 diabetes if you have the condition), then you may want to talk to your doctor about what realistic and sustainable lifestyle changes might make a difference for you.
2. Myth: You can only develop diabetes if you’re overweight.
The vast majority of people with diabetes have type 2 diabetes. And while weight is one factor in developing type 2 diabetes, people can have type 2 diabetes at any weight. (There are plenty of people in bigger bodies who don’t have diabetes too.)
Being overweight is associated with insulin resistance, which can cause type 2 diabetes if your blood sugar remains excessively high. Although body mass index (BMI) is not a good measure of individual health, research shows there’s a correlation between having a higher BMI and developing type 2 diabetes. The reason for this isn’t fully understood, but one reason could be that some people with a higher BMI have more visceral fat (or the fat stored in our stomach surrounding our organs). Visceral fat affects hormone regulation and having more visceral fat is associated with insulin resistance. But having a higher BMI doesn’t guarantee you’ll get diabetes, and there are people with lower BMIs who do have diabetes.
Past research shows that some people who were at risk of developing diabetes lowered their chances of getting the condition after losing weight through diet and exercise. That’s why you’ll often hear that losing weight is recommended to help you lower your chances of getting diabetes if you’re at risk. For some people, weight loss also makes blood sugar easier to manage. But know that there is no specific amount of weight loss guaranteed to lower the odds of developing diabetes if you’re at risk or improve your diabetes if you have the condition. Talking to your physician can help you decide whether you might benefit from losing weight and, if so, how to realistically do that.
3. Myth: You can never eat sugar or carbs if you have diabetes.
If you have diabetes and have received a disapproving stare from someone when you order dessert, then you may have experienced the blowback from this myth. “There is no reason that you have to cut everything out,” Bithika M. Thompson, M.D., an endocrinologist with the Mayo Clinic in Scottsdale, Arizona, tells SELF. “It all comes down to balance.”
In order to avoid diabetes-related complications, you will need to keep your blood sugar levels within a target range that’s specific to you. (Your doctor will help you set this target.) For example, if you have type 2 diabetes and sugar builds up in your blood, then you may develop hyperglycaemia, or dangerously high blood sugar. Over time high blood sugar levels can raise your risk of heart attack, stroke, and other complications.
Although you don’t need to completely avoid eating carbohydrates or sugar if you have diabetes, you may need to make some dietary changes to keep your blood sugar levels in your recommended range. For example, your doctor or dietitian may recommend that you choose complex carbohydrates over refined carbohydrates when possible, like opting for whole wheat bread instead of white bread. Your body breaks all carbohydrates down into glucose (sugar) and uses it for energy. But complex carbohydrates take longer to break down, meaning your blood sugars rise more slowly.
You can use the glycemic index as a guide for choosing foods, says Dr. Moreno. The index assigns a number to certain foods based on how likely they are to make your blood sugars rise. (The lower the GI number, the less likely your blood sugar will rise.) But keep in mind that the GI is not an exhaustive list and doesn’t account for the nutritional content of foods, like whether something has vitamins or fats (which our bodies need). However, it is one tool that might help you make choices about what you want to eat.
4. Myth: Insulin is actually harmful.
Insulin helps keep your blood sugar low by moving sugar from your bloodstream into your cells. And maintaining a healthy blood sugar is one aspect of decreasing your chances of developing other health conditions such as heart disease. However, some people mistakenly believe that insulin can make your diabetes worse.
Insulin is the recommended treatment for most people with type 1 diabetes, according to the American Diabetes Association. People with type 2 diabetes generally take other medications rather than insulin at first but may need to eventually take insulin in the long term.
It’s true that, like any medication, insulin can come with side effects and potential risks. Insulin therapy can also cause issues like trouble breathing, muscle cramps, and constipation, according to the U.S. National Library of Medicine. If you accidentally take too much insulin or your doctor prescribes you a higher dose than what you need, then you may develop low blood sugar. When this happens, you might feel fatigued, irritable, shaky, or confused. In this case, it’s safest to get medical assistance or talk to your doctor about how to counteract taking too much insulin. You may be advised to eat and recheck your blood sugar or to get urgent care, depending on your symptoms. Generally, doctors start by giving you low doses of insulin and gradually increasing your medication to avoid this happening.
Some studies show that insulin may be linked to cardiovascular complications, such as strokes, in people with type 2 diabetes. However, having type 2 diabetes increases your risk of developing heart disease, so insulin wasn’t necessarily the cause for any heart issues in these studies. If you’re worried about taking insulin, it’s worth discussing your specific concerns with your physician so you can work on creating a treatment plan you’re comfortable with.
5. Myth: You can cure diabetes.
You may have seen advertisements for products that claim to cure diabetes, but in reality diabetes is a chronic disease. In other words, there is no diabetes cure.
But you can successfully manage your condition and even achieve remission with the right treatment plan. Some people with type 1 diabetes may lower their blood sugar to a nondiabetic range when they’re not currently taking any drugs after they’ve already been on medication for a while. However, this remission isn’t generally sustainable because their body eventually won’t be able to produce insulin on its own, according to the American Diabetes Association.
With type 2 diabetes, you may be able to achieve very long periods of remission when your blood sugar levels reach a nondiabetic range without using medications, according to the NIDDK.
Ideally, you can have an open and honest conversation with your physician about the best way to manage your blood sugar, such as taking medication, making dietary adjustments, or increasing physical activity. Finding what works for you can take some time, so you may have some trial-and-error before you notice any blood sugar changes, according to Dr. Moreno. “Sometimes it takes more than one try to get to the root cause of the [blood sugar] elevation,” he says.
Understandably, you may feel isolated if you don’t know other people with diabetes or if people you know believe these myths. While having a medical condition can feel really all-consuming, it can be helpful to remember that having diabetes isn’t a character flaw. “It doesn’t define you,” Akankasha Goyal, M.D., clinical assistant professor of medicine and endocrinologist at NYU Langone Health, tells SELF.
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