MYTHBUSTERS: Type 2 Diabetes Edition
Written By: Erin Burke, MS, RDN, LDN
Have you heard? November is National Diabetes Month! Nearly 30 million Americans are diagnosed with type 2 diabetes (1). That is almost 10% of the population. If you search on Dr. Google, you are sure to come up with a long list of things you should or should not eat when you are managing diabetes, but how much of that is true? There are new developments in diabetes all the time. Old adage might lead to unnecessary food restriction and decreased quality of life. However, following current recommendations may offer more flexibility and even improved blood sugar control!
1. You can’t eat sugar
Most likely, everyone with diabetes (or prediabetes) has heard this. In reality, every cell in your body relies on sugar, specifically a simple sugar known as glucose. Nearly all carbohydrates, whether they come from table sugar or potatoes, bread (whole wheat or otherwise), pasta, or even vegetables, are converted to glucose during digestion. When people have type 2 diabetes, their body has a hard time effectively using large amounts of glucose. This is partly due to inadequate insulin, a hormone that helps regulate blood glucose (or blood sugar) levels. To manage this, the amount of carbohydrates consumed needs to be monitored at each meal. Since sugar and desserts are sweetened, they naturally have more carbohydrates per serving than an unsweetened food, such as a piece of fruit or a slice of bread. Therefore, a smaller portion of these foods should be eaten. However, they do not need to be eliminated. They can be incorporated into a balanced diet.
2. Being Overweight or Obese Causes Diabetes
An estimated 70% of adults are overweight or obese (2). If excess weight alone caused diabetes, many more people would be diagnosed! Like mentioned above, diabetes is not caused by any individual factor. There is evidence that excess body fat (specifically, the fat found around your abdomen) may contribute to insulin resistance, in which the body does not efficiently use insulin. This can result in higher-than-normal blood glucose levels. However, the development in type 2 diabetes is much more complex. It is also possible for people of a “normal” body mass index (BMI) to get type 2 diabetes, especially if they have other risk factors.
3. Sugar causes diabetes
Eating sugar will not give you diabetes. Certainly, dietary habits can play a role, but there are many contributing factors to the development of diabetes. Genetics and family history of the disease, older age, lack of physical activity, having high blood pressure or high cholesterol levels, limited access to medical care, and/or a history of gestational diabetes or PCOS all contribute to an individual’s risk for this disease. Many people who eat sweets will never develop diabetes, and many people with diabetes may not even like sweets!
4. You can’t get pregnant if you have diabetes.
High blood sugar during pregnancy can lead to complications such as miscarriage or birth defects. Because of this, people with diabetes were previously advised not to get pregnant. However, now it is known that controlling blood sugar levels before and during pregnancy can support a safe and positive experience for mothers and babies. Women planning to become pregnant should discuss with their medical team and have a plan in place before trying to conceive.
5. People with diabetes can’t participate in sports or activities
This is a concern among people with diabetes due to the risk for hypoglycemia, or low blood sugar. It is true that, depending on what medications you take, you may be at increased risk for a low blood sugar after exercise. However, blood sugar levels can be safely managed to avoid going too low during activity. Individuals are encouraged to get at least 150 minutes of moderate-intensity exercise per week, since this can have positive impacts on your blood sugar levels (3). Walking after a meal has been shown to prevent blood sugar spikes, and those who exercise regularly have improved insulin sensitivity (their body uses insulin more efficiently, therefore requiring less of it). If you are taking insulin or a medication that lowers your blood sugar, or you have a history of hypoglycemia, speak with your doctor and a registered dietitian about strategies to reduce your risk of complications and hypoglycemia.
6. If you don’t take care of your diabetes, you will end up on insulin
Going on insulin is a natural progression of diabetes for many people. The insulin-producing cells of the pancreas (called beta cells) gradually lose their functioning over time. It is estimated that about 50% of the beta cell function is already lost when an individual is diagnosed with type 2 diabetes (4). Needing to go on insulin does not mean that you did not take care of your body, or that you failed. If life expectancy permitted, nearly all people with diabetes would eventually need to take insulin! That being said, managing your blood sugar can help delay the need for insulin, and even prevent the requirement for many people. High blood sugar levels can damage all of our body’s cells, including the beta cells that produce insulin. The goal of diet, lifestyle and medication intervention is to preserve those beta cells, and optimize your health and wellbeing for the long-term.
Have you heard other statements about diabetes you are not sure about? If so, check with your doctor, dietitian, or diabetes educator to see if you should be concerned.
- Colberg, et al. (2010) Exercise and Type 2 Diabetes. Diabetes Care. 33(12): e147-e167. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992225/. DOI: 10.2337/dc10-9990
- Fonseca, V. (2009). Defining and Characterizing the Progression of Type 2 Diabetes. Diabetes Care. 32(2): S151-S156. http://care.diabetesjournal.com. DOI: 10.2337/dc09-S301