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Eight Misconceptions About Diabetes with Dr. Carla Hightower, M.D

By Sheila Collins

With so many myths floating around the internet, it can be hard to differentiate what is true and what is false when it comes to diabetes. We asked Dr. Carla Hightower to clear up common misconceptions about diabetes and share her advice with the Let’s Be Well community. 

Carla Hightower, M.D. is a physician, certified integrative health coach and founder of Living Health Works.  She empowers men and women to take control of their health. She emphasizes plant-based eating habits and lifestyle choices to increase well-being and peace of mind.

Misconception 1: Type 2 diabetes only happens in adults while type 1 only happens in children.

Thirty years ago, type 2 diabetes was called “adult-onset diabetes” because it rarely occurred in children. But today, type 2 diabetes is on the rise in children, mainly due to the obesity epidemic.

In type 2 diabetes, your body still makes insulin but your cells have stopped responding to it. The condition is called insulin resistance.

Type 1 diabetes is different because it is an autoimmune disease, meaning that your immune system mistakenly attacks the pancreas so that it no longer produces insulin. Type 1 diabetes used to be called juvenile diabetes because it is more common among children, but it can develop at any age.

Over the years, researchers noticed that some adults experience features of both type 1 and type 2 diabetes. Thus, they coined the term “type 1.5” diabetes or latent autoimmune diabetes in adults (LADA). 


Misconception 2: People get type 2 diabetes because they are overweight and eat too much sugar.

A common misconception is that type 2 diabetes only occurs in overweight people. While it is true that being overweight or obese increases the risk for type 2 diabetes, slim people can experience type 2 diabetes as well. 

Besides weight, there are several other factors determining your risk of type 2 diabetes. Family history may make you predisposed to developing type 2 diabetes, but your diet and lifestyle habits are the key factors. Research shows that the risk for type 2 diabetes is closely linked to an unhealthy diet and physical inactivity. [Reference 1]

By itself, added sugar is not the actual cause of type 2 diabetes, even though it makes the blood sugar hard to control. On the other hand, a high-calorie diet that’s high in saturated fat was shown to promote type 2 diabetes. [References 2 & 3] 

Regarding sugar, you need to know the difference between added sugar (such as cane sugar) and natural sugar found in whole foods such as fruit, vegetables and whole grains. Added sugar is rapidly absorbed and tends to spike blood glucose levels. Keep in mind, sugar-sweetened beverages often contain surprisingly large amounts of added sugar that can affect your health.  

A diet containing a lot of added sugar is also linked to heart disease. Therefore, the American Heart Association recommends that people consume no more than 6 teaspoons (25 grams) of added sugar per day for women and 9 teaspoons (36 grams) for men. [Reference 4]

Misconception 3: There are no symptoms for diabetes.

With diabetes, some people have symptoms and others do not. It all depends on the severity of the condition and how high blood sugar level rises. Some individuals with prediabetes and type 2 diabetes often have no symptoms. Whereas, individuals with type 1 diabetes tend to experience severe symptoms that arise immediately.

Common symptoms include: 

  • Extreme thirst
  • Frequent urination 
  • Unexplained weight loss 
  • Fatigue
  • Lethargy 
  • Excessive hunger
  • Blurred vision
  • Fruity breath odor.

Misconception 4: It isn’t safe to exercise with diabetes.

With diabetes, if you take the necessary precautions, exercise is great for you. It can improve your cardiovascular health and help you control your blood sugar. Physical activity is fantastic, because it burns calories and facilitates weight loss. Studies show that taking a walk after a meal significantly lowers the blood glucose and improves A1c naturally. [Reference 5] 

To be safe, a person taking diabetes medications needs to carefully avoid low blood glucose following a workout. Check your blood sugar before and after exercising, and eat something in advance. Keep snacks on hand, such as dates, to raise your blood sugar quickly if needed.

Misconception 5: I was only diagnosed with prediabetes, so I don’t need to worry yet.
With prediabetes, it is easy to be lulled into a false sense of complacency. The term prediabetes is misleading, because it implies that you don’t have a problem yet. I prefer to think of prediabetes as the earliest stage of type 2 diabetes. If diagnosed with prediabetes,  take action right away to change your eating habits and lifestyle choices in order to successfully reverse the condition. 

Most people make the mistake of waiting until their condition progresses to diabetes before they begin taking it seriously. By procrastinating, you potentially allow your health to deteriorate.   

Misconception 6: If I am diabetic, I can’t enjoy any of the foods everyone around me eats, and I definitely can never eat sweets again!

Added sugar and other junk foods are not a good idea. However, that does not mean you have to give up all sweet things. Try a healthier version of your favorite sweet treats. For example, I like to make  healthy “ice cream” by placing frozen bananas or berries in a blender. 

Fresh whole fruit is a great way to satisfy your desire for something sweet. Research shows that whole fruits such as berries, grapes and apples actually reduce the risk of type 2 diabetes. [Reference 6] You can enjoy the pleasure of something that’s sweet and good for you.

With diabetes, it's important for you to develop some strategies to stay active and socially connected. When you’re going out to eat with others, I recommend eating a small meal before leaving home to suppress the urge to eat unhealthy foods while you’re out. Choose restaurants with an abundance of healthy vegetables on the menu, such as greens, lentils, sweet potato, whole grains. You’ll find that high-fiber foods are more filling and naturally curb the appetite. 

Misconception 7: With a diagnosis of diabetes, I will lose all my independence, and taking insulin will take over my life.

With diabetes, there are plenty of things that you can do to maintain your independence. 

In order to succeed, create a healthy lifestyle with nutrient-rich foods, which include fresh fruits, vegetables, whole grains and legumes. Exercise, good sleep and a healthy weight are also very important.

In most cases, the complications of diabetes are preventable. It is possible to prevent amputation, blindness, heart disease and kidney failure. Healthy eating and lifestyle changes will help you control your blood sugar and improve your health over time.

Misconception 8: It's impossible to lower A1c and reverse diabetes naturally.

Type 2 diabetes is both preventable and reversible in most cases. A healthy diet and lifestyle are your most effective tools for lowering A1c and reversing the root cause. Research shows that a low-fat, plant-based diet lowers insulin resistance naturally. Weight loss is one of the keys to preventing and reversing type 2 diabetes.  [Reference 7]

Be aware, all carbohydrates are not equal. Unhealthy carbohydrates often consist of highly processed grains and added sugars, like cookies, for example. In contrast, whole grains, fruits, vegetables, and legumes are very healthy carbohydrates that help reverse type 2 diabetes. [Reference 8]

Type 1 and 1.5 diabetes cannot be reversed, because the pancreas does not produce insulin adequately. However, through a healthy diet and lifestyle, A1c can be optimized to decrease the amount of insulin required and lower the risk of complications.

This content is provided for your information only, and should not be relied on as medical advice; you should always consult your own physician before making changes to your own health or treatment plans.

References

  1. Diabetes. Mayo Clinic website. Accessed September 25, 2019. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
  2. C Xiao, A Giacca, A Carpentier, G F Lewis. Differential effects of monounsaturated, polyunsaturated and saturated fat ingestion on glucose-stimulated insulin secretion, sensitivity and clearance in overweight and obese, non-diabetic humans. Diabetologia. 2006 Jun;49(6):1371-9. https://www.ncbi.nlm.nih.gov/pubmed/16596361
  3. Wang L, Folsom AR, Zheng ZJ, et al. Plasma fatty acid composition and incidence of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr. 2003;78:91–98. https://www.ncbi.nlm.nih.gov/pubmed/12816776
  4. Added Sugars. American Heart Association website. Accessed September 28, 2019. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars
  5. Pahra D, Sharma N, Ghai S, Hajela A, Bhansali S, Bhansali A. Impact of post-meal and one-time daily exercise in patient with type 2 diabetes mellitus: a randomized crossover study. Diabetol Metab Syndr. 2017;9:64. Published 2017 Aug 31. doi:10.1186/s13098-017-0263-8 https://www.researchgate.net/publication/319415153_Impact_of_post-meal_and_one-time_daily_exercise_in_patient_with_type_2_diabetes_mellitus_A_randomized_crossover_study
  6. Muraki I, Imamura F, Manson JE, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies [published correction appears in BMJ. 2013;347:f6935]. BMJ. 2013;347:f5001. Published 2013 Aug 28. doi:10.1136/bmj.f5001  https://www.bmj.com/content/347/bmj.f5001
  7. Tonstad S, Butler T, Yan R, et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care. 2009;32:791–796.  https://care.diabetesjournals.org/content/32/5/791
  8. Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet. 2014 Jun 7; 383(9933):1999-2007. https://www.ncbi.nlm.nih.gov/pubmed/24910231/