Improvements in care management of diabetic patients have been recently made thanks to decades of profound research in different areas pertinent to the disease (i.e. diagnosis, treatment, pharmaceutical, behavioral and nutrition), achievements made in clinical practices and the responsible commitments of diabetic patients themselves. Currently, we have nine different types of oral medications and insulin formulations including many different strategies that can be tailored to every patient’s lifestyle and needs.

We also have come to understand that management of diabetes is not an individual problem, but rather a team collaboration. We now take better care of patients by organizing teams of experts in different fields who are dedicated to the integral care of the diabetic patient. Physicians, nurses, podologist, psychologists, nutritionists, educators and pharmacists, among others, are now exceptionally well trained in the management of this disease. They all play an important role not only in helping clinically manage the disease, but also in providing useful information for the patient in their everyday life. Overall, health education plays a key role in adequate management. Basic understanding of the disease, strategies for control, and potential expectations are fundamental to achieving a positive outcome.  In the next lines, I would like to share with you (and debunk) common myths I usually hear from my patients about diabetes mellitus. There are many myths about the disease and most involve its management, which can be misleading to patients and their families Such myths can create multiple misconceptions and stereotypes jeopardizing a patient’s ability to adequately control their disease..

What is Diabetes Mellitus?

Diabetes Mellitus (Diabetes) refers to a chronic metabolic disorder affecting the way food (especially sugar) is metabolized in our bodies and used as energy. Although there are several different types of diabetes, and they may defer in their mechanisms and physiology, the end result is an elevated blood glucose level and with that,  many health risks.

The most common type of diabetes is type 2, accounting for 85-90% of all the cases in the United States.

As of 2011, the Centers for Disease Control (CDC) estimated that nearly 26 million Americans had diabetes. Additionally, 79 million were considered “prediabetic”.  Unfortunately,  Hispanic race presented the highest prevalence rate of diabetes in the United States.

Diabetes Mellitus, Myths and Facts.

Myth #1 : Diabetes is not a serious disease.

Fact: Diabetes should be taken seriously.

If you adequately control your diabetes, the potential complications of the disease can be delayed or even completely prevented. It is important to consider that diabetes is the number one cause of blindness, kidney failure and non-traumatic lower limb amputation in older adults (all of which are preventable with adequate control). In the US, diabetes causes more deaths than AIDS and Breast Cancer combined.

Myth #2: Diabetes means I am going to die soon.

Fact: Definitely not true.

Your careful control and management of the disease will define its progression and the lifestyle you will be able to lead. With great personal responsibility, adequate support from your family, and advice from experts you can definitely live a long and normal life. Diabetes is not a death sentence.

Myth #3: If you are overweight or obese, you are diabetic.

Fact: Being overweight or obese does not necessarily mean diabetes. 

To clarify, excess weight (overweight or obese) stands as the major risk factor for developing Diabetes and its complications. About 90% of patients who develop type 2  diabetes mellitus are obese. However, people considered “normal weight” (BMI 18.5-25kg/m²) may develop the disease if they carry too much fat in their abdomen, the so-called “central obesity”. There are also other risk factors to consider such as family history, ethnicity and age. In general the development of type 2 diabetes result as an interaction of environmental factors (i.e. excessive caloric intake, lack of exercise) and genetic predisposition.

Myth #4: Eating too much sugar causes diabetes.

Fact: Diet alone is not a direct cause of diabetes.

There is a direct relationship between a high-caloric diet (from any source), particularly high in sugar, and weight gain. Excess weight stands as the major risk factor for developing diabetes and not the diet itself. Nevertheless, recent studies suggest that drinking sugary drinks (i.e. sodas, sports drinks or juices) may increase your risk of developing diabetes.

Myth #5: People with diabetes should eat special diabetic foods.

Fact: People with or without diabetes should follow a healthy meal plan.

People with Diabetes can eat anything they want, as long as their blood sugar level is under control. Generally, diabetics should follow the same healthy meal plan people without diabetes should follow as well. In general, a well-balanced diet includes foods moderate in sodium (salt) and sugar, low in saturated and trans fat, and based on lean proteins, non-starchy vegetables, healthy fats, whole grains, and fruit.  Fruit is generally considered a healthy food. It is high in fiber and rich in vitamins and minerals. Because fruits contain carbohydrates, they need to be included as part your healthy meal plan, and consumed with moderation.

Additionally, there is no reason for diabetics to deprive themselves from eating sweets as part of their healthy meal plan as long as they are consumed in reasonable portion sizes, not on a regular basis and their blood glucose levels are maintained under control. Portion sizes of any type of food, healthy or not, is important to pay attention to.  Small portions sizes are always better than large quantities of food.

Myth #6: People with diabetes are more vulnerable to “colds” and other illnesses.

Fact: Diabetic patients are not more prone to other illnesses.

Diabetics generally do not have a higher chance of getting a cold, other infections or illnesses in general. Something to consider is that any illness in a diabetic could potentially cause instability in the control over their disease, therefore increase their chances of developing complications from diabetes. That is why is it highly advisable for diabetic patients to keep their flu shot and vaccinations up to date.

Myth #7: You can get infected with diabetes from someone else.

Fact: Diabetes is not contagious, therefore you cannot catch it from someone else.

Even though some aspects of the mechanisms behind Diabetes aren’t precisely known, we know it cannot be transmitted from one person to another like the flu. As mentioned before, genetic and lifestyle factors play crucial roles in the development of the disease.

Myth #8 : Starting to use Insulin means a failure to take adequate care of diabetes

Fact: Starting to use Insulin DOES NOT mean failure.

Most of the time, type 2 diabetes is considered a chronic and progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with oral medications. However, over time the body gradually produces less insulin, and eventually oral medications may not be sufficient to keep blood glucose levels normal. Using insulin to get blood glucose levels to a healthy level is just another strategy, often a really effective one.

Myth #9: Insulin injection is very painful and I cannot deal with injections or shots.

Fact: Science and technology has created virtually painless means for diagnosing and treating Diabetes.

The best way to test your glucose level is from your blood. However, today there are blood sugar meters that make drawing blood virtually painless. On the other hand, the best way to apply insulin is through an injection. However, these needles are now among the smallest in the market (i.e. 6mm, 8mm and 12.7mm). New clinical recommendations support the use of shorter needles making it virtually painless to test and apply medication for your diabetes. 

Myth#10: Using insulin will inevitably lead you to blindness, kidney failure and/or extremity amputation.

Fact: False. Treatment with Insulin is just another strategy (often a very effective one) for getting diabetes under control.

This is probably the most misleading myth about insulin. The harm this myth has produced, persuading patients not to seek medical attention or not to take insulin, is devastating. The fact is many patients start using Insulin after many years of inadequate control of their diabetes. Because their diabetes has been out of control for so long they are at higher risk for complications such as diabetic retinopathy, renal disease and amputations. The relationship is just a temporal association and not a cause and effect. Adequate control of the disease, combined with oral medications or insulin injections will prevent further complications and enable the patient to live a normal life.

Do not be scared if you have been diagnosed with diabetes. There are plenty of experts and medical resources available to help control your disease. Most importantly, take responsibility and inform yourself. Being educated about your disease will empower you to actively participate in your care, improve your lifestyle, and will reassure and make your family proud.