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Everyone knows everything about diabetes — particularly those who don’t have it. Uniquely among health conditions, uninformed family members, friends, and even strangers think they know all about your diabetes and are quick to judge you, give you advice, or ask whether you can do, whatever the activity under discussion is.
There are numerous myths regarding diabetes. Many are archaic scraps of information that simply no longer are true. Others were never true in the first place, but have been believed by people both with diabetes and without it. Finally, some myths are just curiously bizarre.
The following are truths to dispel some of the fiction surrounding diabetes.
Truth: I doubt there’s a person with diabetes who hasn’t been asked, “Can you eat that?”
Sugar, in any volume, cannot cause diabetes.
When a person has diabetes, the body doesn’t deal well with high levels of sugar, but that doesn’t bar sugar. In fact, every cell in the body lives on glucose. It’s the energy source of life, and the body converts all food to glucose for fuel.
How much sugar can people with diabetes eat? That depends on the person and the medications he or she takes. But sugar in no way is banned from modern diabetes meal planning.
Long ago, people with diabetes were told not to eat foods containing sugar. We now know that people with diabetes can consume sugar safely, but this restriction has remained the most widely held diabetes myth. Myths that start as gospel truths are the most tenacious.
Truth: To poke a sharp pin in this balloon, consider two statistics. First, the U.S. obesity rate is around 37%. The diabetes rate is just under 10%. If obesity caused diabetes, the diabetes rate would be much higher.
The fact is that while excessive weight can serve as a trigger to diabetes onset (as can age), there’s a lot more to diabetes than weight alone. The likelihood for diabetes lies deep in the genes — to develop diabetes you must be genetically predisposed. If you are predisposed, keeping trim and eating a healthy diet delays — but does not prevent — diabetes.
This myth comes from uninformed observation. While it’s true many people who have diabetes are overweight, people sometimes make causal connections that aren’t there.
Truth: Insulin is a miracle drug. It’s a lifesaver. It has fewer side effects than any other diabetes medication, and it has virtually no drug interactions with other medications. And yet it’s nearly universally reviled and misunderstood.
At one time, insulin commonly was used as a drug of last resort, often started too late in the disease course after devastating complications[2] had already set in — including vision loss. This myth still is widely held as truth in some parts of the U.S.
Truth: The weight gain myth is complicated by the fact that many people gain weight after starting insulin therapy. The reason for this is debated even among diabetes experts, and while some experts believe insulin in itself can cause weight gain, there’s a more likely explanation. When blood sugar is elevated, glucose is excreted in the urine, eliminating some of the calories consumed. Once insulin treatment is begun, those calories stay in the body, and if the patient consumes more calories than he or she burns, he or she will gain weight.
Truth: Some shots do hurt, including a number of common vaccines. Some even hurt more the next day. But insulin shots are different. Modern needles are thin and short, with beveled tips that are coated with lubricants.
These needles are injected into fat layers under the skin on parts of the body with few nerve endings. Fingersticks are much more painful than insulin shots and, done correctly, fingersticks are barely noticeable.
Truth: There are no physical limitations imposed by diabetes — in fact, a team of Type 1 cyclists[4] won a transcontinental race.
This myth no doubt originated from the fact that a risk of low blood sugar[5] is associated with increased physical activity. If someone taking insulin is much more active than usual, a low sugar level can result. But this doesn’t bar physical activity, even extreme activity. Activity merely needs to be balanced with medicine and carbohydrate intake to maintain healthy blood sugar levels.
Truth: There is some truth here — depression[6] is more than twice as common among people with diabetes as among the general population, and blood sugar swings can affect mood in the short run.
But depression is a treatable illness, and good diabetes control contains mood swings.
Truth: Diabetes is an inconvenience, not a disability. While we’ve yet to have an astronaut with diabetes, it’s only a matter of time. People with diabetes have done amazing things, filled myriad roles, and worked in nearly every vocation — including Olympic medalists; stars of stage, screen[7], and music[8]; pilots and racecar drivers; political leaders; soldiers; journalists[9]; mountain climbers; and Supreme Court justices.
Truth: At one time, it was the medical standard of care to advise women with diabetes, especially those with Type 1, not to conceive. Movies such as Steel Magnolias keep this myth alive.
Today, while it is considered a high-risk pregnancy that should be managed by a team of health-care experts, thousands of women with diabetes safely deliver healthy babies every year.
Truth: Like many other parts of the diabetes universe, there’s a difference between diabetes and diabetes control. Simply having diabetes is the leading cause of nothing. But a person with poorly controlled diabetes and high blood sugar can experience erectile dysfunction[12], vaginal dryness, or reduced libido.
Truth: Not only can people with diabetes have tattoos, many choose to get medical alert tattoos. But if your diabetes is in poor control, getting a tattoo can be risky because it might not heal properly. An A1C[13] under 7.5 is best for tattoos, and getting a tattoo if your A1C is higher than 9.0 is considered high risk.
Truth: This myth comes from within the diabetes community. No one can accurately guess what his or her blood sugar is by feel. While lows have a distinct set of symptoms, these warning signs provide no reliable indication of how low you actually are, and while some people feel vaguely ill if their sugar goes high quickly, these same symptoms rarely are present when sugar creeps higher over a long period of time.
The only way to truly know your blood sugar number is to get out your meter and test[14].
Want to learn more diabetes basics? Read “What Is a Normal Blood Sugar Level”[15] and “Blood Sugar Monitoring: When to Check and Why.”[16]
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