Medical myths: All about diabetes

Globally, diabetes is becoming increasingly prevalent, as are the myths and misconceptions that surround it. Here, we discuss 11 of these repeated untruths.

Currently, around 1 in 10 people in the United States have diabetes. Globally, more than 422 million people are living with the disease.

Although diabetes is a familiar word, symptoms vary, and the biological mechanisms involved are complex. Because it is both common and complicated, half-truths abound.

Unfortunately, some of the myths we cover in this article increase the stigma attached to diabetes. For this reason alone, it is essential to challenge these falsehoods.

Firstly, we will briefly explain what diabetes is and highlight the differences between the three most common forms of diabetes: type 1, type 2, and gestational diabetes.

Type 1 diabetes is an autoimmune disease in which the immune system attacks the pancreas cells that create insulin. It tends to occur earlier in life than type 2 diabetes. In type 2 diabetes, the body does not make enough insulin, does not respond well to insulin, or both.

At least 90% of people with diabetes in the U.S. have type 2.

Gestational diabetes, as the name suggests, occurs during pregnancy. During pregnancy, the body needs more insulin. Gestational diabetes occurs when the body cannot meet these new requirements.

Although gestational diabetes usually goes away after birth, there is a risk of developing it again during future pregnancies and developing type 2 diabetes later in life.

1. Eating sugar causes diabetes

Eating sugar does not directly cause diabetes. However, consuming a sugary diet can lead to overweight and obesity, which are risk factors for type 2 diabetes.

This is a common myth, perhaps understandably — blood sugar levels play an essential role in diabetes. Sugar itself, though, is not a causal factor.

As ever, the story is complex: there does appear to be a link between regularly drinking soda and risk for type 2 diabetes.

One large study published in 2013 found that, even after controlling for energy intake and body mass index (BMI), drinking soda has links with an increased risk of developing the disease. The study did not find this association in relation to other drinks, such as artificially-sweetened beverages and fruit juices.

Scientists still do not understand why some people develop type 1 diabetes, and others do not. However, nutrition is not a risk factor.

2. Diabetes is not serious

Perhaps because diabetes is so common, some people believe that it is not a serious disease. This is incorrect. There is no cure for diabetes, and there are a host of complications that can occur if a person does not manage the condition well.

Complications include cardiovascular disease, nerve damage, kidney damage, blindness, skin conditions, and hearing impairment.

In 2018, diabetes was the underlying cause of 84,946 deaths in the U.S. The World Health Organization estimate that diabetes caused the death of 1.6 million people in 2016.

3. Diabetes only affects people with obesity

Overweight and obesity are risk factors for type 2 diabetes and gestational diabetes, but the condition can occur in people of any weight. According to data from the Centers for Disease Control and Prevention (CDC) National Diabetes Statistic Report, 2020, 11% of people with type 2 diabetes in the U.S. are neither overweight nor obese.

Type 1 diabetes has no associations with body weight.

4. Obesity always leads to diabetes

Although obesity increases the risk of diabetes, it does not inevitably lead to the disease. According to the CDC, an estimated 39.8% of adults in the U.S. have obesity, but 13% have diabetes.

5. People with diabetes cannot eat sugar

People with diabetes certainly do need to manage their diets carefully: monitoring carbohydrate intake is important. However, they can still incorporate treats.

The American Diabetes Association explain:

“The key to sweets is to have a very small portion and save them for special occasions, so you focus your meals on healthier foods.”

Individuals with diabetes need to carefully plan what and when they will eat to ensure that their blood sugar levels remain balanced.

A related myth is that people with diabetes need to eat special “diabetes-friendly” foods. These products are often more expensive, and some can still raise glucose levels.

6. Diabetes always leads to blindness and amputation

Thankfully, this is a myth. While it is true that diabetes can lead to blindness and amputations in some cases, it is not inevitable. And for individuals who manage their condition carefully, these outcomes are rare.

The CDC estimate that 11.7% of adults with diabetes have some level of vision impairment. Lower-extremity amputation occurs in around 0.56% of people with diabetes in the U.S.

Experts have identified several risk factors that increase the likelihood of experiencing diabetes-related complications. These include obesity and overweight, smoking, physical inactivity, high blood pressure, and high cholesterol.

7. People with diabetes should not drive

A diabetes diagnosis does not automatically mean that someone needs to stop driving. In a position statement on diabetes and driving, the American Diabetes Association explain:

“Most people with diabetes safely operate motor vehicles without creating any meaningful risk of injury to themselves or others.”

However, they also explain that, if concerns arise, people should undergo assessment on an individual basis. According to the U.S. Department of Transportation:

“People with diabetes are able to drive unless they are limited by certain complications of diabetes. These include severely low blood glucose levels or vision problems. If you are experiencing diabetes-related complications, you should work closely with your diabetes healthcare team to find out if diabetes affects your ability to drive.”

8. Prediabetes always leads to diabetes

In the U.S., an estimated 88 million, or 1 in 3, adults have prediabetes. Prediabetes is a condition where blood sugar levels are higher than normal but not quite high enough to classify as diabetes. If left unchecked, prediabetes can develop into type 2 diabetes.

However, it is not a given. Lifestyle changes can turn the tide. Regular physical activity and a more healthful diet can stop diabetes in its tracks.

9. People with diabetes cannot be active

Once again, this is untrue. In fact, exercise is an important component in the management of diabetes. Among other things, exercise helps drive weight loss and reduces blood pressure, both of which are risk factors for complications. It can also help the body use insulin better.

However, exercise can impact blood sugar levels in various ways, sometimes increasing it and, at other times, decreasing it.

According to Diabetes U.K., “Some days, you’ll do exactly the same type of activity and eat the same foods, but your blood sugar levels may act differently to what you’d expect.”

They also offer tips for managing blood sugar during activity:

  • Check your blood sugar while exercising and keep a record of how it behaves to show your doctor. This can help guide any necessary changes in insulin.
  • For people who are at risk of hypos, keep fast-acting carbohydrates close to hand.
  • Wear diabetes identification so that people can help if needed.

10. You can ‘catch’ diabetes

This is a myth. Pathogens do not cause diabetes, so a person cannot pass it to someone else. Doctors classify it as a noncommunicable disease.

11. Some natural products cure diabetes

Currently, there is no cure for diabetes. Any claims that a product can cure diabetes are false. Many herbal or natural products will do little or nothing and, in some cases, they can potentially cause harm; diabetes.co.uk explain:

“Because certain herbs, vitamins, and supplements may interact with diabetes medications (including insulin) and increase their hypoglycemic effects, it is often argued that using natural therapies could reduce blood sugars to dangerously low levels and raise the risk of other diabetes complications.”

Diabetes is a complex but common disease. As its prevalence increases, it is essential to overturn myths as we find them.

Everything you need to know about plant based diets

A plant based diet is one that focuses on only or mostly foods from plant sources. This way of eating may have benefits for both a person’s health and the planet.

In this article, we look at what a plant based diet is, the health benefits, and what nutritional considerations a person should make before switching.

What is a plant based diet?

A plant based diet is a diet that involves consuming mostly or only on foods that come from plants. People understand and use the term plant based diet in different ways.

Some people interpret it as a vegan diet, which involves avoiding all animal products.

For others, a plant based diet means that plant foods, such as fruits, vegetables, whole grains, nuts, and legumes, are the main focus of their diet, but they may, occasionally, consume meat, fish, or dairy products.

A plant based diet also focuses on healthful whole foods, rather than processed foods.

Health benefits

Following a plant based diet offers many possible health benefits, including:

Better weight management

Research suggests that people who eat primarily plant based diets tend to have a lower body mass index (BMI) and lower rates of obesity, diabetes, and heart disease than those who eat meat.

Plant based diets are high in fiber, complex carbohydrates, and water content from fruit and vegetables. This may help to keep people feeling fuller for longer and increase energy use when resting.

A 2018 study found that a plant based diet was effective for treating obesity. In the study, researchers assigned 75 people who were overweight or had obesity to either a vegan diet or a continuation of their regular diet, which contained meat.

After 4 months, only the vegan group showed a significant weight loss of 6.5 kilograms (14.33 pounds). The plant based vegan group also lost more fat mass and saw improvements in insulin sensitivity, whereas those who consumed a regular diet with meat did not.

A 2009 study on more than 60,000 people also found that vegans had the lowest average BMI, followed by lacto-ovo vegetarians (those that eat dairy and eggs) and pescatarians (people who eat fish but no other meat). The group with the higher average BMI were nonvegetarians.

Lower risk of heart disease and other conditions

A 2019 study from the Journal of the American Heart Association found that middle aged adults who ate diets high in healthful plant foods and low in animal products had a lower risk of heart disease.

According to the American Heart Association, eating less meat can also reduce the risk of:

  • stroke
  • high blood pressure
  • high cholesterol
  • certain cancers
  • type 2 diabetes
  • obesity

Diabetes prevention and treatment

Plant based diets may help people prevent or manage diabetes by improving insulin sensitivity and reducing insulin resistance.

Of the 60,000 people studied in 2009, only 2.9% of people on a vegan diet had type 2 diabetes, compared to 7.6% of those eating a nonvegetarian diet.

People eating vegetarian diets that included dairy and eggs also had a lower risk of type 2 diabetes than meat eaters.

Researchers have also looked at whether following a plant based diet can help treat diabetes. The authors of a 2018 review indicate that vegetarian and vegan diets could help people with diabetes reduce their medication needs, lose weight, and improve other metabolic markers.

The authors suggested that doctors might consider recommending plant based diets to people with prediabetes or type 2 diabetes. While veganism showed the most benefits, the researchers stated that all plant based diets would lead to improvements.

People wanting to try a plant based diet should try one that they think they can follow long term.

Foods to eat

People should focus on eating the following food groups when transitioning to a plant based diet:

Fruits

A plant based diet includes all fruits, such as:

  • berries
  • citrus fruits
  • bananas
  • apples
  • grapes
  • melons
  • avocado

Vegetables

A healthful plant based diet contains plenty of vegetables. Including a variety of colorful vegetables provides a wide range of vitamins and minerals.

Examples include:

  • broccoli
  • kale
  • beetroot
  • cauliflower
  • asparagus
  • carrots
  • tomatoes
  • peppers
  • zucchini

Root vegetables are a good source of carbohydrates and vitamins. They include:

  • sweet potato
  • potatoes
  • butternut squash
  • beets

Legumes

Legumes are an excellent source of fiber and plant based protein. People can include a wide variety in their diet, including:

  • chickpeas
  • lentils
  • peas
  • kidney beans
  • black beans

Seeds

Seeds are a great snack or an easy way to add extra nutrients into a salad or on top of a soup.

Sesame seeds contain calcium and sunflower seeds are a good source of vitamin E. Other seeds include:

  • pumpkin
  • chia
  • hemp
  • flax

Nuts

Nuts are a good source of plant based protein and vitamins, such as selenium and vitamin E.

  • brazil
  • almonds
  • cashews
  • pecans
  • macadamia
  • pistachios

Healthful fats

It is vital to consume polyunsaturated and monounsaturated fats, as well as omega-3 fatty acids. Plant based sources include:

  • avocados
  • walnuts
  • chia seeds
  • hemp seeds
  • flaxseed
  • olive oil
  • canola oil

Whole grains

Whole grains are an excellent source of fiber and help maintain stable blood sugar. They also contain essential minerals, such as magnesium, copper, and selenium.

Examples of whole grains include:

  • brown rice
  • oats
  • spelt
  • buckwheat
  • quinoa
  • wholegrain bread
  • rye
  • barley

Plant based milk

If people want to reduce their dairy intake, there is a wide range of plant based milk available in grocery stores and online. These include:

  • almond
  • soy
  • coconut
  • rice
  • oat
  • hemp

Just make sure to choose unsweetened plant milk options.

Foods to avoid

Just reducing or eliminating animal products does not automatically mean a plant based diet is healthful. It is also vital to reduce or avoid unhealthful foods, such as:

  • processed foods
  • sugary foods, such as cakes, biscuits, and pastries
  • refined white carbohydrates
  • processed vegan and vegetarian alternatives that may contain a lot of salt or sugar
  • excess salt
  • fatty, greasy, or deep fried foods

Considerations

Before starting a plant based diet, people should ensure they take steps to get enough of the following nutrients:

Vitamin B-12

Vitamin B-12 is an essential nutrient for blood and cell health. B-12 deficiency can lead to anemia and nerve damage. B-12 is present in many animal products but not in many plant based foods.

People who eat a vegan or even a vegetarian diet could consider taking a B-12 supplement or consume products fortified with B-12. Foods include some cereals, plant based milk, and nutritional yeast.

Iron

People following a plant based diet may have to ensure they get enough iron in their diet, as it has lower bioavailability in plants than meat.

Plant based foods that are a good source of iron include:

  • kidney beans
  • black beans
  • soybeans
  • spinach
  • raisins
  • cashews
  • oatmeal
  • cabbage
  • tomato juice
  • dark leafy greens

Make sure to combine citrus and other vitamin C sources with plant based sources of iron to increase absorption.

Protein

Some people may have concerns about getting enough protein from a plant based diet. However, there is a wide variety of plant based sources of protein, including:

  • lentils
  • chickpeas
  • quinoa
  • beans, such as kidney, pinto, or black beans
  • tofu
  • mushrooms
  • nuts
  • seeds

Consuming proteins from a variety of food sources can help provide all the necessary amino acids for good health. For example, people could add a handful of seeds or a spoonful of hummus to tofu or beans.

Omega-3 fatty acids

Omega-3 fatty acids are essential as they help reduce inflammation, memory loss, and other chronic conditions, such as heart disease. The two primary omega-3 fatty acids are EPA and DHA.

Fish, seafood, and animal products, such as eggs are among the primary sources EPA and DHA.

While several plant based foods, such as walnuts, hempseed, and flaxseed, contain omega-3 ALA, research shows that the body is slow and inefficient at converting ALA to EPA and DHA. Some people are also genetically at risk for poor absorption of ALA.

Vegetarians exhibit lower levels of DHA and EPA in blood and tissue, which may increase inflammation, memory difficulties, brain fog, and other effects. People following a plant based diet might want to consider taking an omega-3 supplement.

Some dietitians advise vegetarians to reduce the amount of pro-inflammatory linoleic acid they consume. Soybean, corn, sunflower, and safflower oils contain linoleic acid.

Summary

Eating a diet higher in plant foods and lower in animal products can have many health benefits, including weight loss or maintenance and a lower risk of heart disease and diabetes.

If people want to make the switch to a plant based diet, they can start by gradually reducing their meat and dairy intake.

Eating an entirely plant based meal once a week, or swapping out one animal product for a plant based one, can be an excellent place to start.

People may also wish to speak to a doctor or dietitian before making significant changes in their diet.