A diagnosis of diabetes can give rise to many emotions and questions. With so much information available, particularly through searching the internet, it can be overwhelming and confusing. It’s important to seek information from trusted sources. Your diabetes healthcare team can signpost to reputable sources of support.
There are many "myths" that have been voiced regarding diabetes over the years. It’s good to know the fact and fiction, so here are just a few of the most common ones -
Declassifying diabetes and dispelling myths
By Dr Mayank Patel, Consultant in Diabetes and Acute Medicine at University Hospital Southampton NHS Foundation Trust.
Diabetes: What's gone wrong?
There are many recognised definitions for diabetes. Put very simply, they all amount to the same thing; there is too much glucose (sugar) in the body. So where does all this surplus glucose come from? Think of glucose as petrol and the body as an engine. The natural tendency is to ensure that there is enough glucose available for the engine to run and keeps the "chemistry of life" ticking over. This essential glucose comes largely from the food we eat.
Normally, if blood glucose levels exceed a safe threshold, to prevent the engine from being flooded, the pancreas will produce insulin, which acts as a key to promote glucose uptake, use and storage. Conversely, if glucose levels fall too low, less insulin is produced and more glucose is then freely available for use. Without diabetes, glucose and insulin levels are nicely balanced. With diabetes, the tendency is towards raised glucose levels, which can cause problems in both the short and long term.
The reason why diabetes is a syndrome of raised glucose is chiefly due to problems with insulin. In type 1 diabetes, the pancreas is damaged and unable to produce insulin, resulting in raised glucose. It is presently not preventable and people with type 1 diabetes have to take insulin by injection in this situation.
In type 2 diabetes, the pancreas may be able to produce some insulin, but not enough for what the body needs, as well as the body becoming resistant to its effects. These people may be able to control type 2 diabetes by adapting their diets at least initially, though there may or may not be a subsequent need to take medication designed to make the pancreas "work harder" to produce more insulin, or to make the body less resistant to the effects of insulin. Increased physical activity can also promote increased glucose use by the body, as well as help with weight loss and improve general wellbeing.
However, the progressive nature of type 2 diabetes means that once the pancreas doesn't respond to conventional treatments, there may then be a need for insulin. Type 2 diabetes is preventable in some cases.
Regardless of diabetes type, the end result is the same. Without control, there is too much glucose.
It also has to be remembered that diabetes is not just about glucose control. Whatever diabetes type, all people with diabetes are encouraged to follow treatment, have blood pressure monitored and treated, keep blood fat (cholesterol) levels at safe levels, eat healthily, take regular exercise, lose or keep weight stable, not smoke and live healthily. No matter how well people with diabetes feel, they should still attend for their annual diabetes health checks at their local surgery. These checks aim to pick up any potential consequences of long term high glucose exposure, such as visual or kidney problems. Action can then be taken early to prevent damage later. People with diabetes are encouraged to take an interest as to why these checks are needed.
Having talked to many people with diabetes, their families and friends, as well as having read various articles, it is clear that there are many misconceptions around diabetes. A few are explored here.
1. Diabetes is not that serious
There is no such thing as "mild diabetes" or "a touch of the sugars". A person either has diabetes or does not. There are precise thresholds defined on blood tests performed by a healthcare professional as to what glucose levels confirm a diagnosis of diabetes. There may also be associated physical symptoms caused by raised blood glucose levels. Even if managed only by diet or with tablets or injections, significant complications from diabetes may occur. All people with diabetes are encouraged to have their health checks and make appropriate lifestyle choices.
2. Developing diabetes is part of the normal ageing process
People are not fated to develop diabetes in later life. In fact, where traditionally a syndrome of older people, type 2 diabetes is now being diagnosed in children in association with obesity. Living healthily is key to reducing the risk, by following an appropriate diet, not becoming overweight and keeping physically active.
3. Eating too much sugar causes diabetes
The precise trigger for the development of type 1 diabetes is not fully understood. However, consuming excessive amounts of sugar which is not immediately used as fuel will result in this being stored as fat, which promotes weight gain, with a subsequent increased risk of developing type 2 diabetes.
4. People have to suffer from diabetes
It is possible to live well with diabetes and not 'suffer'. Many people with diabetes can and do lead active, fulfilling lives with diabetes. Planning ahead, having supportive family and receiving good healthcare support are all important to help live well.
5. People with diabetes cannot eat sweet foods
Everyone with or without diabetes should eat a healthy diet and not eat excessive sugar, or foods rich in salt and fat. The key is to have sweet foods in moderation as a small portion and consider them as a "treat", taken as part of a healthy diet. A regular high sugar intake in diabetes can result in sustained high blood glucose levels which can cause problems.
6. People with diabetes need to eat diabetic foods
Biscuits, jams and other foods labeled as "diabetes friendly" generally offer no extra benefit in diabetes and are expensive. They can still affect blood glucose levels and may have laxative-like effects. It is perfectly acceptable for someone with diabetes to treat themselves, as part of a healthy diet, to "sugary" treat type foods.
7. People with diabetes cannot undertake exercise
Taking regular exercise does not mean donning lycra and joining a gym. Activities such as regular walks or cycling are encouraged in diabetes as part of a healthy lifestyle. This can help promote physical wellbeing, as well as improve blood glucose handling and insulin use by the body. Medical advice should be sought before embarking on an exercise regime, particularly if there are other health issues or if it has been a while since exercise was last undertaken.
8. It is not safe to drive if you have diabetes
There is no evidence to suggest that drivers with diabetes are more dangerous than those without. However, it is important that if taking insulin or certain other diabetes tablets, blood glucose testing should be performed before driving, to ensure that sugar levels are safe to do so. The DVLA offers more specific guidance on this.
9. People with diabetes are more likely to get colds and other illnesses
People with diabetes are encouraged to have a flu jab. The physical stress of being ill in diabetes means that glucose levels can go up, sometimes to worryingly high levels. Sustained high glucose levels whilst unwell can make the body's immune system less effective to fight infections. If unwell and worried, people with diabetes should seek advice and be clear on diabetes "sick day rules".
10. Needing insulin in type 2 diabetes is due to a personal failure
Type 2 diabetes is a progressive disease. This rate of progression can vary from person to person. Eventually, the pancreas is unable to produce sufficient insulin for the body's needs despite diet, lifestyle and support from medication. As a result, supplementary insulin is needed to control glucose levels, to reduce the risk of complications and to help symptoms.
11. Only young people get type 1 diabetes and older people get type 2 diabetes
Whilst this was predominantly the case years ago, the pattern of diabetes presentation has changed over the years. As such, it is the nature of the presentation that can help determine the diabetes type. Type 1 diabetes is often diagnosed in patients over 50 and with increasing levels of childhood obesity and reduced physical activity, we have seen cases of type 2 diabetes widely reported in children.
To summarise, whatever the diabetes type, it is the end result of too much glucose. If uncontrolled, this can cause problems in the short and long term. Living healthily can help to reduce the impact of this. It is essential that people with diabetes, their families and friends know the right facts about diabetes.
There are many myths out there. Time would be well spent by seeking diabetes information from reliable sources, such as local healthcare teams or from well established professional diabetes bodies.
The above article was originally published in the March 2014 issue of Diabetes Wellness News (reviewed May 2017. Next review within an 18 month period). * Source references available on request.
How can I learn more about managing my diabetes effectively?
We offer lots of support in lots of ways, however you want to access it. Not everyone wants, or is able, to attend an event. However, these are a great way of getting to know other people with diabetes on a face-to-face basis. We have an annual programme of Diabetes Wellness events which offer the opportunity to learn more about diabetes, its management and complications, with like-minded people.
Our diabetes information leaflets are available to download in readable and audio format. If you have other access requirements, please let us know and we will do our best to accommodate them.
Although we don’t have a dedicated tele-health help line, we are more than happy to speak to callers about their needs. You can do this by contacting us on firstname.lastname@example.org or by calling 023 9263 7808. Whilst we cannot give medical advice on the telephone, we have a wealth of information at our fingertips.