Myths and misconceptions about diabetes

November is designated American Diabetes Month and while raising awareness this month about preventing diabetes is important, focusing on proper treatment is just as important for those living with the disease.

Myths and misconceptions about diabetes often lead people to make poor care decisions based on bad information, says Anath Shalev, M.D., director of the University of Alabama at Birmingham Comprehensive Diabetes Center.

Shalev, professor of medicine in the Division of Endocrinology, Diabetes, and Metabolism, says the errors are costly: Diabetes kills more people each year than breast cancer and AIDS combined. More than 25 million American children and adults live with diabetes, according to the American Diabetes Association, and the Centers for Disease Control and Prevention projects that one in three Americans will have this disease by 2050.

Shalev says it is first important to understand genetic and other factors influence the development of diabetes. "Type 1 diabetes is caused by an autoimmune process that destroys the cells in the pancreas that produce insulin, the hormone responsible for maintaining normal blood sugar. Type 2 diabetes is the result of insulin resistance, which most often is caused by obesity," he says.

During American Diabetes Month, familiarize yourself with these misconceptions about the causes of and treatment for diabetes:

Myth: Sugar or eating sweets is the cause of diabetes.
It's not the sugar; it's the effect of too many calories of any kind, Shalev says. Obesity is a major risk factor for Type 2 diabetes. Lack of exercise is another major contributor, especially if a sedentary lifestyle is combined with large portions of high-calorie, fatty food.

Myth: Only obese people get diabetes.
"While obesity is the strongest risk factor for Type 2 diabetes, patients with Type 1 diabetes or other less common forms often are very lean," Shalev says. "I have seen several triathletes who are Type 1 diabetics."

Myth: Type 1 diabetes, often called juvenile diabetes, only affects the very young.
Type 1 diabetes can affect people at any age, Shalev says, though it is more common in younger age groups. "Excessive thirst, urination and weight loss should always be warning signs to anyone of any age and warrant a doctor's visit," she adds.

Myth: There is no treatment for Type 2 diabetes.
Some people look at their family tree and their waistline and resign themselves to becoming diabetic. "There are people who have a constellation of genes that put them at a higher risk," Shalev says. "But that doesn't mean they will develop diabetes." In most cases, Type 2 diabetes can be delayed and sometimes even prevented with adequate lifestyle modifications, including exercise and healthy diet, Shalev says. Monitoring and early intervention also are important.

Myth: Starting insulin injections in Type 2 diabetes is the beginning of the end.
Not true, Shalev says. Patients often panic and resist when told injections are necessary, but it's the next logical step if oral medications don't work. Shalev says emerging research suggests that starting insulin treatment early also can reduce strain on insulin-producing cells. And, the need for insulin injections is not always permanent; some patients with Type 2 diabetes eventually can stop taking insulin if they also make lifestyle changes.

Myth: Kids with Type 1 diabetes can't have anything sweet.
People with diabetes once were discouraged from having any sweets, but advances such as fast-acting insulin therapies and monitoring protocols allow for the occasional treat. A child can have a piece of birthday cake, for example, as long as they receive the proper insulin dose beforehand and are monitored closely. "It's an intensive insulin regimen, so patients have to check more frequently, but they gain more freedom," Shalev says.