The Truth About Diabetes

About 38 million Americans are living with diabetes – that's 1 in 10 people. For a relatively common health condition, the disease is still widely misunderstood. To help dispel some of the misconceptions, we asked Sarah Bushweller, PA, a primary care provider at University of Vermont Medical Center to give us some facts about diabetes – and dispel some myths.

The Difference Between Type 1 and Type 2 Diabetes

Type 1 diabetes happens when the pancreas doesn't make insulin. That’s because the body's immune system attacks the cells in the pancreas making insulin. The lack of insulin allows too much blood sugar to stay in your bloodstream, potentially leading to serious health problems.

Type 2 diabetes is caused by a problem with how your body regulates and uses sugar – also called glucose – as a fuel to help the body function on a cellular level. Too much sugar circulating in your blood can lead to disorders of the circulatory, nervous and immune systems. About 95% of people with diabetes have Type 2 diabetes. It usually develops in people over age 45, but the number is rising in children, teens and young adults, according to the CDC. “There are so many factors when it comes to diabetes,” Bushweller says. “Diabetes can happen to anyone, at any age.”

Myth Vs. Reality: All About Diabetes

Myth: Type 2 diabetes isn’t as serious as Type 1 diabetes.

Fact: Every Type of diabetes is serious.

There is no such thing as a casual case of diabetes. Complications from both Type 1 and Type 2 diabetes can harm major organs in the body, including the heart, blood vessels, nerves, eyes and kidneys. Diabetes can appear rapidly or have a slower onset with warnings that can be seen in routine blood work well before a diagnosis of diabetes occurs.

“Any Type of diabetes should be taken seriously and treated,” Bushweller says.

The seriousness associated with Type 1 diabetes may come from the visibility of its treatment, such as wearable insulin pumps or glucose monitoring devices, according to a 2017 study. The same study also found that people with Type 1 diabetes, especially women and parents of children with Type 1 diabetes, felt stigmatized by the disease.

Myth: Only people who eat too much sugar get diabetes.

Fact: Eating sugar does not cause diabetes.

It's true that too much sugar in your diet is unhealthy, whether you have diabetes or not. But consuming sugary food and drinks won’t give you diabetes.

"Eating sugary foods can cause higher blood sugars if you have pre-diabetes or diabetes," Bushweller says. "But if you don’t have diabetes, a healthy functioning pancreas can manage what you eat."

Myth: You only get diabetes if you have a family history of diabetes.

Fact: Genetics can play a part in diabetes but isn’t always a factor. You can get diabetes with no family history.

Type 2 diabetes has a stronger link to family history than Type 1. Lifestyle plays a part: Obesity tends to run in families and is often a result of similar eating and exercise habits. The good news is that diabetes isn’t guaranteed, even with a family history.

"There are plenty of people who have a family history of diabetes and don't have it themselves," Bushweller says.

Myth: Only overweight people get diabetes.

Fact: People of all shapes and sizes have diabetes.

Obesity puts you at greater risk for Type 2 diabetes, as does being overweight with a Body Mass Index (BMI) of 25-29.9. Still, a healthy body weight doesn’t prevent you from getting diabetes as family history, lifestyle, diet, and other factors can play a part.

"Some people diagnosed with diabetes struggle with excess weight, and some don't,” Bushweller says.

Myth: You can't eat fruit if you have diabetes.

Fact: Planning and moderation are key.

Eating fruit is safe. Bushweller says serving size and timing are what matters. Eating fruit after a large meal packed with carbohydrates – say, white bread, pasta or rice – will place greater demand on your pancreas to produce more insulin. Instead, try eating a cup of fruit before exercise or between meals rather than immediately after breakfast, lunch or dinner.

The best fruit choices are fresh, frozen or canned without added sugars, according to the American Diabetes Association. If you opt for canned fruit, look for words on the packaging like "packed in its own juices," "unsweetened" or "no added sugar."

Myth: If you’re diagnosed with diabetes, you’ll need insulin injections.

Fact: Diabetes doesn't always mean injections. And if it does, you can opt for an insulin pump instead.

When you have diabetes, you might take oral medications or use an insulin pump rather than insulin injections. Treatment for Type 1 diabetes always includes insulin. The good news is that you can use an insulin pump – a wearable device – to manage your diabetes. You also need regular blood sugar checks and to keep track of your consumption of carbohydrates.

Treatment for Type 2 diabetes mainly involves lifestyle changes and monitoring your blood sugar. You may also need to take an oral diabetes medication or use an insulin pump.

Myth: You can cure diabetes with…

Fact: There is no cure for diabetes. But you can reverse pre-diabetes.

Diabetes has no cure, but you can stop the progression of pre-diabetes. Pre-diabetes is a condition where your blood sugar levels are higher than normal but not high enough to be diagnosed as Type 2 diabetes. Pre-diabetes can be reversed by modifying your diet, significantly reducing your intake of heavy carbohydrates and sweets, and increasing exercise, Bushweller says.

Myth: You should avoid medications for diabetes as long as you can.

Fact: No two individuals are the same. Talk to your doctor.

All people with Type 1 diabetes need insulin, and most people with Type 2 diabetes need medication. If you have Type 2 diabetes, however, your healthcare provider might initially suggest meal planning and exercise over medication to manage your diabetes. That’s because your body typically makes enough insulin when Type 2 diabetes starts. But over time, your body may stop making enough insulin, requiring you to add medication to your treatment plan.

“To manage Type 2 diabetes, making lifestyle changes is a place to start,” Bushweller says. “Then proceed to medications if that is not helping enough to control it.” Diabetes is a long-term condition, but you can effectively manage it. How to do that is something best discussed with your health care provider.