What They Should Know — From Educator Nora Saul

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Friday’s post: Today let’s borrow a topic from a #dsma chat held last September.  The tweet asked “What is one thing you would tell someone that doesn’t have diabetes about living with diabetes?”.  Let’s do a little advocating and post what we wish people knew about diabetes.  Have more than one thing you wish people knew?  Go ahead and tell us everything.

This editorial is by Nora Saul, M.S., R.D., C.D.E., Manager of Nutritional Services at Joslin

We are heading into the home stretch of Diabetes Blog week and I have enjoyed exploring many new topics with you. BitterSweet left the most intriguing posts for last.

Now, I don’t have diabetes, so I can’t talk about what it’s like to living with the disease. But in the spirit of today’s topic, I thought I would spend some time dispelling some frequently heard myths about about the disease and the people who get it.

Both people with diabetes and those without have a lot of misconceptions about the disease. So these are some of the rumors about diabetes I would like to squash.

Diabetes is a death sentence. At this time there is no cure for diabetes, although certain treatments such as gastric bypass can lead to remission in type 2. However, no matter which type you have, if you take good care of yourself you can live a long and healthy life. In fact, Joslin gives out medals for people who have lived with the disease for 50 and, more and more frequently now, 75 years.

A sweet tooth causes diabetes. Eating sugary foods per say doesn’t cause diabetes. Type 1 is an outgrowth of the confluence of genetics and an unknown environmental trigger, and type 2 arises from a genetic predisposition and known environmental factors such as obesity and physical inactivity.

Starting insulin means your diabetes is “really bad”. Taking insulin if you have type 2 doesn’t mean that your diabetes has gotten worse Once you have diabetes, over the course of years, the beta cells in the pancreas stop making insulin. This is simply the natural history of the disease. Insulin replacement then becomes the only way to control blood glucose.

Starting insulin means you are going to lose your eyesight and your feet. Insulin doesn’t cause complications. Some people develop complications shortly after starting insulin because they waited too long before beginning. The appropriate dose and timing of insulin can help keep blood glucose levels in the safe zone.

Blood glucose checks don’t hurt-although there has been substantial progress in making fingersticks less painful they still are uncomfortable for many people.

Injections are painful. Insulin injections don’t hurt. Today’s needles are small and thin, easily entering the skin.

Chocolate bars are a good way to treat low blood glucose. Easily digested carbohydrate foods without fat should be used to correct hypoglycemia. Chocolate and other fatty foods slow down the rise in blood glucose.

Weight loss will completely control diabetes. Weight reduction, although an important component of treatment for people who are overweight, will not control diabetes if a person’s beta cell function is significantly compromised. In fact, for most people with type 2 diabetes, lifestyle modification alone won’t be sufficient to keep their blood glucose in control beyond a few years.

All people with type 2 are overweight: About 15 percent of people diagnosed with type 2 are in the normal range of body mass index.

Family history is important only in type 1 diabetes. Both type 1 and type 2 are have a genetic component, but genes play a much larger role in the genesis of type 2.

People with diabetes are ill and shouldn’t hold important jobs- there are very few jobs that can’t be done by people with diabetes. There are laws under the Americans with Disabilities Act which prevents discrimination on this basis.

And my favorite- having diabetes turns you into a child. Adults with diabetes don’t need nannies. The best way to help someone care for their diabetes is to ask him or her how you can be of help. Just like with any other disease, all the nagging in the world doesn’t produce results.

If you have other myths you want to shatter, please send them along. Thanks for allowing me to share your week.

5 Responses to What They Should Know — From Educator Nora Saul

  1. Drew says:

    I agree with everything except for me, insulin injections hurt! Its not the needle going in, its the insulin going in, it hurts every time no matter how slow or fast i inject it and no matter its temperature. I’m using an insulin pen, not a syringe. Good post though I love when myths are called out!

  2. C.J. says:

    I agree with everything except for the last one (excluding the insulin as I don’t take that). Quite frankly I may not have turned into a child, but I DAMN SURE HAVE TO EAT LIKE ONE!!!! They say “oh you can have whatever you like, only in moderation”. News flash: moderation really means toddler-sized portions! It’s hardly the veggies, the dirty stone whole grain products, or even drinking only water. I am so unhappy with being able to eat “anything I want”. I’m seriously thinking of just eating like I used to, you know like an ADULT! Just arrange my funeral and baptize me for all of that!

  3. Kat Douma says:

    myth: if you are overweight and have diabetes, it is type 2. I have type 1 and am overweight. I have had diabetes since my teens and have always needed to use insulin, when I weighed 120 lbs. up to my current weight. I have had so many doctors assume I am type 2 because of my weight and not listen to me when I say I am type 1. I have had to argue for years to get it corrected on my records and it has caused problems with my insurance, and with recommended treatment.

  4. What a litany of terrible advice and misinformation. This woman is the head of nutritional services at Joslin? Are you kidding me?

    1) Eating excessive amounts of sugary foods most certainly leads to type 2 diabetes. You mention obesity as if it’s something totally separate from diet. How do you think so many people become so overweight? They eat tons of simple sugars–after nutritionists like you tell them to avoid fat–and they gain weight as their beleaguered pancreas pumps out a bunch of insulin in hopes of dealing with the influx of sugar and other carbohydrates. You don’t feed glucose to a disease of glucose intolerance.

    2) Gastric bypass can lead to remission? How about exercising and sensibly controlling carbs, instead of tying up of people’s stomachs like carnival balloons? Lifestyle change prevents T2D the best, and it has the biggest impact on reversing existing diabetes, assuming it hasn’t reached a point of no return. Let’s go for the least invasive, most effective option–and not surgery–as the default.

    3) “For most people with type 2 diabetes, lifestyle modification alone won’t be sufficient to keep their blood glucose in control beyond a few years.” That’s simply untrue, and does a huge disservice to men and women who could manage diabetes indefinitely with a smart combination of exercise and calorie and carbohydrate control.

    Do you want to know a big reason why one in three adult Americans has diabetes or prediabetes? Because organizations like yours and the ADA don’t know what the hell you’re talking about. And a lot of people needlessly die miserable deaths as a result.

  5. Lucy P. says:

    I have to disagree with a few points. Giving myself insulin shots does hurt. I find that sometimes I barely feel anything and other times it stings and continues to hurt. Needles are no fun. And the part about using food to treat low blood sugar isn’t the best idea. You should really drink something sweet like soda that will go through your system faster.

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