9 Common Myths about Type 2 Diabetes

November is national diabetes awareness month. To support the purpose of this awareness campaign, I’ll be sharing content all month long with the aim of providing shame-free, non-diet diabetes support and education. I’d bet that even if you don’t have diabetes, you know someone that has been affected by this condition. So, this month is for you whether you have a loved one with diabetes, you have a family history of diabetes, or especially if have already been told you have diabetes or pre-diabetes. And if you have diabetes or pre-diabetes, you’ve probably heard some broad sweeping statements about the condition and suggestions for management that are pretty restrictive. Which of the following myths have you heard? 

Myth #1: If you have prediabetes, you are unequivocally on the path to a diabetes diagnosis.

Reality: The term prediabetes resulted from a brainstorming session of six diabetes thought leaders hoping to elevate the level of concern in patients and doctors for a high blood sugar that was not quite diabetes (Pillar 2019). Despite other specialists in the field citing weak support, and even scaremongering, the American Diabetes Association and Centers for Disease Control (CDC) went on to declare prediabetes as the first step on the path to diabetes. To this day, the World Health Organization (WHO) and other medical authorities remain unconvinced that prediabetes routinely leads to diabetes or that existing treatments do much good, rejecting the idea of a prediabetes diagnostic category altogether. And it makes sense: a 2018 comprehensive review of 103 studies showed that most people in the prediabetes range never actually progressed to diabetes over any period studied. In fact, 59% of the prediabetes patients studied returned to normal blood glucose values in one to 11 years without any treatment (Richter et al. 2018)!

Myth #2: Diabetes is caused by eating “too much” sugar

Reality: Diabetes is a complex condition which has many root causes. These include social determinants of health (such as education, financial stability, health care access and quality, neighborhood and built environment, social cohesion, food security, environmental contaminants), sleep patterns, certain medication usage, genetic factors, nutrient deficiencies, weight cycling, and exposure to endocrine disrupting chemicals. 

Myth #3: You can’t eat sweets if you have diabetes 

Reality: Sweets and desserts are part of life and are enjoyed in most cultures around the world. If you have diabetes, you, too, can enjoy sweets. Making peace with food, such as desserts, can assist you in discovering  your true intuitive eater. An intuitive eater is able to eat and enjoy foods without guilt because they know that all foods fit. 

Myth #4: Weight loss is necessary to manage diabetes

Reality:  When the pursuit of weight loss leads to restrictive eating habits (aka dieting), weight cycling—weight loss followed by subsequent weight gain—is a nearly guaranteed result. Weight cycling isn’t to be taken lightly as more and more studies are finding that body weight fluctuations lead to metabolic harm, including increasing diabetes risk. A 2021 review of 14 studies by Zou, et al. with more than 250,000 people found that individuals who weight cycled had a 23% increased risk of developing diabetes.

Myth #5: If you have diabetes, you should avoid “white” foods

Reality: I often hear statements such as, “my doctor told me to cut out [fill in the blank]!” This is a form of “diabetes police.” Diabetes police may come from within or from external influences, and commonly originates from clinicians. I’ve heard so many of these diabetes policing experiences over the years, ranging from being told to lose weight, cut out carbs, cut out white foods, only eat within certain hours of the day, etc. When the diabetes police are loud, your intuitive self gets silenced. There’s nothing wrong with “white” foods and they can certainly be part of a nutritious, balanced food intake that is mindful of blood sugars.

Myth #6: If you just try hard enough, you can avoid diabetes medication

Reality: When it comes to prescription medications for diabetes, doctors will often tell patients with elevated sugars to try “diet and exercise” first; I also often hear from clients that they want to avoid medications at all costs. If you find that you are eating with attunement yet your blood glucose isn’t in range, then it’s time for a chat with your healthcare team. If your glucose and HbA1c are out of ideal range, it’s possible that you may need to start (or add more) medication. The good news is that there are many options for meds at this point, and while all medications have the potential for side effects, there may also be the potential for enhanced health outcomes and enhanced food freedoms as well.

Myth #7: You should eat food in a particular order

Reality: There are many influencers and books that tout the idea that eating food in a particular order will improve blood sugar results. When I dug into this more, I found only a handful of studies with extremely small sample sizes of less than 20 people. In addition, eating food in order is just another food rule that will take away from the ability to be intuitive. Does it sound satisfying to you to eat vegetables and protein first and avoid starches until the end of the meal? If so, go ahead! If not, mix away. 

Myth #8: There are proven ways to “reverse” diabetes

Reality: Diabetes is a chronic medical condition that can be managed and in some cases, blood sugar levels may be managed well enough to be in “normal” ranges for someone without diabetes. However, this doesn’t mean the diabetes has been reversed; it simply means that it’s being well managed. I understand the appeal of wanting to reverse diabetes, or any medical condition for that matter, yet there are no proven strategies to do so at this time. The ADA has developed criteria in which someone’s diabetes may be considered to be in “remission,” but maintains that “reversal” is not a legitimate state of the disease (Riddle et al. 2021). 

Myth #9: Having diabetes means saying goodbye to cultural foods you love

Reality: In a review by Majeed-Ariss et al. (2015) it was noted that many diverse ethnic groups have experienced being told to “reject culturally traditional foods.” However, there is no need to abandon any food when you have diabetes! There are so many wonderfully delicious cuisines from around the globe and all of them fit - even with a diabetes diagnosis. The first step to building a balanced plate using your cuisine of choice is to understand which food group each of the foods belongs to. For example, in Nigerian culture, there are often several types of carbohydrate-based foods as part of one meal. One plate might include fufu (made from cassava), jollof rice, and fried plantain. It’s totally fine to include multiple carbohydrate sources; one should simply be mindful of the rest of the plate and the typical blood sugar response. Perhaps the rest of the plate will include stew meat, and cooked vegetables to round out the meal. What would your ideal plate include? 

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