Monday Medical: Learning more about diabetes

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— People have many questions and misconceptions about diabetes. Here are some of the more common ones, along with some answers.

Q. How serious is diabetes?

A. According to the American Diabetes Association, diabetes contributes to more deaths per year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke. Despite these scary numbers, daily attention to diabetes management can prevent the complications of diabetes that lead to death.

Q. Does everyone who is overweight or obese develop Type 2 diabetes?

A. No. Although being overweight or obese is a risk factor for Type 2 diabetes, family history, ethnicity, history of giving birth to a large baby and age also play a role.

According to the American Diabetes Association, most overweight people never develop Type 2 diabetes and many people with Type 2 diabetes are at a normal weight or only moderately overweight. It is important to pay attention to all the risk factors for diabetes and not only weight.

Q. Does eating too much sugar cause diabetes?

A. No. Type 1 diabetes is an autoimmune disorder, and no one knows for sure what triggers the onset of the disease. Type 2 diabetes is caused by genetics and lifestyle factors.

Eating too much food and/or unhealthy food choices contributes to weight gain, and being overweight can lead to Type 2 diabetes.

If you have a family history of diabetes, making healthy food choices and getting regular exercise are recommended to manage your weight and possibly delay diabetes.

Q. Do people with diabetes have to follow a special diet?

A. There is no such thing as a diabetic diet. The message is the same for people with and without diabetes: Follow a healthy eating plan that is low in saturated and trans fat, moderate in salt and sugar, and contains lean protein, whole grains, high fiber, vegetables and fruit.

Watch portion sizes and meet with a registered dietitian if you need help figuring out healthy portion sizes for your body.

Q. Is one type of diabetes worse than another?

A. Diabetes, regardless of the type, is a serious disease. Type 1 and Type 2 diabetes have different causes and are sometimes managed in different ways. However, the bottom line is that diabetes means elevated blood glucose levels, and the goal is to achieve and maintain blood glucose levels as close to normal as possible as much of the time as possible.

Q. Does insulin cause weight gain?

A. It does not have to. Insulin is called a “storage hormone” because it helps the body store extra glucose as fat. By taking the right amount of insulin for one’s body, eating the right amount of healthy foods and exercising regularly, people who take insulin can maintain a healthy body weight.

Q. Can people with diabetes eat fruit?

A. Yes. Fruit is a healthy food and great source of nutrients. Fruit also is full of fruit sugar, which raises the blood glucose level. While fruit is a healthy part of an eating plan for people with and without diabetes, it is important for those with diabetes to be aware of how much fruit they are eating and how it affects the blood glucose level.

Whole fruit is a better choice than fruit juice because there is fiber in whole fruit. Combining a healthy fat (nuts, avocado, nut butter) with fruit can keep the blood glucose level from rising as much.

These are by no means the only diabetes questions and answers. I encourage those with questions about diabetes to email me at jane.dickinson@yvmc.org.

Jane K. Dickinson, RN, PhD, CDE, is a longtime diabetes educator at Yampa Valley Medical Center and also is coordinator for the Master of Science in Diabetes Education and Management Program at Teachers College Columbia University.

Comments

Guinevere 2 years, 7 months ago

With all due respect, this article is not the best thing for people to read if they want to know more about diabetes or how not to get it. I would suggest going to the Blood Sugar 101 website which is maintained by someone smart who has type 2 diabetes and has included all the research over many years:

http://www.phlaunt.com/diabetes/

The dietary advice given in this article ("follow a healthy eating plan that is low in saturated and trans fat, moderate in salt and sugar, and contains lean protein, whole grains, high fiber, vegetables and fruit") is partly wrong and is the same spiel given by the American Diabetes Association (funded by big Pharma and cereal makers and much derided by all online diabetes forums). Diabetes is a disease of carbohydrate intolerance, therefore it makes sense to cut down on carbohydrates. Diabetics should not be advised to eat whole grains (that is harmful advice) and there is nothing wrong with saturated fat.

If you want to see what's going on with your blood sugar, get a $9 blood sugar meter at Wal-Mart and test yourself one and two hours after meals. See what makes your blood sugar spike. Blood sugars over 140 can damage your body and lead to type 2 diabetes. If you want a good book on diabetes, get Dr. Richard Bernstein's. If you want to see what a lot of people who actually have diabetes say to the typical ADA advice, see the comments on the following worthless ADA article:

http://www.diabeteshealth.com/read/2011/06/28/7199/type-2-diabetes-from-old-dogmas-to-new-realities---part-2/?isComment=1#comments

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Guinevere 2 years, 7 months ago

Also, you say that sugar does not cause diabetes. But if you regularly eat a lot of sugar and it causes your blood sugar to soar, then that makes it way more likely that you will get diabetes. Not to mention all the other health problems caused by too much fructose.

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