What to Know—and What to Forget—About Diabetes

By Deborah Wilburn

Type 2 diabetes is a condition which, if not properly managed, can lead to more serious health problems that can affect your longevity and quality of life. According to the American Diabetes Association, approximately one out of 11 Americans has type 2 diabetes, and one out of three have prediabetes. Despite its prevalence, however, people harbor misconceptions about who gets it, what causes it and effective ways in which to manage it. Here are common misconceptions about type 2 diabetes and the facts you need to protect your health. 

While obesity is definitely a risk factor, people whose BMI is within the normal range (between 18.5 and 24.9) are at risk if they carry extra weight in their abdomen—what you probably think of as belly fat. But the fat you feel when you pinch your skin (subcutaneous fat) isn’t the problem. It’s visceral fat, a type of fat located deep within the abdominal cavity surrounding the liver, intestines and other organs. Experts believe that high visceral fat volume triggers an increase in blood pressure, blood sugar levels and other changes that could lead to insulin resistance—greatly increasing the likelihood of diabetes.

High visceral fat volume isn’t the only reason a normal-weight person could develop type 2 diabetes. Genetic predisposition, lack of exercise and an unhealthy diet also play a role. According to the Joslin Diabetes Center, 15 percent of people who develop type 2 diabetes have a normal weight.

How can you know if you’re carrying too much visceral fat? Measure your waist and hips, then divide your waist measurement by your hips measurement. If the result is 0.8 or above, you may be at higher risk.

Exercising to reduce weight along with a healthy diet are just as important to keep blood sugar steady and prevent additional health problems.

Fruit is a necessary part of any healthy diet, since it provides fiber and important vitamins and minerals. But fruit also includes carbohydrates. Since carbs raise blood sugar levels, they need to be factored into your meal plan.

You may be eating right, exercising and taking your oral medications—but your blood sugar is still too high. If your healthcare provider says you need to start taking insulin, it doesn’t mean you’ve done something wrong. The fact is, type 2 diabetes is a progressive disease. For some people, the time comes when oral medications aren’t enough and insulin is needed to keep glucose levels in the normal range.

Your nutritional needs are the same as anyone else’s. A healthy diet includes a portion-controlled mix of whole grains; healthy fats from foods like olive oil and nuts; fruits and veggies; lean protein and moderate amounts of sugar and sodium. If you have diabetes, one difference is that you need to pay attention to the carbs you eat, since the amount of insulin in your body and carbs affect your blood sugar levels. It’s worth noting that foods labeled “diabetes friendly” tend to be more expensive and offer no greater benefit than a healthy diet. 

Foods high in sugar don’t cause diabetes. But sugary foods along with a high-calorie diet can lead to weight gain—and obesity is one factor that increases your risk. There is one exception where sugar is concerned: Research has shown that consuming sugar-sweetened drinks like regular soda, fruit drinks, sweet tea and energy drinks is associated with a higher chance of developing diabetes. In one study, the health of over 90,000 nurses was studied over an eight-year period. Those who reported drinking one or more servings of a sugar-sweetened drink or fruit punch each day were two times more likely to develop diabetes during the time of the study than those who said they infrequently consumed those beverages. 

According to the Centers for Disease Control and Prevention, diabetes was the seventh leading cause of death in the U.S. in 2014 (the latest data available) and may be underreported. Mortality rates aside, living with diabetes and not managing it opens you up to a wide range of complications and related conditions, including heart disease and stroke; blindness, cataracts and other vision problems; amputations, especially of the feet due to nerve and blood vessel damage; and kidney disease, which can lead to kidney failure. In fact, uncontrolled high blood sugar can damage your kidneys before you experience any symptoms. These are just a few compelling reasons why it’s crucial to manage diabetes—and take steps to avoid it if you’re prediabetic.