According to the American Diabetes Association (ADA), diabetes is a disease in which the body does not produce or properly utilize insulin. Insulin is a hormone that is required to convert sugar, starches, and other food into energy needed for daily life. While nobody knows for sure what causes diabetes, research does show that genetics and environmental factors such as obesity and lack of exercise play roles.
In order to determine if a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). The ADA recommends the FPG because it is easier, faster, and less expensive to perform. If the results of a FPG show a fasting blood glucose level between 100 and 125 mg/dl then this signals pre-diabetes. A fasting blood glucose level of 126 mg/dl or higher indicates diabetes.
In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.
There are also several types of diabetes: type 1, type 2, gestational, and pre-diabetes.
Type 1: the body does not at all produce insulin.
Type 2: the body does produce insulin, but either it is not enough insulin or the body cannot use it properly.
Gestational: this affects about 4% of pregnant women; abnormal glucose levels result from hormonal changes in pregnancy
Pre-diabetes: this occurs when the person's blood glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes.
According to the American Diabetes Association, here are ten myths to be aware of:
Myth #1 You can catch diabetes from someone else (since there are no viruses/bacteria involved, it cannot be "spread")
Myth #2 People with diabetes can't eat sweets or chocolate (as long as the diabetes is under control, then it cannot hurt in moderation)
Myth #3 Eating too much sugar causes diabetes (there is a combination of lifestyle and genetic factors involved such as obesity)
Myth #4 People with diabetes should eat special diabetic foods (healthy eating habits for diabetics are the same for everyone)
Myth #5 If you have diabetes, you should only eat small amounts of starchy foods, such as bread, potatoes and pasta (portion size is what's important)
Myth #6 People with diabetes are more likely to get colds and other illnesses (if the diabetes is well-controlled, then there is nothing to worry about)
Myth #7 Insulin causes atherosclerosis (hardening of the arteries) and high blood pressure (no strong scientific evidence supports this)
Myth #8 Insulin causes weight gain, and because obesity is bad for you, insulin should not be taken (scientific evidence shows that benefits outweigh the risks)
Myth #9 Fruit is a healthy food. Therefore, it is ok to eat as much of it as you wish (a dietician can tell someone the amount, frequency, and types of fruits to eat)
Myth #10 You don't need to change your diabetes regimen unless your A1C is greater than 8 percent (the ideal range is less than 7 percent)
Reference: Andrew Martinez
Kenneth Hampshire responds to answers to diabetes “myths” by American Diabetes Association
ReplyDeleteMyth: Diabetes is not that serious of a disease.
Fact: Diabetes causes more deaths a year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke.
Correction: While the ADA, to their credit, properly identified diabetes as serious, it labeled diabetes a disease rather than a disorder.
Type 2 diabetes should be more accurately called a disorder. This is a small but important distinction. Most people understand the definition of disease, and indeed part of the official definition is, a condition caused by an invading microbiological agent. None of us would hold anyone at fault who is suffering from typhus, small pox, or measles.
But diabetes is different. It isn't contagious. You don't "catch" diabetes from your neighbor walking down the sidewalk. Diabetes is nearly 100% caused by those who have it. This is not meant to point a finger, but to bring about an understanding that people with diabetes are not powerless. Far from it. We can elect to change the path diabetes takes.
If we allow ourselves to be convinced that diabetes is not our fault, we lose the only real weapon we have to combat it. Calling diabetes a disease excuses personal responsibility to change lifestyle.
Myth: If you are overweight or obese, you will eventually develop type 2 diabetes.
Fact: Being overweight is a risk factor for developing this disease, but other risk factors such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.
cont.
ReplyDeleteCorrection: Again, diabetes is not a disease. Big errors here by omission. Inexcusable.
The #1 factor in developing diabetes is lifestyle, largely improper diet and lack of exercise. By citing obesity, family history, ethnicity, and age as the only causes of diabetes, the ADA displays a tragic disregard to people’s health by shifting focus away from the main causes of this disorder. All of the risk factors cited by the ADA combined, don’t account for even half of the risk factors for diabetes. Multiple studies conclude that improper diet and lack of exercise are the predominant causes of diabetes.
This is a breach of someone in a position of trust. People largely believe that the ADA has their best interests in mind and, therefore believe what the ADA states. To misinform the public in this manner is the height of irresponsibility.
Supporting Studies: Arch Intern Med 2009; 169: 798–807, N Engl J Med 2001; 344: 1343-50, http://chronicillness.suite101.com/article.cfm/lifestyle_factors_prevent_chronic_illness#ixzz0VMWj5mOc.
Myth: Eating too much sugar causes diabetes.
Fact: No, it does not. Type 1 diabetes is caused by genetics and unknown factors that trigger the onset of the disease; type 2 diabetes is caused by genetics and lifestyle factors. Being overweight does increase your risk for developing type 2 diabetes, and a diet high in calories, whether from sugar or from fat, can contribute to weight gain. If you have a history of diabetes in your family, eating a healthy meal plan and regular exercise are recommended to manage your weight.
Correction: To plainly state that eating too much sugar does not cause diabetes, without calling out sugar’s role in an improper diet, is an immeasurable disservice.
To state that diabetes is caused by genetics and lifestyle factors leads people to believe that genetics is the leading cause of type 2 diabetes, more influential than even lifestyle factors. Wrong.
cont.
ReplyDeleteBetween 80% and 95% of all diabetes cases are attributable to lifestyle factors, with genetics playing a minor role. This ADA “answer” states that there are two primary causes of diabetes, with genetics playing the lead role. How shameful.
Myth: People with diabetes should eat special diabetic foods.
Fact: A healthy meal plan for people with diabetes is generally the same as a healthy diet for anyone – low in fat (especially saturated and trans fat), moderate in salt and sugar, with meals based on whole grain foods, vegetables and fruit. Diabetic and “dietetic” foods generally offer no special benefit. Most of them still raise blood glucose levels, are usually more expensive, and can also have a laxative effect if they contain sugar alcohols.
Correction: Let’s see,,, diabetes is a disorder whereby the body has lost the ability to properly metabolize glucose. If higher than normal levels of glucose exist in the blood stream for extended periods of time, great bodily damage occurs. So, the “recommended” diet (high in carbohydrates) for diabetics should be the same as for those people who are able to properly metabolize glucose? What, have we collectively gone insane? By what stretch of the imagination can this information be correct?
This doesn’t even consider the damage caused by systemic inflammatory response precipitated by elevated levels of blood insulin. By recommending this level of dietary carbohydrate to a diabetic, it is guaranteed that massive physiological damage will continue unabated since the body will respond by producing large amounts of insulin (excepting minor variations of diabetes like type 1.5, or end stage diabetes).
If a causative agent is present in a disorder or injury, you remove the causative agent before treating anything. The main causative agent is a diet high in carbohydrates. To state, “A healthy meal plan for people with diabetes is generally the same as a healthy diet for anyone – low in fat (especially saturated and trans fat), moderate in salt and sugar, with meals based on whole grain foods, vegetables and fruit.” is just wrong.
cont.
ReplyDeleteMyth: If you have diabetes, you should only eat small amounts of starchy foods, such as bread, potatoes and pasta.
Fact: Starchy foods are part of a healthy meal plan. What is important is the portion size. Whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. The key is portions. For most people with diabetes, having 3-4 servings of carbohydrate-containing foods is about right. Whole grain starchy foods are also a good source of fiber, which helps keep your gut healthy.
Correction: The ADA is right. It is all about portion size, but they’re wrong on their recommended portion size.
Most people with diabetes eat far, far too many carbohydrate-containing foods, and this recommendation does nothing to correct that. For most diabetics, a healthier recommendation would be to eliminate all simple sugars (cookies, cakes, candies, ice cream, honey, molasses, maple syrup, etc.), soda, fruit juices, and anything made from white, refined flour (many cereals/breads, most pasta, and all pastries), and severely limit all whole fruits and grains, whole or otherwise.
Myth: People with diabetes can't eat sweets or chocolate.
Fact: If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more “off limits” to people with diabetes than they are to people without diabetes.
Correction: Well, sure, anything can be eaten by people with diabetes, if they want to continue to suffer the terrible consequences of that decision.
What kind of diabetes organization tells a person with diabetes that they can eat sweets and chocolate? Or that there are “…no more “off limits” to people with diabetes than they are to people without diabetes.”
Think about that statement for a minute. Third grade reasoning tells you this is absurd. Nobody is this stupid by accident. When I encounter something like this, I ask, “Who benefits?”
cont.
ReplyDeleteMyth: You can catch diabetes from someone else.
Fact: No. Although we don’t know exactly why some people develop diabetes, we know diabetes is not contagious. It can’t be caught like a cold or flu. There seems to be some genetic link in diabetes, particularly type 2 diabetes. Lifestyle factors also play a part.
Correction: At least they got this one almost right. Maybe we don’t know “exactly” why people get diabetes, but we’ve got some good “guesses.” Like, duh, maybe improper diet and lack of exercise.
Here, the ADA tells people that there is a genetic link to diabetes. While this is technically correct, most people read this to say that genetics “causes” diabetes. This is not correct. Genetics never causes type 2 diabetes. It can only pre-dispose to it. Lifestyle is the primary causative agent.
The ADA says that, “Lifestyle factors also play a role.” Yeah, kinda.
Myth: People with diabetes are more likely to get colds and other illnesses.
Fact: You are no more likely to get a cold or another illness if you have diabetes. However, people with diabetes are advised to get flu shots. This is because any illness can make diabetes more difficult to control, and people with diabetes who do get the flu are more likely than others to go on to develop serious complications.
No correction. Give one to the other team.
Myth: If you have type 2 diabetes and your doctor says you need to start using insulin, it means you’re failing to take care of your diabetes properly.
Fact: For most people, type 2 diabetes is a progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with oral medications. But over time, the body gradually produces less and less of its own insulin, and eventually oral medications may not be enough to keep blood glucose levels normal. Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.
Correction: Oh how we love to treat symptoms, but ignore the causes.
ReplyDeleteThis answer just totally misses the point. If you have this conversation with your doctor, you have failed to take care of your diabetes. And so has your doctor. Unfortunately you will be the one to pay for your doctor’s ignorance and for being so gullible.
Nearly everything done to diagnose and treat diabetes in this country is wrong. Insulin resistance begins years, usually decades before blood glucose rises above normal ranges. Why is it then that testing for blood insulin levels is not a routine test for everyone? Why do most people with diabetes find out they have diabetes only when they are in stage 3 of the disorder? This is not only shortsighted, but borders on the immoral.
People could receive proper instructions on how to change lifestyle habits years or decades earlier. There are natural products that are safe and effective at reducing insulin resistance that could be used before pharmaceutical drugs. That, and other lifestyle options never come into play because the crucial information of impending diabetes or other complications is rarely communicated to those with insulin resistance.
Responsibility, personal and professional, is key to good health and to reducing the healthcare costs that are bankrupting the Western world (See http://archinte.ama-assn.org/cgi/content/full/ 169/15/1355).
The truth is that most people with type 2 diabetes can turn around their disorder by making significant changes in their diet and fitness level before any insulin or medications are needed, but this safe and proven treatment is totally ignored by organizations like the ADA.
Myth: Fruit is a healthy food. Therefore, it is ok to eat as much of it as you wish.
Fact: Fruit is a healthy food. It contains fiber and lots of vitamins and minerals. Because fruits contain carbohydrates, they need to be included in your meal plan. Talk to your dietitian about the amount, frequency and types of fruits you should eat.
Correction: What? “Because fruits contain carbohydrates, they need to be included in your meal plan.” Are you kidding me? Consuming fruit by a diabetic will drive blood glucose levels up dramatically. This the ADA recommends? Carbohydrates in vegetables, rather than fruits, are much more suited to the diabetic since the amount of carbohydrate is far lower while contributing valuable nutrients and fiber.
ReplyDeleteAnd fruit is a healthy food? Sure, in moderation for people without diabetes. But for people with diabetes, consuming more than severely limited quantities will lead to elevated blood glucose levels and serious long-term complications. For diabetics, the main source of carbohydrates should be vegetables. Period. Unless, you like using pharmaceutical drugs and suffering the consequences that come with their long-term use.
This information taken from the American Diabetes Association website: http://www.diabetes.org/diabetes-basics/diabetes-myths/ on November 4, 2009.
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ReplyDeletePre Diabetes Diet