November: Diabetes Awareness Month

November is Diabetes Awareness month so I wanted to take this opportunity to shed some light on common myths associated with Type 1 diabetes.  A majority of the information about diabetes in the media is referring to Type 2 diabetes not Type 1 diabetes. There isn’t a lot of information provided regarding Type 1 diabetes OR they are just lumped together as the same disease.  The distinction between the two kinds of diabetes is EXTREMELY important! They are both very different as is the management of these chronic conditions.

Basic definitions you should know before getting started:

1. Pancreas: the organ that houses beta cells which secrete insulin
2. Insulin: a hormone that allows our bodies to turn our blood glucose into energy by allowing it to enter our cells in muscles, organs and the brain so our bodies can function on a day to day basis. EVERYONE needs insulin-not just people with diabetes
3. Blood glucose: Our body’s main and best source of energy. Glucose enters our blood stream after we eat and digest carbohydrates
4. Glycogen: the body’s stored form of glucose that is slowly secreted by the liver 24/7 so we always have a source of energy even when we are not eating
5. Hemoglobin A1c: an average of your blood glucose* over the past 2-3 months measured in percentages. A very general A1c goal would be 7% (an average blood glucose of approximately 150mg/dL) can prevent complications from occurring. Your own A1c goal will be determined between you and your healthcare provider

*Blood glucose and blood sugar mean the same thing

COMMON MYTHS ABOUT TYPE 1 DIABETES

1. ALL TYPES OF DIABETES ARE CREATED EQUAL: FALSE

There are two main types of diabetes: Type 1 diabetes and Type 2 diabetes. In Type 2 diabetes the pancreas still secretes insulin but blood sugars remain elevated for a few different reasons. One reason is that the cells can’t utilize glucose as well as they once could because they are resistant to insulin. Another reason is that the liver is secreting too much glycogen throughout the day and the pancreas can’t keep up with the demand of insulin needed to lower blood glucose.

In Type 1 diabetes there is an auto immune response where the immune system views the beta cell as a foreign object and destroys it. As a result the beta cell can no longer secrete insulin and it needs to be supplemented from the outside of the body via multiple daily injections (MDI) or insulin pump therapy. Exogenous insulin is currently the only way to manage Type 1 diabetes (and checking blood sugars). Oral medications do not treat Type 1 diabetes. 

Other autoimmune conditions you may be familiar with include Celiac disease, rheumatoid arthritis, hypothyroidism, ulcerative colitis, psoriasis, alopecia and vitiligo.

2. A DIET HIGH IN SUGAR OR JUNK FOOD CAUSES TYPE 1 DIABETES: FALSE

Whereas with some people, a poor diet and obesity may cause Type 2 diabetes, this is absolutely not the case with Type 1 diabetes. We know that there is a genetic component to Type 1 diabetes and then usually there is an environmental trigger that will set the immune system response into action to destroy beta cells in the pancreas. This could be a stressful event such as an illness. There is no one person or food to blame for the onset of Type 1 diabetes.

3. PEOPLE TYPE 1 DIABETES MUST FOLLOW A “DIABETIC DIET” AND CANNOT EAT SUGAR OR CARBOHYDRATES: FALSE

As I mentioned earlier, carbohydrates are our body’s best source of energy so we do not want to restrict them. As a dietitian working with people living with Type 1 diabetes, my goal is to make sure they are eating a diet full of whole grains, fruits and vegetables, lean proteins and healthy plant based fats. Treats in moderation are perfectly acceptable (birthdays, holidays, special occasions, etc).

These are foods that should be the basis of EVERYONE’S diet-not just because you have diabetes.

The only foods that are truly off limits are concentrated sweets such as juice, regular soda, “sports” waters, pure sugar candies, syrup, etc. These so called foods are nutritionally bankrupt and are just pure sugar. Again, regardless of having diabetes or not, no one should be including concentrated sweets into their diet.

I do teach people how to determine how many grams of carbohydrate they are eating at a meal or snack. This is solely for the purpose of being able to dose their insulin properly to prevent elevated blood sugars after eating carbohydrates.

4. SUGAR FREE MEANS CARBOHYDRATE FREE: FALSE

Sugar free foods commonly found in super markets such as cookies, cakes, chocolate and ice cream still have carbohydrates and can still raise your blood sugar. These are foods that should be eaten in moderation so if you are going to indulge have a real piece of chocolate or a real scoop of ice cream. Don’t waste your time or money on something that has 42 ingredients you can’t pronounce!

The one type of food where sugar free is important is with food products that would be liquid sugar i.e. drinks. One or two artificially sweetened beverages should be okay to have throughout the day but remember water is best!

5. TYPE 1 DIABETES ONLY OCCURS IN CHILDREN: FALSE

Type 1 diabetes can occur at any age. Sadly many adults are mistakenly diagnosed with Type 2 diabetes just because they are over 18. Healthcare providers need to keep an open mind when it comes to diagnosing diabetes and screen for Type 1 and Type 2 diabetes.

6. THE ONLY DIFFERENCE BETWEEN A PERSON WITH TYPE 1 DIABETES AND A PERSON WITHOUT IS THAT A PERSON WITH TYPE 1 DIABETES TAKES THEIR INSULIN FROM THE OUTSIDE AND PEOPLE WITHOUT DIABETES MAKE THEIR INSULIN ON THE INSIDE OF THEIR BODIES: TRUE!!!

Please remember that a person living with Type 1 diabetes is not a sick person-they are simply supplementing their insulin supply from the outside because they are not producing insulin on the inside. There are no limitations as to what a person living with Type 1 diabetes can do!!!!

I hope this information helps you understand a little bit about Type 1 diabetes and how different it is from Type 2 diabetes. The next time you read an article about diabetes you'll know which type the author is referring to;)

Happy Diabetes Awareness month!!!

Xoxo, Devon