November 1, 2015 | by H. Chung So
Few diseases have the reach and impact that diabetes does. According to the American Diabetes Association, one out of three Americans are living with or at risk of developing type 1 or type 2 diabetes, and they cost $245 billion annually in the United States — directly through medical care and indirectly through lost productivity and higher mortality.
So this November — Diabetes Awareness Month — it makes extra sense to pay to attention to the disease, including its risk factors, symptoms, management methods and potential complications.
This also means dispelling some common misconceptions about its prevention and treatment, said Raynald Samoa, M.D., assistant professor in City of Hope’s Department of Clinical Diabetes, Endocrinology & Metabolism. Here, Samoa shares, and debunks, four prevalent myths he has regularly encountered about diabetes.
MYTH: “Only overweight and obese people get type 2 diabetes.”
“This is the most common myth I hear about diabetes,” Samoa said. “Although being overweight is linked to a higher type 2 diabetes risk, the disease can develop in people with normal body mass index (BMI) measurements too.”
Samoa further cited research suggesting that insulin resistance (in which the body does not properly process sugar for energy) is more closely linked to where body fat is being accumulated, instead of how much. Specifically, Samoa said that intramuscular and visceral fat — fat found in and around muscles and abdominal cavity — have a bigger impact on insulin resistance than subcutaneous fat, or fat found under the skin.
Given this evidence, Samoa said that certain populations — such as Asians and Asian-Americans, who tend to accumulate visceral and intramuscular fat— should consider diabetes screening even if they are within normal BMI range, particularly if they are experiencing symptoms associated with the disease, such as unexpected weight loss and frequent hunger, thirst and urination.
MYTH: “I can lower my type 2 diabetes risk with a juice-based, whole grain or vegetarian diet.”
While Samoa is supportive of healthier eating patterns that can lower risk of diabetes and other diseases, he noted that there are some diet fads that may do more harm than good.
To lower diabetes risk and improve overall health, Samoa suggests a sensible diet (“one you can adhere to”) that is rich in micronutrients (vitamins and minerals) and balanced in macronutrients (carbohydrates, proteins and fats) with minimal refined fats and sugars.
MYTH: “Cardiovascular exercise is best for weight loss, reducing type 2 diabetes risk and maintaining normal blood sugar levels.”
“Many people tend to overestimate how many calories, and how much glucose, they burn with cardiovascular exercise,” Samoa said. Doing cardiovascular workouts at the expense of muscle-strengthening exercises may actually raise diabetes risk, Samoa said, because it leads to loss of muscle mass, reducing insulin sensitivity.
For optimal results in losing weight and lowering disease risk, Samoa advises people to do a mix of cardiovascular and weight-bearing exercises regularly throughout the week. According to the Office of Disease Prevention and Health Promotion, this means at least 150 minutes of moderate-intensity aerobic exercise plus 60 minutes of muscle-strengthening exercise a week for adults.
MYTH: “If I have a continuous glucose monitor (CGM), I no longer need to do finger prick tests.”
“CGMs have advanced greatly in the accuracy and speed of their readings, but they are not meant to be a substitute for the standard blood test — particularly for immediate clinical decisions such as administering insulin or consuming a fast-absorbing carbohydrate,” Samoa said.
This is because continuous glucose monitors measure glucose in interstitial fluid, not the bloodstream, so there is a delay time of several minutes between blood sugar level changes and its detection on the device, which can impact the interventions needed to correct blood sugar levels.
However, the monitors are still very useful for patients with type 1 or type 2 diabetes and their care teams, Samoa said, because they provide around-the-clock blood sugar monitoring that can be used to detect long-term patterns and help plan appropriate interventions.
Lastly, Samoa dispels the myth that a diabetes diagnosis means frequent insulin injections for the rest of one’s life. “There are many newer drugs available that can help diabetics maintain normal blood sugar levels for a longer period of time,” he said, citing medications that can boost the body’s insulin sensitivity, slow the absorption of sugar into the bloodstream and help excrete excess sugar through urine. Combined with a healthy diet and physical activity regimen, these drugs can greatly reduce or delay the need for insulin injections.
Learn more about our diabetes program, unique patient experience, how to make an appointment or get a second opinion at City of Hope. You may also request a new patient appointment online or call 800-826-HOPE (4673) for more information.