Diabetes myths and misconceptions

Type 1 diabetes and type 2 diabetes are the most common forms of diabetes mellitus. This said, while type 1 only affects around 8% of those living with diabetes, type 2 affects a vast majority at 90%. While there are similarities in what living with type 1 and type 2 diabetes is like, there are also key differences.

It is important to remember that both types of diabetes are equally serious and have the potential to lead to other health complications.

The difference between type 1 and type 2 diabetes

Diabetes UK explains what these two main types of diabetes have in common: "If you have either type 1 or type 2 diabetes, it means you have too much glucose (a type of sugar) in your blood. This is the same for both types."

As a result, type 1 and type 2 diabetes share common symptoms:

• Feeling more tired than usual.
• Wounds and cuts taking longer to heal.
• Needing to go to the toilet more than usual, particularly at night.
• Feeling really thirsty.
• Experiencing thrush or genital itching.
• Having blurred vision.
• Losing weight without trying to.

However, the difference lies in how having too much glucose in your blood happens. This affects how the symptoms of diabetes appear - much more quickly in type 1 - as well as how the diabetes is managed.

"If you have type 1 diabetes, it means you have an autoimmune condition. This means your body has attacked and destroyed the cells that make a hormone called insulin, and so you can't make insulin anymore. We all need insulin as it helps take the glucose from our blood into our bodies' cells. We then use this glucose for energy.

"Type 2 diabetes is different. If you've got type 2 diabetes, either your body doesn't make enough insulin, or your insulin doesn't work properly. This is known as insulin resistance."

It is not currently known what causes type 1 diabetes and there is no cure. Instead, treatment is centred around management of symptoms - through taking insulin to control blood sugar levels. 

There are several risk factors that increase your chance of developing type 2 diabetes. The first-line treatment is diet, weight control and physical activity. However, medications including insulin may also be needed to help control blood glucose levels.

Type 1 diabetes myths and misconceptions

Myth: Type 1 diabetes is caused by your lifestyle

This is a fundamental difference between type 1 and type 2 diabetes. As an autoimmune condition, type 1 isn't caused or impacted by your lifestyle. This means lifestyle factors, including changes to your diet, weight, or exercise routine, make no difference to your risk of developing type 1 diabetes.

Myth: Type 1 diabetes can be reversed by making lifestyle changes

While following a healthy diet and getting plenty of exercise play an important role in how some people manage their type 1 diabetes, there is no known cure. People with type 1 rely on insulin injections throughout their lives.

Type 2 diabetes myths and misconceptions

Myth: Type 2 diabetes isn't as serious as type 1 diabetes

Both type 2 and type 1 diabetes are serious conditions and there is no such thing as 'mild diabetes'. Regular treatment and making effective lifestyle changes when living with type 2 diabetes can reduce the risk of complications, although they are still possible.

Myth: Type 2 diabetes is caused by eating too much sugar

People often wrongly attribute high blood glucose levels to excessive sugar consumption. Type 1 diabetes is not affected by lifestyle factors like diet at all. Risk factors for type 2 diabetes include - but are not limited to - weight gain and inactivity.

People gain weight by consuming too many calories, and while some of those calories can come from sugar, eating too much sugar is not a direct cause of diabetes. To reduce the risk of developing type 2, it's more important not to consume more calories than the body needs.

Myth: Type 2 diabetes is solely caused by being overweight

While being overweight or obese is a big risk factor for developing type 2 diabetes, there are many other factors. Some can be controlled through lifestyle changes while others can't. They include:

• Getting older.
• Having a family history of diabetes.
• Being an 'apple' rather than a 'pear' - in other words, excess weight accumulating around your midriff.
• Leading an inactive lifestyle.
• Having an Afro-Caribbean, Black African, or South Asian ethnic background.

The World Health Organization (WHO) has estimated that being overweight or obese accounts for 65-80% of new cases of type 2 diabetes.

Research has also shown that type 2 diabetes doesn't only affect people who are overweight. According to Public Health England (PHE), 10% of adults living with type 2 aged 16-54 years are not overweight.

Myth: You will always know if you have type 2 diabetes

During the early stages, the symptoms can be much less noticeable than for type 1. Therefore, it is possible to have type 2 diabetes without knowing it. One CDC report suggests that as many as 1 in 4 American adults with diabetes do not have a diagnosis.

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Diabetes myths and misconceptions

Many myths are the same for both type 1 and 2 diabetes.

Myth: Diabetes means you can't have sugar

One of the most common misconceptions is that living with diabetes means not being able to eat any sugar. However, people are still able to enjoy a wide variety of foods that contain sugar.

In fact, a lot of food choices that contain sugar - such as fruits - can form part of a healthy balanced diet. Most fruits have a low to medium glycaemic index, meaning that they do not lead to a sharp rise in blood glucose levels.

However, carbohydrates - both starchy and sugary - are what cause your blood glucose to rise. Reducing both sugary and starchy carbohydrates - and particularly 'refined' carbs like white flour/sugar/bread - can make a big difference to your blood glucose control.

Myth: Diabetes means you can't drink alcohol

It is true that alcohol interferes with blood glucose levels and that it could increase the risk of having a 'hypo' (also known as hypoglycaemia), where blood glucose levels drop too low. This occurs because alcohol affects the liver's ability to release extra glucose into the blood.

However, people may not need to cut out alcohol from their lives entirely, and not all medication makes them vulnerable to hypos.

It's best to speak to a healthcare expert if you are unsure. It's also good to keep health risks from alcohol at a low level by following the UK government's official guidelines on alcohol consumption.

Myth: Diabetes means you can't be physically active

While it is recommended that those with diabetes are evaluated for additional health complications before establishing an exercise routine, they are actively encouraged to stay physically active.

The health benefits of exercise are important for people with both type 1 and type 2 diabetes:

• It can reduce the risk of complications associated with diabetes, such as heart disease.
• It can help the body to use insulin better.
• It can help to improve cholesterol (blood fats), which helps to protect against problems like heart disease.
• It can help with joints and flexibility.
• It can energise and improve sleep.
• It can reduce stress and improve low mood.

Being physically inactive or overweight can increase the risk of developing type 2 diabetes, and make it harder to control.

Myth: Diabetes means you will eventually go blind

It is true that all people with type 1 and type 2 diabetes are at risk of developing diabetic retinopathy, an eye condition which can lead to blindness. However, this will not happen to everyone.

The risk of developing retinopathy is high in people with type 1 diabetes, with research suggesting this happens in 98% of cases during the first two decades a person has diabetes. The risk is not as high but still significant - at up to 60% - in people with type 2 diabetes.

However, according to the National Institute of Diabetes and Digestive and Kidney Diseases, finding and treating retinopathy early can reduce the risk of blindness by 95%. That's why it is so essential to attend annual check-ups at which retinal photography - pictures of the lining of the back of your eye - are taken.

Research has also proven that the risk of developing retinopathy, as well as other diabetic complications, can be reduced through physical activity and good management of blood glucose, blood pressure and blood fat levels.

Myth: Diabetes means you can't drive

There is no reason why someone controlling their blood glucose levels shouldn't drive. However, there are rules around driving and diabetes. There are two main factors that should be considered first:

• Whether a person is at risk of having a hypo.
• Whether a person has developed complications, such as retinopathy or nerve damage (neuropathy), that may make it less safe for them to drive.

According to Diabetes UK, if either of these applies to you then you need to be aware of the rules. They are working with the Driver and Vehicle Licensing Agency (DVLA) in England, Scotland and Wales and the Driver and Vehicle Agency (DVA) in Northern Ireland to ensure that the process for applying for driving licences is "fair, safe and transparent".

Rules for Group 2 (bus and lorry) drivers are different to those for Group 1 (car and motorcycle) drivers.

Myth: Diabetes means you can't cut your toenails

This more bizarre common myth stems from the fact that people with diabetes need to be careful while cutting their toenails, because they can face health issues with their feet.

If toenails are cut incorrectly this can lead to ingrown toenails. Those with diabetes need to be more wary of this because if the antibiotics don't heal the infection, the toenail may need to be removed by a doctor. In this scenario, circulation and healing time can be more of an issue for those with diabetes.

Another reason to be careful is to avoid cuts and rubbing, which can happen if you cut your toenail too short. This may result in soreness, infection and ulcers, which may take longer to heal and may lead to other ongoing feet problems in people with diabetes.