Diabetes lowdown: Dietitians bust 10 top myths

Diabetes is one of the fastest-growing lifestyle diseases. The costs of diabetes to our country are astronomical. This is according to the Association of Dietetics in South Africa (ADSA), which says that it is estimated that around 96 000 South Africans died of diabetes-related causes in 2021. 

To observe Diabetes Awareness Month, ADSA shares 10 myth-busting questions about diabetes:

Does type 2 diabetes only affect overweight people?  

Nasreen Jaffer: Type 2 diabetes does not only affect overweight people. However, overweight and obesity are the major risk factors for developing type 2 diabetes because they lead to insulin resistance. Therefore, maintaining a healthy weight can prevent the onset of diabetes, and is an important cornerstone of managing diabetes.

Are all people with diabetes at risk of losing their legs, or of going blind?

Nasreen Jaffer: No, not all people with diabetes will experience these complications of poorly managed or undiagnosed and unmanaged diabetes. These complications set in when the blood sugar levels are not maintained within the targeted levels over an extended period. This is why it is so important to be tested, and if diagnosed, to follow recommended treatment. 

“The onset of complications can be delayed or avoided by maintaining optimal blood glucose control through medical treatment, diet, and physical activity.”

Do people with diabetes need to eat special foods formulated for them or follow a special diet?

Ria Catsicas: People with diabetes need to prioritise the intake of foods that are part of a healthy diet. There is no need to buy special foods or expensive foods labelled for people living with diabetes. Foods that form part of a healthy diet are available at any grocery store and include whole grains; fresh vegetables and fruits; dried beans, legumes, and pulses; fish, chicken, lean red meat; low fat dairy products; seeds and nuts; and plant-based oils such as olive, canola, sunflower and other seed, or nut oils. 

This means that people living with the disease have as wide a choice of foods as anyone else.  A challenge is that people may know what they should eat but find it difficult to change their eating habits.

“Each person requires individual dietary guidance, with consideration of several factors, including your health status, medication, lifestyle, and food preferences.”

Do people with diabetes have to avoid eating fruits?

Ria Catsicas: No, people with diabetes do not have to avoid fruit.  All types of fruit contain fibre and have a low glycaemic load, a term that refers to the type and quantity of carbohydrate that is eaten.

A low glycaemic load means that if you eat any fruit in moderation you will not experience a high blood sugar response. It is the amount of fruit you eat that matters and it is best to get your dietitian to check how much fruit you can consume as this is an individual recommendation.

Is it true that carbohydrates are ‘the enemy’?

Ria Catsicas: No, carbohydrates, also known as ‘starches’ or ‘starchy foods’, are not ‘the enemy’ for people with diabetes. Although carbohydrates are the foods that affect blood sugar most significantly, robust evidence has shown that starchy foods do not have to be avoided to attain blood sugar control.

There are a lot of tasty, high fibre carbohydrate foods that should be included such as dense seed and health breads; unsweetened, high fibre breakfast cereals; rolled oats; wild brown rice; baby potatoes and sweet potatoes with skins on, legumes such as beans, lentils, and chickpeas; corn on the cob; grains such as barley, quinoa, and bulgur wheat; high fibre crackers, and all fresh fruit and vegetables. 

Some people think that a diabetes diagnosis means they can never eat sweets, chocolates, or desserts ever again. Any suggestions for satisfying a sweet tooth?

Nasreen Jaffer: It is not true that a person living with diabetes can never enjoy a sweet treat ever again. What is of greater importance is how much and how often these foods are eaten and making sure that there’s a balance of the food groups in a meal or snack. A dietitian can guide them on how to incorporate some treats, in moderation of course, while still managing their blood sugar levels. They can also help to identify healthier alternatives that may well become favourite go-to treats.

ALSO READ: Diabetes: 60% not screened for complications

Is it true that type 2 is a mild form of diabetes?

Ria Catsicas: No, it is a myth that type 1 is a worse type of diabetes than type 2. The differences between the two types are how they develop. Type 1 normally develops in people of a younger age in a short space of time due to an autoimmune disorder, and people living with type 1 diabetes are 100% dependent on injecting insulin.

Type 2 develops in older people over a longer period due to genetic predisposition, abdominal obesity, poor diet, inactivity, and stress. Insulin resistance and fatty infiltration of the pancreas cause the pancreas to produce too little insulin to control blood sugar levels within the normal range. 

Some people with type 2 diabetes also use insulin while others use alternative medicine. Both types are treated using a variety of medications including injections to control blood sugar levels optimally. 

“In truth, the worst type of diabetes is diabetes that is untested, undiagnosed, or uncontrolled because this leads to dramatic health complications including blindness, loss of limbs and death.”

Should people with diabetes avoid physical activity?  

Kgadi Moabelo: People with diabetes should not avoid physical activity unless they are specifically advised to do so by their doctors. Physical activity offers significant benefits for people with diabetes as it improves insulin sensitivity and supports the control of blood sugar levels.

Physical activity also helps control weight, protect nerve damage, and can delay the progression of diabetes complications. Each individual living with diabetes should be aware of their unique glucose response to exercise, and tailor their activities accordingly. The general guideline is 150 minutes of moderate-intensity exercise weekly, such as walking, jogging, cycling, and swimming; or 75 minutes of vigorous intensity activity per week. 

Are there any natural products that can cure diabetes or support health for people with diabetes?  

Kgadi Moabelo: No plants or medicine can cure diabetes. Among the many plant species used over time to treat diseases, there are reports that over 800 of them may have beneficial effects on blood sugar levels. There is a significant lack of research that is needed to determine important factors such as safe dosage and administration. It’s important to note that ‘natural’ does not mean ‘safe’ and that while there may be medicinal plants that can help at the right dose, administered in the right way, the same plants can be toxic at the wrong dose or taken in another form. 

If a person with diabetes adheres to their medication, can they eat anything they like?

Kgadi Moabelo: It is crucial for any person living with the disease to eat a healthy diet even when their blood sugar level is controlled. Moreover, maintaining a healthy body weight is of great importance when managing diabetes. Focusing on high-fibre carbohydrate foods instead of highly refined carbohydrates, plenty of vegetables, low-fat foods and limited salt intake is essential for the proper management of diabetes.

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