Dr Ambrish Mithal: Myths about diabetes

Did you know a 15% weight reduction has shown to normalize glucose tolerance? Or that even with diabetes, you can eat sugar in moderate amounts? Padma Bhushan awardee and renowned endocrinologist Dr Ambrish Mithal weighs on 10 myths surrounding the ailment.

#1 MYTH

Diabetes is caused by eating too much sugar.

FACT A lot of people believe that eating sugar causes diabetes, but that is far from the truth. Onset of diabetes is not really linked to intake of sweets and sugars. In fact, having high calorie food, refined carbohydrates like maida, high fat intake, and leading a sedentary lifestyle increases the risk of obesity, which is a major risk factor for diabetes. But once you have developed diabetes, sweets are best avoided.

#2 MYTH

No one in my family has it so I can’t get it.

FACT Though the genetic factor plays a key role in the onset of diabetes, inappropriate and sedentary lifestyle is becoming the major concern for its onset. Even in the absence of genetic factors, with the increase in age, weight, physical inactivity, faulty food habits, incidence of diabetes has increased many folds.

#3 MYTH

If I have diabetes, I’ll show symptoms.

FACT Diabetes is known to be a silent disorder! Though some people show symptoms like polyphagia (excessive eating), polydipsia (abnormally great thirst), increased frequency of urination, etc. More often than not people with diabetes do not feel symptoms. Hence, it is always recommended to keep a close watch at the blood glucose levels to rule out any ups and downs which silently affect other vital organs and visit a doctor regularly as a precautionary step.

#4 MYTH

Diabetes can be cured by weight loss.

FACT We can cure diseases, disorders can be managed! Diabetes is a lifestyle disorder. Through weight loss, diabetes progression can be easily controlled and to a certain extent even prevented or delayed. As per studies, with 3% reduction in weight, people with diabetes have shown improvement in glycaemic control and more than 15% weight reduction has shown to normalize glucose tolerance. An increase in weight leads to insulin resistance and increases the risk of Type 2 diabetes. Reducing the body weight helps to increase the efficiency of insulin thus reduces the risk of diabetes.

#5 MYTH

It is best to delay using the medication as long as possible?

FACT The first line of defense in Type 2 diabetes is lifestyle management but diabetes is a progressive disorder. Even after following the right diet and exercise schedule, one may require the support of medication or insulin. It is not wise to delay the treatment if suggested by a doctor as uncontrolled sugars can harm vital organs of the body.

#6 MYTH

If you have diabetes you can’t eat any sugar and carbs.

FACT People with diabetes can surely eat complex carbohydrates and also eat sugar in a moderate amount. Eating simple sugar and carbs increases the blood glucose level immediately as they have high glycaemic index as well as are devoid of fibers. They do not give satiety, thus people tend to eat them in large amounts. Complex carbohydrates which have more fibers, for example, fruits and whole pulses, should be preferred over simple sugar and carbohydrates. Also, portion size and frequency of eating should be controlled.

#7 MYTH

Diabetics cannot consume fruits.

FACT Fruits are not forbidden for people who have diabetes. Fruits are loaded with vitamins, minerals, antioxidants and fiber and are a good source of energy as well. When consumed with their skin, seeds and fiber, fruits are one of the best foods to be consumed by diabetics. The key is to keep an eye on portion sizes and stay away from fruits canned in syrups or other types of added sugar.

#8 MYTH

You can adjust your diabetes drugs to ‘cover’ whatever you eat.

FACT Adjusting doses of insulin or medicine to compensate for over-eating is not the right approach to diabetes control. Controlling the amount and timing of food is more important. Small and frequent meals prevent hypoglycemia as well as hyperglycemia. Along with diet, exercise also acts as a preventive strategy.

#9 MYTH

Diabetics can’t consume alcoholic drinks at all.

FACT Moderation is the key! People with diabetes can have alcohol however, they are advised to avoid it. Since excess alcohol consumption reduces the release of glucose from the liver, it can lead to a major drop in blood sugar levels (hypoglycemia) in some patients. Such patients can misjudge the hypoglycaemic condition with being under the influence of alcohol (hangover). Thus, they miss the timely treatment of low sugars, which may lead to unconsciousness.

Moreover, alcohol gives empty calories and no nutritional benefit. It also increases the risk of other diabetes-related complications. Hence, it should be taken occasionally and in lesser amounts.

#10 MYTH

Anti-diabetic medication isn’t effective in the long-term.

FACT This statement is partly correct and partly wrong as well. The effectiveness of drugs seems to dim with time because pancreatic function declines with age, and therefore less insulin is produced by the body. Hence over time, the dosage of medication needs to be increased. However, anti-diabetic medication works for a very long time. One solution is to control diabetes aggressively right from the early stages. The medicine will work really well because the pancreatic function will be preserved. Apart from following a strict schedule of drugs, diabetics must manage their condition with frequent self-monitoring of blood glucose, dietary modifications and exercise.

About Dr Ambrish Mithal

Dr Mithal is presently the Chairman and Head of the Endocrinology and Diabetes Division at Medanta, the Medicity where he has established one of India’s premier diabetes and endocrinology centres.

He is immediate Past President, Endocrine Society of India, and the Chairperson, Bone and Joint Decade, India. He is the founder, Past President, and currently Chief Advisor to the Indian Society Bone and Mineral Research (ISBMR).

In 2015, he was awarded the Padma Bhushan for “distinguished service of a high order” in the medicine category.

He is an advisor with HealthifyMe.com.