More than 24 million Americans have diabetes, and many people who have the disease don't know it.
What can be done to reduce the risk of this devastating illness, which can lead to heart attack, stroke, blindness, and amputations? Quite a bit, says diabetes expert Dr. Neal Barnard, president of the Physicians Committee for Responsible Medicine. The key, he says, is not to fall victim to common myths about the disease. Here are 10 of the worst.
Myth: Diabetes Doesn't Run in My Family, So I'm Safe
Many people develop diabetes despite the fact that they have no family history of the disease. Heredity certainly plays a role, but studies involving identical twins show it is not the only factor.
When one twin has type 1 diabetes, the other has a fifty-fifty chance of having it, too. For type 2 diabetes, twins are more likely to share the diagnosis - the odds of the second twin having it can be as high as 75 percent. But even then, the reason may be that their diets and weight gain are similar.
Bottom line? To minimize your risk for diabetes, you need to exercise and watch what you eat no matter what your family history is.
Myth: Diabetes Is Caused by Eating Carbohydrates
Diabetes is least common in the population groups whose diets emphasize carbohydrates. Take Japan, where rice is a traditional staple. Prior to 1980, fewer than 5 percent of the adult population there had diabetes. But once fast food and meat started to displace rice, diabetes became much more prevalent. By 1990 the prevalence of diabetes in Japan had doubled.
In the U.S., the risk for type 2 diabetes is highest among frequent meat-eaters. Vegans have the lowest risk, and other groups (semi-vegetarians, fish-eaters, and lacto-ovo-vegetarians) are in between.
The real problem seems to be not carbohydrates, but fatty foods.
Myth: I'm Not Fat, So I Won't Get Diabetes
Staying slim cuts the risk dramatically, but thin people can certainly develop diabetes. The condition arises when the cells in the body become resistant to insulin, the hormone that escorts blood sugar (glucose) into cells.
Doctors think insulin resistance is caused by the build-up of microscopic fat droplets inside cells - especially muscle cells and fat cells. This can occur even in someone who has little belly or hip fat.
Luckily, the same dietary steps that reduce belly fat and hip fat also help prevent the build-up of fat inside cells.
Myth: Diet Has Nothing to Do with Type 1 Diabetes
Type 1 diabetes is caused by antibodies - tiny biological "torpedoes" that under normal circumstances are produced by the body to fight invading bacteria and viruses. Diabetes results when, in the body's version of "friendly fire," antibodies attack the insulin-producing cells of the pancreas.
What turns antibodies against the pancreas? One theory is that certain viral infections are to blame. But another possible culprit is cow's milk. Researchers are now exploring whether avoiding cow's milk early in life can help prevent diabetes.
Human milk is no problem. Studies have shown that breast-fed children are much less likely to develop diabetes than children fed milk-based formula.
Myth: Only Adults Get Type 2 Diabetes
At one time, type 2 diabetes was called "adult-onset" diabetes. But more and more cases are showing up in children, likely the result of poor dietary habits and the childhood obesity epidemic.
Myth: Gestational Diabetes Is a Problem Only for Pregnant Women
It's true that gestational diabetes occurs during pregnancy and disappears when you are no longer pregnant. But doctors now know that women who have had gestational diabetes are at increased risk for developing type 2 diabetes later on.
Women should take gestational diabetes very seriously - and make the same sorts of dietary changes that help prevent type 2 diabetes.
Credit: CBS/The Early Show
Myth: Diabetes Is Irreversible
Conventional wisdom long held that once someone developed diabetes, he/she would have it forever. But with the advent of gastric bypass surgery, it became clear that extreme weight loss could reverse some cases of type 2 diabetes.
In 2009, the American Diabetes Association endorsed a new dietary approach to treating diabetes - one that focuses on low-fat, vegan (pure vegetarian) eating. Many people have found that this approach leads to significant weight loss and sometimes to the disappearance of signs of diabetes.
Of course, going back to poor eating habits is likely to cause diabetes to come roaring back.
Myth: Diabetics Must Avoid Carbs
Actually, carbohydrates are essential for good health, and people who eat plenty of whole grains, vegetables, fruits, and beans - all carbohydrate-rich foods - control their diabetes better than people who eat fattier diets.
The key is to know the difference between foods that contain lots of "good" carbs and those rich in "bad" carbs. One way to do this is to use the glycemic index, a rating system that indicates how much a given food affects blood sugar. Foods with low (healthy) glycemic index values include beans, pasta, yams, sweet potatoes, green vegetables, barley, and fresh fruit.
White bread, white potatoes, and sugar have high glycemic index values and tend to cause blood sugar to rise.
Myth: Drugs Are as Effective as Diet at Controlling Diabetes
Medications can be essential, even life-saving. But they cannot bring about the weight loss that is needed for really tackling diabetes and keeping blood sugar under control. And while medications usually target one problem at a time - blood glucose or cholesterol, for example - a healthy diet tackles all of these at once.
Diet and lifestyle are especially important for preventing diabetes. Recently, scientists tested two methods for preventing type 2 diabetes in at-risk people. Diet and exercise proved more powerful for prevent diabetes than drug treatments.
Myth: Diabetes Drugs Are Mostly Free of Side Effects
One of the most popular diabetes drugs, Avandia, has been in the news a lot lately. That's because it's been associated with heart problems. But all diabetes medications have side effects.
Metformin, the oral drug most often used as a first line of defense against type 2 diabetes, often causes digestive symptoms. Other drugs used to treat type 2 diabetes cause weight gain - which is unfortunate, since being overweight is a common problem among people with type 2 diabetes. Insulin injections present the same annoying problem.
This doesn't mean that people shouldn't take diabetes medications. But It does emphasize the need for diet and lifestyle approaches that can minimize the need for medicines.