Diabetes affects more than five million people in Britain – that’s one in every 14 of us – with around 90 per cent of those living with type 2 diabetes. Yet in spite of so many having the condition, or knowing someone with it, there remains a lot of confusion about the causes and what diabetics should and shouldn’t eat.
“Knowing more about diabetes is the first step in helping to prevent and manage it,” explains Douglas Twenefour, registered dietitian and head of care at Diabetes UK. Here he busts some common myths:
MYTH 1: Diabetes is caused by too much sugar
As diabetes is characterised by high levels of sugar (glucose) in the blood, it is unsurprising many people think it’s caused by high sugar intakes. But science says otherwise. The Scientific Advisory Committee on Nutrition says there’s no evidence sugar itself causes type 2, although higher intakes of sugary drinks may increase the risk.
Douglas says: “We still don’t really know what causes type 1 diabetes, but our immune system is involved. Our body seems to turn against itself and destroys the cells in the pancreas that produce insulin.
“But type 2 is more common as we get older and if we have a family history or are from certain ethnic groups. Our weight also plays a part. Around nine out of 10 people newly diagnosed with type 2 live with obesity or are overweight.”
This is where sugar most likely plays a part. High sugar intakes are linked to higher calorie intakes and an excess of calories increases weight.
MYTH 2: You have to completely give up sugar
The main dietary advice for people living with type 2 is to have a healthy, balanced diet low in saturated fat, salt and sugar. But this doesn’t mean being totally sugar-free. Douglas says: “It’s fine to enjoy small amounts of sugar-containing foods when you have diabetes – but it’s important to have them less frequently and in small portions, as too much can make it difficult to manage blood sugar levels and weight.”
MYTH 3: Sugar is the only ingredient you need to worry about
It’s easy to fall into the trap of thinking this. But diabetes increases the risk of heart disease and stroke, so a healthy diet is even more important than cutting sugar to keep blood cholesterol and blood pressure under control.
The benefits don’t stop there. “Filling up on nourishing foods that provide us with all the protein, fibre, healthy fats, vitamins and minerals we need, helps to keep every part of our body healthy, from our brain and bones to our skin and gut,” says Douglas.
MYTH 4: Fruit contains too much sugar for diabetics
Health advice for everyone, including those living with diabetes, is to eat five portions of fruit and vegetables a day. Most fruit and veg are lower in calories and provide fibre, making them great for filling us up and managing our weight. And they contain vitamins, minerals and phyto-chemicals, all vital for good health.
“Many people think they need to avoid bananas, grapes or other fruits, but there’s no reason for this so long as you keep an eye on portions,” says Douglas. “They all count towards our five-a-day too, so should be enjoyed. Variety is the key, so aim for a rainbow of different colours each day.”
MYTH 5: You can cure diabetes with the right diet
“It’s not possible to cure or reverse diabetes, but weight loss can put type 2 into remission, especially if this is soon after diagnosis,” explains Douglas.
“It’s also one of the times when rapidly losing a lot of weight – around 2st 5lb (15kg) – is beneficial.“Research funded by Diabetes UK found 46 per cent of people living with obesity put their type 2 diabetes into remission by following a diet with 850 calories a day for three to five months, followed by a gradual reintroduction of food and advice on weight maintenance. The bigger the weight loss, the greater the chance of remission.
“About seven per cent of those losing less than 5kg went into remission compared with about 90 per cent of those who lost at least 15kg. Also, after two years, more than a third of people were still in remission and not needing diabetes medications.”
To try this, ask your GP to refer you to the NHS Remission programme or to a dietitian for advice and support.
MYTH 6: Diabetics must follow a low-carb diet
A balanced diet with meals based on healthy food choices remains the main advice. Douglas says: “Fruits, veg, wholegrains and pulses are important to a healthy diet. The key is to choose carbohydrates with the most fibre for a healthy gut and watch portions to manage blood glucose levels.”
Low-carb diets can be useful for some with type 2 though. Advice from the Scientific Advisory Committee on Nutrition confirms in the short term (up to six months), a lower carb diet with 50-130g carbohydrate a day may lead to better blood glucose control and lower triglyceride, a type of blood fat that raises heart disease risk.
Lower carb diets may also allow for reductions in medication, but this must be assessed on an individual basis. But it’s best to avoid keto diets that restrict carbohydrates to less than 50g a day and typically mean avoiding milk, fruit and some vegetables.
MYTH 7: Type 2 is a mild form of diabetes – you don’t need to worry about your diet
“Some people think type 2 diabetes is a mild form of the condition, but this is incorrect,” says Douglas. “Whether you have type 1 or type 2, if it’s not diagnosed or managed, glucose starts building up in the blood.
“This causes symptoms such as feeling tired and thirsty, needing to pee a lot (especially at night), blurred vision, slower healing, a raised risk of urinary infections and thrush and, in the long term, damage to the nerves, eyes, kidneys and feet.
“There’s also an increased risk of heart attack and stroke. So getting support to manage blood glucose levels through a combination of diet, exercise and medication is crucial for anyone with diabetes.”
MYTH 8: Taking supplements can help control blood sugar levels
The internet is full of supplements and products, such as ginseng, aloe vera, cinnamon and apple cider vinegar that claim to help control blood glucose, but there’s a lack of science to support that.
Chromium, found in meat, pulses, wholegrains, nuts, fruit and vegetables, has a role in achieving normal blood glucose levels but there’s insufficient evidence to support taking supplements to treat diabetes.
Douglas says: “It’s more effective to eat a varied diet to get all the nutrients you need. Don’t replace diabetes medications with supplements. “And let your GP know before you start any supplement because some may interfere with medications or even make diabetes complications worse.”
■For more information visit Diabetes UK