Actress Halle Berry is the epitome of good health, which is why it was a surprise to find out that she has diabetes.
But she and many other celebs, including Nick Jonas of the Jonas brothers and hip-hop mogul Damon Dash, are Type 1 diabetics. This condition (previously referred to as insulin-dependent diabetes) occurs when the body doesn’t produce insulin. It usually starts before 30, often in infancy or early childhood.
Type 1 patients need insulin treatment either through injections (the most common form), an inhaler or a pump. Then there’s Type 2 diabetes. The likes of Sophie Ndaba, Patti Labelle and Randy Jackson have managed their diabetes well, even with their busy lifestyles.
Type 2 occurs when the body either doesn’t produce enough insulin or the cells don’t respond to the insulin. It often develops later in life, although prevalence among children have increased. Unlike Type 1 diabetics, people with Type 2 can manage the condition without medication (although this is not always successful).
Unmanaged Type 2 diabetes can lead to kidney failure, blindness and impotence. Then there’s gestational diabetes, which is a sudden-onset condition in which women who were not previously diagnosed with diabetes exhibit symptoms of the disease while pregnant. If untreated, it can lead to complications during pregnancy and a higher chance of developing Type 2 diabetes post-pregnancy.
Diabetes is one of the fastest growing diseases worldwide, and also one of the most expensive, costing patients, governments and healthcare providers billions.
These warnings aren’t unwarranted, but much of what we think we know about the condition isn’t entirely accurate. Here’s the truth:
1. I’m slim, so I’m safe
You’re not. In the past 50 years, both obesity levels and the number of people suffering from diabetes have increased. The result is that many people link the two exclusively and assume that being thin means they can’t be diabetic.
But while obesity is certainly a risk factor for developing Type 2 diabetes, it’s not the only one: your ethnicity, family history, age and activity levels all play a role in determining your risk level.
Still, losing weight (if you are overweight) is necessary for managing diabetes. Experts recommend a loss of seven percent of your body mass. Because the onset of Type 2 diabetes usually occurs slowly, symptoms can be missed (especially in people who don’t automatically link these symptoms to diabetes because they’re not overweight).
Look out for fatigue; increased hunger, thirst and urination; pain or numbness in hands and feet; or blurred vision.
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2. Sugar causes diabetes
It doesn’t. This is probably the biggest misconception around Type 2 diabetes. And with words and phrases like “glucose” and “blood sugar levels” being a part of any diabetes discussion, it’s no surprise. But it’s not as simple as a conclusive link between a sweet tooth and diabetes.
But there is – as mentioned in Myth 1 – evidence that carrying too much weight is a risk factor, and it doesn’t matter whether it’s too much fat or too much sugar that caused that weight gain – it’s the “too much” part that matters.
A diabetes diagnosis also doesn’t mean you can’t eat sugar. Your intake just needs to be in controlled amounts (as with all elements of your diet) and preferably part of an eating plan devised by a dietician who specialises in the management of diabetes.
3. If my blood sugar levels are fine, I’m not at risk
Not so. While it’s true you can’t “kind of” have diabetes – you either have it or you don’t – you can be diagnosed as “prediabetic”, where the results of a fasting blood glucose test are higher than normal but lower than the level required for a diabetes diagnosis.
Doctors recommend acting on blood sugar results of anywhere between five, six and six, nine (these figures will be explained when you do the blood glucose test).
It’s vital that measures are taken even if you’re in the “pre-diabetic” zone, as recent research suggests that some of the long-term damage associated with diabetes begins during this period.
Joburg-based GP Dr Tsholofelo Bendile has the following advice for people with diabetes:
- Have a checkup with your doctor. If you have Type 1, take your insulin with you. Pack some glucose – usually in the form of sweets or peanut butter – in case your glucose drops too low.
- Those with Type 2 should ensure that they have packed enough medication with them.
- Have a list of emergency contact numbers and give a copy to your travel companions.
- Wear a medical ID bracelet so that medical specialists can treat you accordingly in an emergency.
- Pack your gym clothes so you can maintain your exercise routine.
4. I have diabetes, so I have to cut out all carbs
You don’t. This subject has been the topic of much debate after sports scientist Professor Tim Noakes reported that by following a high fat/very low carb diet he’d seen improvements in his markers for diabetes.
But endocrinologists at South Africa’s Centre for Diabetes and Endocrinology have stated that they don’t endorse a carb-free diet for the management of diabetes, saying that while weight management is a “key aspect of the treatment of Type 2 diabetes… the optimal macronutrient distribution for weight-loss diets has not been established.
“While high-carbohydrate diets are not promoted for people with diabetes, the emphasis should be on portion control and a choice of good-quality, high-fibre carbohydrates”.
Dieticians specialising in diabetes stress that the focus should be on foods to include rather than exclude. Beans, fish, dairy, oats, barley, greens and lentils are all highly recommended.
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5. A diabetes diagnosis means medication for life
Not necessarily. While Type 1 diabetes patients require insulin treatment, this treatment is not automatically required for those diagnosed with Type 2 diabetes.
In fact, the large Chinese Da Qing Diabetes Prevention study showed that lifestyle changes (including diet and exercise) were more effective than medication in delaying or preventing Type 2 diabetes.
For those already diagnosed, medical nutrition therapy – overseen by a dietician who specialises in diabetes – can often limit the need for medication.
But if you require insulin treatment, this isn’t a sign that exercise and a healthy, controlled diet “weren’t good enough” – it’s simply because over time, the body produces less of its own insulin and these measures might no longer be sufficient to keep blood glucose levels stable.
