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Diabetes Myth Busting

Almost all my patients have diabetes. In the hundreds of patients with diabetes I see every month, I’m saddened by how little most patients know about their disease. Worse, many patients have been given incorrect, dangerous, detrimental information. This post is to address common diabetes misconceptions for patients and providers.

1. I have to eat six times per day because I have diabetes.
False. Diabetes causes high blood sugar, not low blood sugar.
– If you are having low blood sugars, it is more than likely a problem with your medications and dosages. Common medications that lead to low blood sugar are sulfonylureas and insulin.
– Why is this myth dangerous? Eating more leads to weight gain, worsening insulin resistance, thereby worsening diabetes. “Snack foods” are often the worst of all.

2. Breakfast is a must.
False. In fact, one effective way to lose weight and decrease insulin resistance is intermittent fasting. Skipping breakfast is the easiest way to intermittently fast for most people.
– Many of my patients tell me they eat breakfast even if they are not hungry, and are relieved to hear they don’t have to!
– Some of my patients with type two diabetes on high doses of insulin have been able to stop insulin completely using intermittent fasting.
– Want to learn more about intermittent fasting? I highly recommend this book

3. I can cure type one diabetes with diet.
False. Type one diabetes is an autoimmune disease where one’s body attacks its own pancreas – the organ that secretes insulin. If you have type one diabetes, you will die without insulin.
– Caveat: You can significantly reduce your insulin dosages with diet changes even in type one diabetes.

4. I can never eat sweets because I have diabetes.
Kind of false. You can eat sweets just recognize that your blood sugar will go up.
– If you take insulin, you will need higher doses to cover high carb foods like most desserts.

5. Diet drinks and artificial sweeteners are healthy.
False. While these may have less of an impact on your immediate blood sugar, they can lead to worsened weight gain and insulin resistance, the underlying causes of type two diabetes.

6. My blood sugar is all over the place with no rhyme or reason.
Usually false. Usually with a thorough history and a physician experienced in appropriate diabetes management, we can figure out the problem.
– I have seen thousands of patients with diabetes in the hospital, which is a more controlled setting than home. Here I can recall very few patients we had trouble figuring out. It gets tougher in the clinic, because home life is unpredictable.
– If you are struggling with this, make sure to bring your doctor a detailed meal, snack and blood sugar log. There are many other things that can affect blood sugar including illness, medications and hormones, so also consider seeing a specialist.
– Continuous blood glucose monitors such as the FreeStyle Libre or Dexcom can also help.

7. I have to stop all other medications when I start insulin if I have type two diabetes.
Usually false. Unless there is a specific reason to stop them (e.g. kidney disease, side effects), many medications can be used in conjunction with insulin. In fact, keeping insulin doses as low as possible by using other meds that don’t cause weight gain actually decreases the weight gain associated with insulin.

Hope this clarifies some things! Leave me a comment if you have any further questions!

Doctor. Mom. Wife. Journalist.

Hi and welcome to my blog! I’m a practicing physician in San Antonio, Texas, and I specialize in endocrinology, diabetes and metabolism. My field focuses on hormones, which are chemical signals in the body that enable important body functions – hunger, satiety, weight, temperature, sleep, blood sugar, blood pressure, the list goes on.

I treat patients who suffer from diabetes, overweight and obesity, thyroid diseases, metabolic bone disease including osteoporosis, diseases of the pituitary and adrenal glands and male and female reproductive hormone problems. The interplay of organ systems and their impact on people fascinates me. As you may guess, my job involves taking detailed histories, enabling me to learn so much about my patients’ lives and bodies. This process requires trust and faith and it is an honor to provide my patients individualized care.

I am continually exploring avenues to strengthen the patient-physician interaction, and this blog will chronicle my journey to develop these. Technology can bridge the gap between physicians and patients, especially in the management of chronic diseases, like diabetes and obesity, which require active daily engagement. Gaps in engagement have led to growing epidemics despite pharmaceutical innovation.

I believe in no wasted effort, and I am a formally trained journalist courtesy of Northwestern’s Medill School of Journalism. I’ve worked at newspapers, magazines, free-lanced and kept a blog for Medscape as a medical student. I took a hiatus during training, and now with more experience, knowledge and passion, I am ready to write again.

I hope this blog is a place where I can teach, help, share and bridge the gap. I’m a doctor, a mom, a wife, a daughter, a sister, a niece, an aunt, a struggler, a juggler, and both a superhero and the worst person in the world to a toddler. My life is a beautiful journey of learning and change, and I’d love for you to join me for the ride.