In Categories: Practical Tips

There are many common misconceptions about diabetes that persist despite evidence to the contrary. Here are the five I encounter most with my patients.

Myth #1: Insulin or pill medications are an inevitable part of the treatment for diabetes

Many people believe they will have to take medicine for the rest of their life if they are diagnosed with diabetes. This depends on the type of diabetes a person is diagnosed with. In adults, the most common forms of diabetes mellitus are type 1 and type 2. With type 1 diabetes, the body is unable to produce insulin, and taking medication (insulin injections specifically) is absolutely necessary in order to avoid life-threatening problems due to high blood sugar.

However, almost 95% of adults who are diagnosed with diabetes have the type 2 form. With type 2 diabetes, the body is usually still able to produce insulin, so the insulin injections that are necessary for treatment of type 1 diabetes are not always needed with type 2. If a person is diagnosed with type 2 diabetes, then medications can be completely avoided if lifestyle changes allow the body’s own insulin to work more effectively. Diabetes reversal and reducing or completely stopping diabetes medications are the goals of the Virta Treatment, a physician-supervised nutritional intervention supported by one-on-one health coaching, a step-by-step educational program, biomarker testing, and a patient community, all delivered through a continuous remote care platform

Myth #2: Diabetes is chronic and irreversible

At this point in time, there is no proven cure for diabetes. However, we do know that diabetes can be controlled with healthy eating habits—even to the point where diabetes medications are not needed. At Virta, we consider diabetes to be reversed if a person is able to lower his or her blood glucose (sugar) levels to below the diabetes diagnostic threshold without the use of certain diabetes medications.

It is important to note that while a person can accomplish control (or reversal) of his or her diabetes without the use of medications, this control can be lost if that person no longer sticks to a healthy diet. Medications would need to be taken in order to regain quick control of blood glucose (sugar) levels if this happens. There is no guarantee that a person who is able to come off of his or her diabetes medicines will be able to stay off of these medicines permanently, especially if he or she goes back to unhealthy eating habits.

Myth #3: Thin people don’t get diabetes

While the majority of people who are diagnosed with either diabetes or prediabetes are overweight or obese, people who are either thin or at a normal weight can certainly develop diabetes, too (Jo, 2018)!

Ethnicity is a well-known risk factor for developing type 2 diabetes, especially in African American, Latino, and Native American populations. Women who are diagnosed with gestational diabetes during pregnancy can also develop type 2 diabetes later on. Also, the risk of developing diabetes goes up as a person ages, especially for people over 40 years old. People with any these risk factors can still develop diabetes, even if they are thin or at a normal weight.

Myth #4: Prediabetes is not a problem because it isn’t the same as type 2 diabetes

Prediabetes is commonly referred to as “borderline diabetes.” It is diagnosed by a higher than normal blood glucose (sugar) level on labs, but the blood glucose level is not yet high enough to qualify for a type 2 diabetes diagnosis. Prediabetes often eventually leads to a diagnosis of type 2 diabetes if the abnormal blood glucose levels do not return to normal over time. This can happen several months or even years down the road.

While people with prediabetes do not have to deal with some of the serious complications of diabetes (such as amputations, loss of vision, and kidney problems), being diagnosed with prediabetes still puts a person at a higher risk of developing type 2 diabetes, heart disease, and stroke. In addition, doctors may recommend that certain people with prediabetes begin taking a medication called metformin in order to try to prevent or slow down progression to type 2 diabetes. When a person is diagnosed with prediabetes, weight loss, regular exercise, and healthy eating habits are always recommended as ways to lower the risk of developing these problems.

Myth #5: You have to have symptoms in order to be diagnosed with diabetes

Both type 1 and type 2 diabetes can cause symptoms such as feeling thirsty, urinating often, extreme fatigue, and hunger. However, not all people with diabetes have these symptoms, or any symptoms at all. This is especially true for type 2 diabetes.

Because type 2 diabetes can be present for several months to years without any noticeable symptoms, the diagnosis and treatment can become delayed if a person does not see his or her doctor on a regular basis. The longer the diabetes goes unrecognized and untreated, then the risk of developing serious complications of diabetes (such as amputations, loss of vision, and kidney problems) becomes much higher. Diabetes is easily diagnosed on routine labs long before any symptoms can occur. Because diabetes is so common, doctors routinely screen people for this condition, even when they are being seen for other reasons (such as a cough, a cold, or allergies).

Don’t fall for these diabetes myths! Talk to your doctor today if you have any questions or concerns about your risk of diabetes.

The information we provide at virtahealth.com and blog.virtahealth.com is not medical advice, nor is it intended to replace a consultation with a medical professional. Please inform your physician of any changes you make to your diet or lifestyle and discuss these changes with them. If you have questions or concerns about any medical conditions you may have, please contact your physician.

18 Comments

  1. Avatar

    What is thought to be the mechanism
    by which Statins may contribute or be associated with an increased incidence
    of T2DM?

    Reply

    1. Virta Health

      There is strong evidence from multiple epidemiological and prospective studies that statin drugs as a class raise the risk for developing type 2 diabetes. There is a lot of speculation as to one statin carrying more risk than another, but this remains subject to debate. There is also great interest in the mechanism for this effect (i.e., what statins do to make this happen), and there is some emerging evidence that it involves epigenetic triggering of genes associated with diabetes risk.

      At this point, most experts agree that the reduced risk of developing heart disease with statin use in people judged to be at high risk far outweighs the diabetes risk associated with statin use. In addition, although we have not formally studied this in our research here at Virta, it appears that statin use by people on the Virta Treatment does not interfere with the many metabolic benefits of nutritional ketosis, including reversal of type 2 diabetes. In fact, in a 6-week long study, Dr. Volek’s team recruited a group of patients who were already taking a statin and had them follow a well-formulated ketogenic diet. Despite being on the statin, these patients showed significant improvements in blood pressure, insulin and triglycerides (ref below).

      Kevin D.Ballard Erin E.Quann Brian R.Kupchak Brittanie M.Volk Diana M.Kawiecki Maria Luz Fernandez Richard L.Seip Carl M.Maresh William J.Kraemer Jeff S.Volek. Dietary carbohydrate restriction improves insulin sensitivity, blood pressure, microvascular function, and cellular adhesion markers in individuals taking statins. Nutrition Research. 2013; 33:905-912

      Reply

    2. Avatar

      Some of the literature points to the integrity of cell membranes as the possible root cause of type 2 diabetes. Damage or destruction of the membrane bi-layer in cells leads to inhibition of the Glucose Transporters and Insulin Receptors in the membrane. If these don’t work properly, glucose cannot enter the cell. Now, a sensible explanation of how this is linked to Statins use is that Statins inhibit the synthesis of cholesterol by cells, and cholesterol are a fundamental part of cell membranes. Without cholesterol, the cell membranes lose integrity, hence inhibiting glucose transporters..

      Reply

  2. Avatar

    I have a friend, a Phd Math professor who was Type I and when I knew him at age 50 he had never had an insulin injection or pills. He controlled his diabetes with diet and exercise. He was impressively diligent with this and it worked. His eyes were good and so was his circulation. He said if one eats a really low carb diet with small meals, the body does not need insulin and he proved it.

    Reply

  3. Avatar
    Pradeep Awasthi February 5, 2019 at 1:43 am

    Its more common to notice that People who are afflicted with type II diabetes have different myths and they have many misconceptions regarding it.But the fact about type II diabetes is Its. more individualized and thus requires several interventions at early stages in order to achieve a healthy state and quality of life in long run.

    Reply

  4. Avatar

    Is it possible to have diabetes nearly all of your life and not know it?

    Reply

    1. Virta Health

      Type 2 diabetes can take many years to develop and one can develop insulin resistance decades before blood sugar is elevated enough to qualify as Type 2 diabetes. You may find this post helpful as it discusses the signs and symptoms as well as how diabetes is diagnosed: https://blog.virtahealth.com/how-do-i-know-if-i-have-diabetes/

      Reply

  5. Avatar

    Is it common practice to be put on cholesterol medication just because you were diagnosed with diabetes (type 2)? What research makes this a mandatory step? I was told that I will be on Metformin, Losartan, and a cholesterol medication for the rest of my life, no matter what my numbers say, due to my diabetes diagnosis. If not, I will have a heart attack or stroke. Is this proven to be true? I keep getting a run-around answer that “research shows this will decrease your chances…” but nothing to prove that there is a plaque buildup. Please advise. I am not comfortable with the answers I am getting.

    Reply

    1. Virta Health

      Hi Lynda, I just wanted to let you know that we have shared this question with our scientific team and will get back to you as soon as we have an answer. Thanks for your patience!

      Reply

    2. Virta Health

      This is an excellent question with the answer being a bit more nuanced than “Everyone must do…”. Yes, it is the standard recommendation by the American Diabetes Association that people with type 2 diabetes receive these 3 medications to reduce the known complications of this chronic, progressive disease. However, if someone has a clear intolerance of any of these medications, the pros and cons of continuing it needs to be discussed with one’s doctor. Additionally, since the Virta Treatment has been demonstrated effective in reversing type 2 diabetes in the majority of our patients after one year, for these individuals it is no longer a ‘chronic, progressive disease’. In this case, a discussion with your doctor of the need to continue some or all of these medications may be in order.

      Reply

  6. Avatar

    Why are providers not testing a fasting insulin level? Seems it would give people an even sooner heads up as to what lies ahead? Is it cost, or does research not bear this out?

    Reply

    1. Virta Health

      Great question! For why doctors in general don’t test fasting insulin, it’s actually not that predictive of future diabetes risk. This is likely because diabetes is such a varied disorder with components of insulin resistance and insulin deficiency even among classic type 2s. At Virta, we test a fasting c-peptide which gets at the same information but also gives consistent data even in patients on exogenous insulin.

      Reply

  7. Avatar

    I was put on a dietician supervised diet in 1958 to gain weight.I did not gain any weight but instead got symptoms of diabetes.That was verified by a glucose tolerance test.I considered the type 2 diabetes to be an eating problem and cut back on carbohydrates.That worked reasonably well until I got married and was eating more carbs than before.I was rediagnosed in 1970 as diabetic with another glucose tolerance test. I corrected back to low carb with some fat supplementation and got the diabetes under good control as I understood it.Then when doctors started using the A1c testing mine was always normal, it has never tested even in the prediabetes range. In Feb of this year my new doctor told me that I am not diabetic. Sounds good but I still need to eat as usual.

    Reply

  8. Avatar

    I think it’s a myth to think diabetes medications (majority) are actually helping the disease! Did anyone ever get cured using them?

    Reply

  9. Avatar
    John Howard Briggs September 24, 2019 at 10:24 am

    To Messrs Volek and Phinney. I am curious about the vegan article. Where’s the fat coming from to get into ketosis ? I have read both your books , continue to read your books and look at your blogs. You are one of the few practioners involved in this subject that practice the scientific method. There are so many people out there spouting rubbish who wouldn’t know science and causality if it bit them ! I’m not diabetic or overweight, just got into keto eating about eight years ago, curiosity fired up by Gary Taubs and Wolfgang Lutz. I fall off the wagon occasionally, usually when on holiday. As an aside after much reading and considering the real facts, I am convinced cholesterol is not an issue so do not worry about mine. Statins I consider a total con, it’s well documented. Thanks,Howard.

    Reply

    1. Virta Health

      Thanks for following along, Howard! Those who follow a vegan diet can get fat from coconut, avocado, & olive oils.

      Reply

  10. Avatar

    I keep reading that Type 2 diabetes can be “cured” just by losing weight. Is that true?
    Note, I was pre-diabetic for years, couldn’t lose weight until I changed to ketogenic diet. My weight and A1c have been normal for about 2 years.

    Reply

    1. Virta Health

      We believe that weight gain is a symptom of metabolic dysfunction that leads to Type 2 diabetes and not the reason. For those on the Virta Treatment, as their metabolic health improves, they are able to lose weight.

      Reply

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