5 Diabetes Myths and How They Harm Mental Health
By Amelia Harnish
Myths and misconceptions about diabetes can cause added anxiety and stress for people living with the condition. Here we debunk some common diabetes myths and offer advice on how to limit their impact on mental health.
Myths about diabetes – be it type 1 or type 2 – abound. Whether they come from inside or outside the community, misconceptions can cause added stress for those living with the condition.
For people with diabetes, in particular, stress is a health risk. For example, recent research finds that those living with type 1 or type 2 diabetes are at significantly greater risk of mental health issues like depression. Other research points to a “bi-directional” relationship between diabetes and depression.
“That means that not only are people with diabetes more likely to have depression, but having depression can make it harder to manage the disease and stay on top of lifestyle habits and taking medication,” said Dr. Karl Nadolsky, an endocrinologist at Holland Hospital in Michigan. “That increases the risk of diabetes complications.”
Managing day-to-day life as someone living with diabetes brings unique added stressors. Of course, there’s the extra mental load of worrying about your blood sugar and diet. But less talked about is the persistence of myths among friends and family: like the idea that diabetes is purely a result of lifestyle choices or that taking insulin means you’ve “failed.”
“The potential embarrassment, shame, or stigma associated with diabetes may in turn negatively affect one’s mental health,” said Dr. Lesley Johnson, an assistant professor at Emory University and MQ Mental Health research fellow who studies depression and diabetes. “Especially when it’s internalized, and individuals feel it’s their burden to bear alone.”
Busting myths about diabetes shouldn’t only be on the shoulders of people with the condition. However, knowing about them – and how to manage them – can help limit their impact on your mental health.
Myth 1: Type 1 and type 2 diabetes are the same
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. Type 2 diabetes is a progressive loss of beta cell function caused by a complicated mix of lifestyle, environmental, and genetic factors.
Somewhere between 90-95% of people diagnosed with diabetes have type 2, but it’s important to distinguish between the types as misconceptions can cause confusion, frustration, and feelings of guilt and shame for those with either form of diabetes.
“Unfortunately, the onus is still very much on affected people to educate those around them, particularly when faced with misconceptions about what it means to live with diabetes,” Johnson said.
It may help to have a small script ready when you encounter this myth and lean on reputable public health campaigns to help you with education. You could say something like: “Type 2 and type 1 diabetes are not the same disease. The American Diabetes Association has a great website where you can learn more.”
Myth 2: Type 2 diabetes is a lifestyle disease
Because certain healthy lifestyle behaviors have been shown to reduce the risk of getting type 2 diabetes, those who have the condition often end up being blamed for their disease. This myth affects mental health by making people feel shame when they can’t “solve” their diabetes. Judgment from friends, family, and coworkers can add stigma to the mix.
“Genetics plays a role in type 2 diabetes,” said Nadolsky. “Other factors, like medications, can also drive type 2 diabetes. It’s a complicated mix of things, many of which aren’t always in people’s control.”
Even lifestyle factors like diet and exercise are not in people’s control as much as they might think. For example, we’d all love to have a conveniently-located grocery store and plenty of time (and motivation) to exercise, but that’s just not the case for many people – especially those trying to manage diabetes.
The best advice in dealing with this myth is to release yourself from what you can’t control and focus on what you can. For example, you can’t change the genetics that predisposes you to diabetes, but you can take charge of making it to appointments and take advantage of diabetes education and self-management resources available to you.
Myth 3: Having glucose levels in range is the only important goal for treating diabetes
Those with diabetes tend to focus a lot on their A1C – and rightfully so. Generally speaking, keeping A1C below 7% and time in range above 70% can help protect you from long-term complications of diabetes, according to the American Diabetes Association (ADA).
However, glycemic goals should be individualized based on a person’s unique situation and health, Nadolsky said. A hyper-focus on blood sugar (by both doctors and people with diabetes) can not only lead people to lose sight of their overall health, but it may also lead to a fixation on carb counting or disordered eating.
“There’s so much more to the disease process beyond just sugar control,” Nadolsky said. “We don’t actually have to have perfect sugars. We want to be holistic and focus on overall health.”
Myth 4: People with diabetes shouldn’t ever eat sugar or carbs
Sure, keeping blood sugar in the recommended range is a balancing act that may require dietary changes. But that doesn’t mean you can never have carbs or sweets.
Those with diabetes know how to manage their diets, but that doesn’t stop disapproving stares or judgment from others when they want to indulge in birthday cake or pasta. Aside from feelings of frustration, this is another myth that can also impact mental health in the form of disordered eating habits, Nadolsky said.
And according to Johnson’s research, this myth can be particularly sinister because of the way it may impact a person’s ability to manage their diabetes effectively.
“Affected individuals report being aware that others may be judging them based on those choices,” said Johnson. “Having people ask, ‘Should you be eating that much sugar?’ underscores the misperception that diabetes is caused by sugar consumption.”
“These negative attitudes towards people with diabetes may keep affected individuals from performing those more visible aspects of diabetes self-care, such as injecting insulin, checking blood sugar levels, or wearing diabetes devices,” added Johnson.
Myth 5: Exercise is the cure for diabetes
It’s true, research has shown that regular physical activity can help regulate blood sugar levels and improve insulin sensitivity. But exercise is not the panacea people would like it to be.
“My patients often come in with almost an apology like, ‘I know I don’t exercise enough,’” Nadolsky said. “And I always tell them, it’s okay! Look, exercise is important, but it’s only part of the equation.”
Instead, think of exercise as one of the many things you can do to support your mental and physical health. Try to find activities that you enjoy doing. If you dread the treadmill, don’t beat yourself up about skipping the gym. Instead, try a yoga class with friends to make it social and more fun, or go for a walk outside to get fresh air.
What you can do
Myths and misconceptions don’t go away on their own – they must be dispelled and corrected. You can’t control the beliefs of everyone in your orbit, but educating yourself on diabetes self-care and management goes a long way.
Knowing what you need to do to live a healthy life while managing your disease can help you feel free of stigma or shame and more in control. The other important thing to keep in mind: prioritizing your mental health.
“People living with type 1 or type 2 diabetes are more likely to experience a mental illness, such as depression or anxiety,” Johnson said. “Left untreated, these conditions can lead to worsening mental and physical health.”
“There are many different things that people can do to promote their mental health (like meditation and developing social connectedness),” she added. “But maintaining regular physical activity and a healthy, well-balanced diet are practices that serve a dual purpose of supporting diabetes management.
