People with diabetes cannot eat sugar. Not only is this not supported in the science, I have yet to meet someone that “cannot have sugar”, because they have diabetes. Part of the reason why this belief is frustrating is because it lacks recognition of the fact that most foods have sugar in them. The better statement here would be that, people with diabetes are required to monitor their sugar intake and consider alternatives. Blood glucose levels are impacted primarily by carbohydrate ingestion; glucose/sugar is a type of carbohydrate (this is why it is indented and not bold on the nutrition label). It is important to aim for complex carbohydrates rather than simple carbohydrates in terms of glucose control. Yes, an ice cream sundae is a poor choice for how it will spike blood sugar, but it is not disallowed, nor will an occasional sweet treat hurt someone. Note use of the word occasional. 

People with diabetes are unhealthy. This can be very true, but is not true enough to be used as a blanket statement. I am going to use myself as an example here. I have had diabetes for 21 years, and I’ve often reflected on the status of my health as a result of my diabetes diagnosis. My guesstimate is that I have led a quite healthy life because of my diabetes. Not only was I a healthy teenager when I was diagnosed with diabetes, I became a healthy adult living with diabetes. I was motivated early on to eat well, exercise regularly and ascertain care for the management and prevention of complications. I would argue that I might be less health conscious were it not for my diagnosis. While too many individuals with diabetes are not caring for their bodies, the diagnosis can be extremely motivating for others. For those of us working in the hospital setting, it can be easy to fall into the trap of this myth, but there are truly many people thriving with diabetes. 

As long as the food is “healthy”, people with diabetes can eat as much as they want. “Healthy” is open to interpretation. But, I will assume we have an agreed upon interpretation of the word. The goal of the diabetes diet (which is not a diet; rather, it is a lifestyle) is moderation. Moderation, moderation, moderation. Glucose levels are directly impacted by carbohydrates; to a lesser degree they are impacted by fat content, protein content and fiber. Attention to the amount and type of carbohydrate is key. For example, fruits provide a tremendous amount of nutrients, but they still cannot be taken in in large quantities. Someone with diabetes should not eat four cups of berries with the expectation that their blood glucose levels won’t be impacted. The same concept can be applied to many “healthy” foods.  

Eating too much sugar is the primary cause of diabetes. Of course this has a component of truth to it, however it is an unfair statement that reflects a gross misunderstanding of the complex disease that diabetes is. We have been researching diabetes for decades, and there still is not evidence to support that Type 1 is induced necessarily by any sort of lifestyle choice or habit. Type 2 diabetes is heavily influenced by genetics, which tells us that, even a healthy individual with a family history of Type 2 can be diagnosed with Type 2. Don’t get me wrong, the lifestyle components are huge; those that have a family history, eat unwell and are sedentary are most likely going to be diagnosed with diabetes earlier on in life than those that have a family history but are not sedentary and that eat well. 

People with diabetes cannot drink alcohol. I want to remind anyone reading that anything said here is not medical advice, and I am not giving anyone permission to do something or mandating that they not do something. People with diabetes can drink alcohol. The recommendations/limits for alcohol consumption for those with diabetes are about the same as the recommendations for the rest of the general population. People with diabetes can absolutely enjoy a cocktail, glass of wine, beer or whatever it may be, but only with a careful approach. A lot of finding out what does and does not impact blood glucose is trial and error, unfortunately; additionally, results are always user-specific, meaning what works for one person with diabetes may not work well for the next (in terms of glucose management). Limiting sugary cocktails, sweet wines and heavy beers is helpful. Those with diabetes should always eat at/around the time of alcohol ingestion; this has to do with how the liver is impacted in diabetes and how it processes alcohol. The better statement here would be that, People with diabetes can have alcohol, but alcohol use requires a more careful and thoughtful approach and a fair amount of planning. 

Diabetes can be cured or reversed. While I wish this were true, it simply isn’t. Those that promote this idea are usually doing so in regards to Type 2. Some incorrectly believe that if the A1c gets below 6.5% after the diagnosis, diabetes then once again ceases to exist. This is incorrect. The general rule of thumb is that once your A1c is 6.5% or greater, you not only have diabetes, but you always have diabetes; you might manage your numbers so tightly that the A1c lessens, however the diagnosis remains. “Well managed” diabetes is a quite different concept than being cured or reversing the diagnosis.