Most of us believe in some of the myths about diabetes. Even the American Diabetes Association.
The ADA has a pretty good list of what it thinks are the main myths. But a lot of us think that its "myth #5" is in fact a fact. "If you have diabetes, you should only eat small amounts of starchy foods, such as bread, potatoes and pasta," the ADA says.
Whoa! Is our leading diabetes organization still ignorant of the glycemic index? Does the largest diabetes organization in the United States and probably in the world think that we can eat large amounts of starchy foods that play havoc with our blood glucose levels?
While the way the ADA states its "myth #5" sounds straightforward, it backtracks a long way in the way it explains it:
"Starchy foods are part of a healthy meal plan. What is important is the portion size. Whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. The key is portions. For most people with diabetes, having 3-4 servings of carbohydrate-containing foods is about right. Whole grain starchy foods are also a good source of fiber, which helps keep your gut healthy."
Everything in this explanation is correct. Portion size is important, and that’s certainly the same thing as "small amounts" of starchy foods. When we have three or four servings of foods that are high in carbs it can make sense when we remember that most carbs aren’t the infamous starchy ones like bread, potatoes, and rice.
Low-glycemic veggies are technically "carbohydrate-containing foods." So I can accept the ADA position to include three servings of low-carb veggies and one serving of a low glycemic index high fiber grain.
"The ADA seems to be dancing around this issue," a good friend of mine says. I agree and think the organization doesn’t dance on carbs any better than I do on the dance floor.
Until a couple of evenings ago I didn’t think about the ADA’s diabetes myths. But a game about deciding if certain statements are myths or facts was one of the most interesting parts of a training session for health care professionals I attended in Denver.
The session taught those professionals and this journalistic observer some great new ways to enhance the education of people with diabetes. Emphasis is on building interactive dialogue so that we can improve our self-management.
It’s the U.S. Diabetes Conversation Maps. The ADA worked with an organization called Healthy Interactions Inc. to develop the training. Right now they are rolling it out to the 10,000 health care professions that they will train in the next three years.
They call them maps because they use 3 foot by 5 foot graphics in the form of road maps to guide conversations between the health care professionals and groups of up to 10 people at a time. The maps are neat visual gimmicks.
In a few days I’ll have another article about the Conversation Maps. Today the focus is myths.
I’ve always thought that Diabetes UK has a much better web page about diabetes myths than the ADA has. That web page came to my mind when the facilitators for the training session I attended brought up myths. And I also reflected on some of the myths I’ve heard recently.
1. The most insidious one is the belief that diabetes is progressive. I wrote about that myth in a recent article here.
2. An A1C level of 7 percent is good enough to prevent complications. This is the level that the ADA sets. It’s better by far than the typical level that most of us with diabetes have. But if we stay at 7 percent for many years, our diabetes will indeed become a progressive disease.
3. A truly cynical myth is that the pharmaceutical companies know how to cure diabetes, but they are holding back because they can make so much money off of us. Sure, the drugs we buy from them cost a lot. But anyone who believes this myth simply doesn’t understand how scientists and researchers think. Gretchen Becker makes it clear how scientists think. Who wouldn’t want the Nobel Prize for curing diabetes?
4. Likewise, many skeptical people think that it’s safer to use herbs than prescription drugs to help control their diabetes. They forget that herbs are drugs, as complementary medicine expert Laura Shane-McWhorter told me.
The ADA’s and UK Diabetes’ web pages about myths covered the other big myths that came to mind. But this morning I had the chance to discuss these fallacies with the wisest Certified Diabetes Educator I know.
She’s been through the Conversation Maps training, and she agrees with me it’s a myth that diabetes has to be progressive. The second one on her list is the myth that "a carb is a carb is a carb."
Not only are different forms of carbohydrates chemically different from each other but they also differ in how they act on our blood glucose levels. While fiber is a carb, it has little or no effect in raising BG. Many starchy foods have a great effect, but they vary greatly from refined flour on the high side to barley on the low side. Sugars have some effect.
Both her list and mine contains several more myths. What other myths would you like to expose?
David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.