There are a lot of things about diabetes that are taken as "gospel," both by doctors and patients. But at the JDRF Capitol Research Summit last month, I learned that many commonly accepted beliefs about diabetes haven't actually been proven by medical science with convincing evidence (far beyond 'you got it because you ate too much candy.') Eminent scholar Dr. Mark Atkinson was pretty adamant that "these ideas need to be put to pasture."
Here are five of those "common medical myths" you may have heard, and the truth behind them, according to Dr. A:
1. Type 1 diabetes is caused by a virus
Apparently there is little evidence to support this idea. While it's true that many people may have a virus prior to diagnosis, Dr. Atkinsons says: "There's never been a virus that's been identified that explains the vast majority of most cases. What we do think is that at the time of diagnosis, for some people, they are on the edge of a cliff. If you get a viral infection it tips you over the edge, but it was kind of destined to happen." So your immune system itself had to actually be pre-disposed to target your beta cells. It was just waiting for the "bat signal," so to speak.
2. The honeymoon period is the only time the body makes insulin
Some new studies, such as Dr. Atkinson's JDRF/NPOD study, show that up to three-quarters of patients still have a few beta cells left, no matter how long you've had diabetes. That means whether you were diagnosed six months ago, six years ago, or sixty years ago, you could still have beta cells plugging away. Of course, the amount of beta cells that currently still active in most PWDs are too minimal to do any good, but it does hold promise if research on diabetes autoimmunity is ever successful. Just maybe, these beta cells could be regenerated in humans!
3. There is something in the environment that causes diabetes
"We really don't know what causes type 1 diabetes," Dr. Atkinson says. "There are many, many things in the environment that could lead to diabetes." Over the years, researchers and parents have tried a variety of different ways to identify what environmental factors could cause diabetes, since we know for sure it's not 100% genetic. Everything from infant cereals to breastfeeding to vitamin D deficiencies to immunizations have been targeted in the environmental investigations, but no convincing evidence has surfaced. Many researchers now believe it might be a combination of several environmental factors rather than just one thing. Dr.
Atkinson's advice: "If you're thinking, 'If I just breastfed longer or not used rice cereal as soon,' don't beat yourself up. That's not the cause."
4. Type 1 diabetes usually happens in kids
Not so, says Dr. Atkinson. A lot of people think the majority of cases occur in childhood or adolescence (although we know that more folks are getting diagnosed as adults, like Amy). What is interesting is that the average age now trends toward the mid-30s range. "(Many) adults are misdiagnosed as having type 2 diabetes, but they have type 1," Dr. Atkinson says. "Diabetes can be diagnosed at any age."
5. Type 1 diabetes is just one disease
Type 1 diabetes is more than one disease? Well, with new acronyms like LADA popping up, it's not surprising that are as many pathways to type 1 diabetes as there are to type 2 diabetes. "There's a lot of variety in the way individuals come to the point of requiring daily insulin," Dr. Atkinson says. There are a number of disorders that look like type 1 diabetes, where people need to take insulin." In the past, conventional wisdom said you needed autoimmunity to determine whether or not you had "classic" type 1 diabetes, but nowadays, Dr. Atkinson explains, it seems there are a small portion of people who look and act like they have type 1 diabetes, but do not have autoimmunity.
On a personal note, I admit I was raised to believe that my diabetes was caused by a virus, because I was diagnosed with type 1 diabetes a mere three weeks after a major Christmas break flu. It took many years and many diabetes conferences before I finally put the challenging puzzle of diabetes together and realized that my body was already on the path toward diabetes. Any of these myth-busters surprising for you all?