10 Myths and Misconceptions About Type 1 Diabetes

Today, thanks to social media, there’s still a lot of confusion about diabetes.

So, we thought it would be helpful to go over the biggest myths and misconceptions we’ve personally heard regarding type 1 diabetes, in the hopes of eliminating some of that confusion and making this condition clearer to everyone.

Let’s get into it.

Debunking 10 Common Myths About T1D

Although we know a lot more about it now than decades or even a short amount of years ago, myths about how diabetes develops, what it does and how it can be treated are everywhere!

Here are 10 interesting debunks of some common, modern-day myths.

Myth 1: T1D Isn’t Connected to Obesity

Young, frequent need to urinate, thirst and weight loss – all classic symptoms of type one diabetes. 

Even an experienced doctor might diagnose T2D when a patient presenting with the first three symptoms is obese.

However, a paper published in late 2023 tells us that for every jump in the BMI of obese 16- to 19-year-olds, the risk of developing T1D increases by 25%. Even when diabetes doesn’t run in the family.

The good news? Type 1 diabetes development can, in more cases than you might think, be slowed through weight loss.

Myth 2: You Always Feel A Hypo

Shaking, sweating, blurred vision, confusion, slurred speech, mood changes, stumbling … It’s hardly surprising that even trained medical professionals think a PWD suffering from a hypo has had one glass too many. 

But up to 40% of people with T1D have ‘hypoglycemia unawareness’ – until blood sugar levels become dangerously low.

There’s more. It’s not just the mind that isn’t aware of a hypo. The body can also become blinkered.

When the body is aware of low blood sugar, lots of hormones (we’ll look at some of these later) spring into action.

The more hypos a PWD has, the less effective this response becomes.

Using a CGM or regular finger stick testing not only protects type 1 diabetics from hypos, but it also protects the body’s natural safety mechanisms.

Myth 3: High-Intensity Exercise Brings Down High Blood Sugar Levels Quickly

Exercise is an important addition to diabetes therapy. It increases insulin sensitivity, decreases the risk of cardiovascular disease and neuropathy, and lowers blood sugar.

At least, it lowers blood sugar in certain circumstances.

Post-exercise hyperglycemia is a known problem for many PWD. The more intense the exercise, the greater the risk. What’s more, using intense exercise to bring down existing hyperglycemia can actually increase that sugar spike.

Anyone who takes insulin knows to have a snack on hand when going for a walk or to the gym. A person with diabetes is more likely to experience a hypo with low-intensity exercise, like a long walk, gentle swim or bicycle ride.

High-intensity exercise can have the opposite effect. Stress hormones (catecholamines) that raise blood sugar levels are released when taking part in an energetic workout. To counteract this, the body needs more insulin, which a person with T1D can’t produce. 

With insulin therapy, high blood sugar will normalize. Calculating how much insulin to administer before high-intensity exercise is extremely difficult. A PWD should never start a high-energy activity with existing high blood sugar. They should normalize it first.

Myth 4: Type 1 Diabetics Can’t Eat Grapes

When social media influencers tell people with diabetes to cut out natural, unprocessed foods, something’s wrong.

Natural fruits contain fiber, minerals, vitamins, antioxidants and phenolics. Whole fruits (not fruit juices, dried fruits, or fruits processed with added sugar) improve health and should be part of everyone’s diet. There’s no reason a person with insulin-dependent diabetes can’t eat grapes … but there are some rules.

Rapidly absorbed natural sugars can be enjoyed together with the correct insulin timing and dose. As fruit sugars like dextrose enter the blood very quickly, they should only be eaten after short-acting insulin has had enough time to produce a glucose-lowering effect. With Fiasp, for example, that’s 15 to 20 minutes. Humulin needs a little longer – about 30 minutes.

Simultaneously, slow the absorption rate of natural fruit sugars by adding lower glycemic index foods – unsweetened yogurt, seeds, apple and citrus segments, for example. 

Myth 5: T1D Starts When You’re Young

T1D can start in childhood (child-onset T1D) or adulthood (adult-onset T1D). In fact, recent studies show that new diagnoses are split approximately 60/50 in favor of the adult type.

Child-onset and adult-onset T1D are the same disease in different clothing. However, research is already discovering deeper distinctions.

Many adults with newly diagnosed T1D don’t need to start insulin therapy straight away, for example. Practically all cases of child-onset T1D do. People with adult-onset type 1 diabetes also have a significantly increased risk of developing hypothyroidism, metabolic syndrome and celiac disease.

Unfortunately, up to 40% of adult-onset T1D cases are misdiagnosed as T2D.

Myth 6: All T1D Is Inherited

In the case of child-onset T1D, only about 50% of children inherit the disease through one or both parents. That inherited DNA is a mix of genes that increase the risk of developing certain antibodies.

In adult-onset diabetes, cases linked to inherited genes are much lower.

The more groups of susceptible genes you inherit, the greater the risk of producing beta-cell autoantibodies.

Autoantibodies connect all the different forms of T1D into one bundle. These self-produced waste-disposal experts see insulin-producing beta cells as the enemy. Their mission – to attack and destroy. It’s this destructive action that makes T1D an autoimmune disease.

Autoantibodies work against beta cells in different ways, so are grouped into different types. The more antibody types a person has, the quicker T1D progresses.

But we’re not born with a complete package of antibodies. We receive some from our mother, and the rest develop over time via contact with our environment – viruses in the air around us, chemicals in our food. Antibodies are also administered via vaccinations or breast milk. 

So, while a percentage of PWD inherit genes that ‘encourage’ beta-cell autoantibodies, the rest develop T1D through other factors. Scientists have found potential beta-cell autoimmunity causes that range from gut bacteria to pollution.

Myth 7: Intermittent Fasting Is Bad For T1D

In the 1920s, fasting to the point of starvation was used to treat T1D. This therapy severely weakened – often killed – the patient, but did bring blood sugar levels down in cases of T2D.

Intermittent fasting (IF) is an ancient phenomenon that’s taken social media by storm. It certainly does no harm to people who don’t need insulin. IF helps with weight loss and insulin sensitivity in people with T2D.

But does it have a positive effect on autoimmune diabetes?

During the Muslim month of Ramadan, when no food or water is consumed from sunrise to sunset, cases of severe hypoglycemia in people with T1D soar. So intermittent fasting has a definite risk and should never be attempted by:

  • children with insulin-dependent diabetes
  • insulin-dependent diabetics who find it hard to calculate doses
  • newly-diagnosed T1D patients
  • type 1 diabetics with unpredictable or varying responses to insulin
  • anyone who regularly experiences hypoglycemia.

But for people with T1D who successfully calculate and administer insulin, avoid hypos and achieve stable blood glucose levels within target ranges, intermittent fasting can be a good thing.

Not only can IF lower HbA1c values, but it increases insulin sensitivity, meaning lower insulin doses (this reduction isn’t guaranteed – T1D doesn’t always mean insulin resistance).

Intermittent fasting also reduces cellular stress and lowers blood pressure.

But even when a person with type 1 diabetes is a good candidate for IF, medical supervision is essential. Intervals, insulin doses and portion sizes should be discussed in detail with a diabetes specialist before starting.

Myth 8: Use Controlled Hypos To Improve HbA1c Results

Purposely lowering blood sugar levels by taking extra insulin is called factitious hypoglycemia.

It’s worrying that there’s a medical term for it.

The majority of PWDs who resort to factitious hypoglycemia are women in their 30s and 40s. A psychological need for better personal blood glucose control, a positive reaction from the doctor, as well as fear of how a diabetes specialist might react to an increase in HbA1c are to blame.

Hypos are classified according to 3 levels:

  • Level 1:  55 – 69 mg/dL
  • Level 2: under 54 mg/dL
  • Level 3: any value where another person is required to administer glucose when the PWD is unable to do this due to hypoglycemic symptoms

Even with carefully administered additional insulin to attain level 1 status, factitious hypoglycemia is a perilous step.

As we’ve seen in myth 2, not everyone feels the symptoms of a hypo early on. Without testing blood glucose and eating carbs, ‘mild’ hypoglycemia can quickly become a life-threatening event.

In many people with adult-onset T1D, the body often rectifies a hypo without food. The liver releases glucose and the blood sugar level rises.

But when hypos take place at regular intervals, signaling between different glucose-regulating hormones is negatively affected. The body doesn’t respond as well to low blood sugar.

Furthermore, endocrinologists are now less likely to judge diabetes control by HbA1c alone. They look at Time-in-Range, meaning the number of hypos (and hypers) are taken into account. 

The goal for any PWD is a stable curve within a medically-specified range.

Myth 9: T1D Is Only About Insulin And Glucagon

When we think of diabetes, we usually think of insulin. This hormone gives cells access to glucose to use as a source of energy. If cells can’t access glucose because there’s no or insufficient insulin, it stays in the blood (hyperglycemia). 

Less people know about glucagon. This pancreatic hormone is sent to the liver when blood glucose levels sink too low, or when cells can’t access enough glucose to function. 

But there are many other hormones involved in blood sugar regulation:

  • Somatostatin: balances insulin and glucagon production;
  • Amylin: lowers glucagon secretion, reduces the urge to eat and slows the rate of stomach emptying;
  • GLP-1: increases insulin and decreases glucagon secretion, and improves beta cell function and multiplication;
  • GIP: initiates insulin secretion, and speeds up the growth and slows down the death rates of beta cells;
  • Epinephrine (or adrenaline): stimulates the liver to produce glycogen when blood sugar levels become low. As high-intensity exercise also releases epinephrine, this partially explains myth 3;
  • Cortisol: reduces insulin secretion and stimulates the liver to produce more glucose. Chronic stress is heavily associated with high cortisol levels in the body … and diabetes;
  • Growth hormone (GH or somatotropin): is produced in higher quantities when blood sugar levels are low or during vigorous exercise. GH encourages the liver to produce glucose and, in higher amounts, increases insulin resistance.

We know much more about how these hormones work than we did 10 years ago but still have a lot to learn.

Myth 10: You Either Have T1D Or T2D

Many doctors find it hard to prescribe multiple diabetes medications to their patients because health insurance companies require a single diagnosis – type 1 or type 2. 

But having both types is common, and those companies will have to catch up.

Non-specialist doctors might also confuse T1D and T2D in adult patients. 

For example, LADA (latent autoimmune diabetes) combines progressive autoimmunity (as in adult-onset T1D) with insulin insensitivity and metabolic syndrome (characteristic of T2D). MODY (mature onset diabetes in the young) can mimic both T1D and T2D.

As we saw in myth 1, obesity and T1D are linked. However, obesity also leads to T2D.

It’s perfectly possible to develop both types of diabetes at any stage in life. Especially if you also have susceptible genes. 

Having both types is described in medical publications as ‘double diabetes’. 

Final Thougths

I hope you’ve enjoyed this rather scientific look at common T1D myths.

The more a PWD learns about this complex disease, the better the results of self-management and HbA1c values. 

Another tool that’s essential for better self-management is a diabetes app. We recommend you check out Gluroo. As one of hundreds of happy users put it, Gluroo is an:

“Essential app for any diabetic.

I have struggled with my diabetes and glucose levels and this app along with my CGM have made life so much simpler and my health has improved immensely. My wife can see what’s going on and if I’m nearing a low or if I need to adjust for a high glucose level. The freestyle app doesn’t have a link for my watch but this along with nightguard is a godsend as it feeds my levels onto the nightguard app and lets me really see alerts and I’m able to constantly monitor easily.” – Verified app store review

If you’d like to download Gluroo, you can do so for free, using the links below. It’s available for both Android and iOS.

Install Gluroo from Apple App Store
Install Gluroo from Google Play Store

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