hi i'm dr debra wechsler an endocrinologist and the clinical director of the massachusetts general hospital diabetes center and this is fact check type 2 diabetes fact check no one in my family has had diabetes so my chances of getting type 2 diabetes are low false not everyone with type 2 diabetes has a family history of type 2 diabetes and that can be true for many reasons we know that type 2 diabetes is caused by a combination of genetics and environmental factors such as inactivity being overweight and it may be possible that people's parents did not
have the risk factors for type 2 diabetes so while most people with type 2 diabetes do have a family history of type 2 diabetes an absence of a family history doesn't mean that you're not at risk fact check giving birth to a baby over 9 pounds increases my chances of having type 2 diabetes false this really highlights the difference between a risk factor and a risk marker women who have babies who are large for gestational age over 9 pounds often have conditions that cause them to have larger gestational age babies and those very same conditions
are the conditions that increase the risk of type 2 diabetes later in life the factors that increase the risk of having a large for gestational age baby are gestational diabetes or being overweight or obese during pregnancy after pregnancy often many women later in life will progress to having type 2 diabetes but it wasn't the large baby that caused the risk fact check too much sugar is the main cause of type 2 diabetes true this one is one of my favorites because i used to say the answer was false and now i say in fact too
much sugar can be a contributing cause to type 2 diabetes and i used to think that the main way that sugar would cause type 2 diabetes was by generally causing overweight and obesity itself and that is certainly true but what we've subsequently learned thanks to researchers at mass general brigham and elsewhere is that high fructose corn syrup and other concentrated sweets can alter the way the liver processes glucose and fructose in a way that leads to accumulation of fat in the liver or a condition called fatty liver which in and of itself is a very
strong risk factor for type 2 diabetes fact check people with type 2 diabetes shouldn't eat carbohydrates false the dietary quality and the balance of carbohydrates to proteins and fats in the diet is more important than whether people consume carbohydrates or don't consume carbohydrates there are healthy carbohydrates and unhealthy carbohydrates healthy carbohydrates tend to be the whole grain carbohydrates legumes the brown starches such as whole wheat bread brown rice whereas unhealthy carbohydrates tend to be the ones we find in processed foods and fast food fact check if i'm a man with a waist circumference over 40
inches it's likely that i have diabetes this one is more likely true than not what does it mean to have a waist circumference over 40 inches it means that overall body weight is distributed more we can think of it in the upper body sort of like an apple shape as opposed to other people who might have the same degree of extra weight but they tend to distribute it in the lower body and tend to be more pear-shaped the excess body weight that's stored in the abdomen tends to interfere with our normal body's metabolism and increase
the risk of type 2 diabetes and other metabolic and cardiovascular diseases fact check skinny people can't get type 2 diabetes false in fact many people can get type 2 diabetes at relatively lean body weights why is that well for some people it's because they store even very small amounts of excess weight in their abdomen which leads to increased insulin resistance at relatively low body weight but for other people it's because they have a strong genetic predisposition to type 2 diabetes and even though they don't have a strong degree of insulin resistance their pancreas is still
not making enough insulin to keep up with their body's demand fact check it's best to avoid using medications to treat diabetes for as long as possible false the reason i said false is that diabetes at every level is due to not having enough insulin to meet the body's insulin demand diet and exercise will always be the foundational treatment of all forms of diabetes but if your body is not making enough insulin to keep up with the body's demand then taking medication that either decreases the body's demand or helps increase the insulin supply is the best
way to prevent long-term complications from having high blood sugars and diabetes the good news is that it's been an incredible time to treat people with type 2 diabetes there are many new medications available and there have been many large randomized controlled trials conducted over the last decade so we really know a lot more about treating type 2 diabetes with medications than we ever did before it's important to have a conversation with your doctor about what your priorities are and which medication will work best for you thanks for joining me today i'm dr debra wexler at
mass general brigham for more information on insulin resistance check out my video here
