Nearly 30 million Americans are living with diabetes — and millions remain undiagnosed. It could be because the signs and symptoms of type 2 diabetes are often subtle, and they usually develop slowly over time. It may also be because many people aren’t aware of their risk, what really causes diabetes, or even how serious diabetes complications can be. Here, we separate fact from fiction and debunk common misconceptions about type 2 diabetes.
“While diet plays a critical role in controlling blood sugars, it’s usually much more complicated than that,” says Minisha Sood, MD, an endocrinologist in New York City. Type 2 diabetes occurs when your body doesn't make enough insulin or use insulin well. Type 2 diabetes occurs as a result of several factors, including lifestyle (poor diet, physical inactivity, and being overweight), insulin resistance, and genes.
You might have heard your grandma describe her diabetes as “just a touch of sugar,” or that it’s not as serious type 1 diabetes, which is treated with insulin from the get-go. The truth is that every case of diabetes should be considered serious. Type 2 diabetes is a major risk factor heart disease and other conditions like kidney disease, foot problems, and nerve damage. “Patients often don’t think this is the case, because they don’t feel unwell; they don’t feel the high blood sugar,” says Sonal Chaudhry, MD, an endocrinologist at NYU Langone Health.
“Not everyone with type 2 diabetes will need insulin, but many people will, and that’s just the nature of the progression of the disease over time,” says Dr. Sood. If a person with diabetes needs insulin, and is resistant to the idea of using it, complications may arise. “If we use insulin early on when it’s needed, we can maybe stave off the complications,” she says.
Even people with a healthy lifestyle—eating well, keeping weight in check, and staying active—can still get type 2 diabetes (although most people with type 2 diabetes are overweight or obese). Patients sometimes feel disappointed when they’re diagnosed with diabetes, because they think it was caused by lack of their own willpower, says Dr. Chaudhry. While maintaining a healthy lifestyle significantly reduces your risk of developing type 2 diabetes (learn the astounding benefits of exercise for diabetes here), factors you can’t control (like genes, family history, and ethnicity) also can play a role in the development of type 2 diabetes, she says.
The takeaway: Type 2 diabetes is serious, and anyone can get it. Whether you have diabetes or not, it’s important know your family history and the signs and symptoms—increased thirst or hunger, blurred vision, fatigue, numbness or tingling—so you can alert your doctor ASAP if you think you may be affected.

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