Common Myths About Diabetes in Pakistan

Many common beliefs about diabetes in Pakistan are inaccurate and can delay diagnosis, encourage unsafe treatment choices, or make people feel unnecessarily restricted. Diabetes is not caused by one food, insulin is not a sign of failure, and traditional remedies cannot replace clinically proven care.

Correcting these myths matters because Pakistan has one of the world’s highest diabetes burdens. The International Diabetes Federation estimated that approximately 34.5 million Pakistani adults aged 20–79 were living with diabetes in 2024.

Why Diabetes Myths Are Harmful

Diabetes myths often spread through family advice, social media, advertisements, and personal stories. Some contain a small element of truth but leave out important medical context.

Acting on misinformation may lead a person to:

• avoid screening despite having risk factors or symptoms;
• stop prescribed medicines without medical supervision;
• replace treatment with an unproven herbal product;
• follow an unnecessarily restrictive diet;
• delay insulin when it is clinically needed;
• develop preventable complications affecting the heart, kidneys, eyes, nerves, or feet.

Common Myths About Diabetes in Pakistan

Myth 1: Diabetes Is Caused Only by Eating Too Much Sugar

Fact: Eating excessive sugar does not directly explain every case of diabetes.

Type 1 diabetes develops when the immune system attacks the insulin-producing cells of the pancreas. It is not caused by eating sweets.

Type 2 diabetes develops through a combination of insulin resistance and reduced insulin production. Risk is influenced by several factors, including:

• family history and genetics;
• increasing age;
• abdominal weight gain;
• low physical activity;
• previous gestational diabetes;
• high blood pressure or abnormal cholesterol levels;
• polycystic ovary syndrome;
• certain medicines and medical conditions.

Frequent consumption of sugary drinks and energy-dense foods can contribute to weight gain and raise the risk of type 2 diabetes. However, saying that diabetes is caused only by sugar oversimplifies a complex condition.

Myth 2: Only People With Obesity Develop Diabetes

Fact: Diabetes can affect people at any body size.

Excess body fat, particularly around the abdomen, is an important risk factor for type 2 diabetes. However, some people develop diabetes despite appearing slim. South Asian populations may develop insulin resistance and metabolic risk at a lower body mass index than some other populations.

A person’s appearance cannot confirm or exclude diabetes. Blood testing is required for diagnosis.

Myth 3: Diabetes Is Not Serious if You Feel Well

Fact: High blood glucose may cause damage before noticeable symptoms appear.

Type 2 diabetes can remain undiagnosed for years. During that time, persistent high glucose levels may damage blood vessels and nerves. Possible long-term complications include:

• heart attack and stroke;
• chronic kidney disease;
• diabetic retinopathy and vision loss;
• nerve damage;
• foot ulcers and amputations;
• increased susceptibility to some infections.

Feeling normal does not mean glucose, blood pressure, cholesterol, kidney function, or eye health are within safe ranges. Regular follow-up remains necessary even when symptoms are absent.

Myth 4: People With Diabetes Must Completely Stop Eating Roti or Rice

Fact: Carbohydrates can usually remain part of a balanced diabetes eating plan.

Roti, rice, potatoes, fruit, milk, lentils, and many other foods contain carbohydrates that affect blood glucose. The aim is not necessarily to eliminate all carbohydrates but to manage their type, portion size, timing, and combination with other foods.

Helpful strategies may include:

• controlling portions of rice and roti;
• choosing whole-grain atta when practical;
• including vegetables, lentils, beans, lean protein, or yoghurt with meals;
• reducing refined flour products and heavily processed snacks;
• avoiding or limiting sugary drinks;
• monitoring glucose responses when advised.

A dietitian or diabetes clinician can help adapt meals to Pakistani foods, household budgets, cultural preferences, medicines, and glucose targets.

Myth 5: People With Diabetes Cannot Eat Fruit

Fact: Whole fruit can usually be included in an appropriate portion.

Fruit contains natural sugar, but it also provides fibre, vitamins, minerals, and other nutrients. Whole fruit generally affects blood glucose differently from juice because fibre slows digestion and the serving is easier to control.

Practical considerations include:

• choose whole fruit rather than juice or sweetened fruit drinks;
• eat a sensible portion instead of several servings at once;
• be cautious with large portions of dried fruit;
• spread fruit intake across the day when appropriate;
• consider personal glucose readings and medical advice.

Mangoes, bananas, dates, and grapes are not automatically forbidden. Their portions may need closer attention because it is easy to consume a large carbohydrate load quickly.

Myth 6: Brown Sugar, Gur, Honey, and Desi Shakkar Are Safe Alternatives

Fact: These products can still raise blood glucose.

Brown sugar, jaggery or gur, honey, and desi shakkar may differ slightly in taste and processing, but they remain concentrated sources of sugar. Describing them as natural does not make them harmless or suitable for unlimited use.

A small amount may sometimes fit within an individual meal plan, but replacing white sugar with an equal quantity of honey or gur does not remove its effect on blood glucose.

Myth 7: Bitter Gourd, Fenugreek, or Herbal Powders Can Cure Diabetes

Fact: No herbal remedy has been proven to cure diabetes.

Karela, methi, cinnamon, jamun seed powder, and numerous herbal mixtures are commonly promoted for glucose control. Some substances have been studied, but the evidence is often limited, inconsistent, or insufficient to establish reliable dosing, safety, purity, and long-term benefit.

Herbal products can also:

• interact with diabetes medicines;
• cause glucose to fall too low;
• contain undeclared pharmaceutical ingredients;
• damage the liver or kidneys;
• delay effective treatment.

Food ingredients such as karela may be eaten as part of a normal balanced diet, but concentrated extracts or supplements should not replace prescribed treatment. Discuss any supplement with a qualified healthcare professional.

Myth 8: Starting Insulin Means the Diabetes Has Reached Its Final Stage

Fact: Insulin is a treatment, not a measure of personal failure or hopelessness.

People with type 1 diabetes require insulin for survival. In type 2 diabetes, insulin may be recommended when other treatments are insufficient, during pregnancy, around surgery, during severe illness, or when glucose is very high.

Type 2 diabetes can progress because the pancreas may produce less insulin over time. Needing insulin does not necessarily mean that the person caused their condition or failed to follow instructions.

Appropriately used insulin can improve symptoms, lower the risk of complications, and sometimes be required only temporarily. It should not be delayed solely because of fear or stigma.

Myth 9: Diabetes Medicines Damage the Kidneys

Fact: Uncontrolled diabetes is a major cause of kidney damage, while medicines are selected according to kidney function.

Some diabetes medicines require dose adjustments or may not be suitable at certain levels of kidney impairment. This is why clinicians check kidney function and review treatment regularly.

Stopping treatment without advice can allow glucose to rise and may increase the risk of diabetic kidney disease. Some modern diabetes medicines may also provide kidney or cardiovascular benefits for suitable patients.

Anyone concerned about side effects should ask for a medication review rather than stopping tablets independently.

Myth 10: Once Glucose Becomes Normal, Medicines Can Be Stopped

Fact: Normal results may show that the treatment plan is working.

Blood glucose can improve because of medication, dietary changes, physical activity, weight management, or a combination of these. Stopping treatment suddenly may cause glucose levels to rise again.

Some people with type 2 diabetes may achieve remission after substantial and sustained weight loss, but remission is not the same as a permanent cure. Ongoing monitoring is still required, and medication changes should be supervised by a healthcare professional.

Myth 11: Exercise Is Dangerous for Everyone With Diabetes

Fact: Regular physical activity is beneficial for most people with diabetes.

Exercise can improve insulin sensitivity, cardiovascular health, mobility, mood, and weight management. Activities may include brisk walking, cycling, swimming, household activity, and resistance exercises.

However, exercise plans should be individualised. Extra precautions may be necessary for people using insulin or medicines that can cause hypoglycaemia, as well as those with foot ulcers, advanced eye disease, heart disease, nerve damage, or other complications.

People who experience chest pain, severe breathlessness, fainting, or other concerning symptoms during activity should stop and seek medical assessment.

Myth 12: A Person With Diabetes Can Never Fast During Ramadan

Fact: Some people may fast safely with preparation, while others have a high medical risk and should not fast.

Fasting can increase the risk of low glucose, high glucose, dehydration, and diabetic ketoacidosis in vulnerable individuals. Risk depends on diabetes type, glucose control, medicines, pregnancy status, kidney function, recent complications, and previous episodes of severe hypoglycaemia.

A pre-Ramadan consultation should ideally cover:

• individual fasting risk;
• medicine or insulin timing;
• glucose monitoring;
• meal planning and hydration;
• physical activity;
• conditions that require breaking the fast.

Checking blood glucose does not provide calories and is medically necessary for many people who fast. Religious guidance can be sought alongside medical advice when exemption from fasting is recommended.

Myth 13: Diabetes Is Contagious

Fact: Diabetes cannot spread through touch, food, marriage, blood contact, or living in the same household.

Families may have several members with diabetes because they share genetic susceptibility, dietary patterns, physical activity habits, and environmental exposures. This is not person-to-person transmission.

Myth 14: Diabetes Always Produces Obvious Symptoms

Fact: Many people with type 2 diabetes have mild symptoms or no symptoms.

Possible symptoms include frequent urination, excessive thirst, unexplained weight loss, tiredness, blurred vision, recurrent infections, slow-healing wounds, and tingling or numbness. However, screening may detect diabetes before these symptoms develop.

Testing is particularly important for people with risk factors such as a strong family history, overweight or abdominal obesity, hypertension, previous gestational diabetes, polycystic ovary syndrome, or a history of elevated glucose.

Myth 15: Home Glucose Readings Are Enough to Manage Diabetes

Fact: Glucose readings are useful, but diabetes care involves more than a single number.

Depending on the individual, follow-up may include:

• HbA1c testing;
• blood pressure measurement;
• cholesterol assessment;
• kidney function and urine albumin testing;
• retinal or eye examinations;
• foot and nerve assessment;
• review of medicines, nutrition, activity, sleep, and smoking.

A normal fasting glucose on one morning does not confirm that diabetes is fully controlled.

How to Identify Unreliable Diabetes Advice

Be cautious when a person, clinic, video, or advertisement:

• promises a permanent cure within days or weeks;
• claims one product works for every type of diabetes;
• advises stopping insulin or tablets immediately;
• uses testimonials instead of reliable clinical evidence;
• refuses to disclose ingredients or doses;
• claims that doctors are hiding a simple cure;
• sells expensive packages while discouraging laboratory monitoring.

Reliable advice should explain benefits, limitations, possible harms, alternatives, and the need for individualised care.

Practical Steps for Better Diabetes Care

1. Confirm the diagnosis properly. Do not diagnose diabetes through symptoms, a social media quiz, or another person’s glucose meter result alone.
2. Attend regular follow-up. Treatment should be reviewed according to glucose levels, complications, age, other illnesses, and personal priorities.
3. Take medicines as prescribed. Report side effects rather than changing doses independently.
4. Build meals around portions and balance. Focus on vegetables, pulses, appropriate portions of carbohydrates, adequate protein, and fewer sugary drinks and highly processed foods.
5. Stay physically active. Choose activities that are safe and sustainable for your health status.
6. Do not ignore the feet, eyes, kidneys, blood pressure, or cholesterol. Preventing complications requires broader monitoring.
7. Discuss Ramadan fasting in advance. Do not wait until the first day of fasting to adjust medicines.
8. Verify herbal products. Tell your healthcare professional about every supplement or traditional remedy you use.

When to Seek Urgent Medical Care

Seek prompt professional assistance for severe weakness, confusion, fainting, persistent vomiting, difficulty breathing, severe dehydration, very high or very low glucose, chest pain, signs of stroke, an infected foot wound, or loss of consciousness.

People using insulin should receive personalised guidance on recognising and treating hypoglycaemia and managing diabetes during illness.

Conclusion

Common myths about diabetes in Pakistan often turn a manageable medical condition into a source of fear, blame, or unsafe experimentation. Diabetes care should be based on an accurate diagnosis, individualised nutrition, appropriate physical activity, proven medicines, regular monitoring, and informed discussions with qualified healthcare professionals.

Medical disclaimer: This article is for general education and does not diagnose, treat, or replace personalised medical advice. Do not start, stop, or change diabetes medicine or insulin without consulting an appropriate healthcare professional.