While type 1 diabetes is caused by an immune system that destroys insulin-making cells, type 2 is often thought of as a disease caused by too much food and too little exerciseand indeed, it can be exacerbated by those factors. This perception unfairly casts type 2 diabetes as a willpower problem.
Genes and other risk factors play a complex role in determining who gets type 2 diabetes and who doesn't. While the likelihood of having type 2 diabetes increases with age and weight, that isn't always the case. Anywhere from 10% to 20% of all people who have the disease are not overweight. What's more, many overweight people never get diabetes.
"People think, 'Oh well, you deserve it: You've overeaten, you've abused yourself, and that's why you have diabetes,'" says Susan Guzman, PhD, a senior psychologist with the Behavioral Diabetes Institute in San Diego.
People with type 2 diabetes sometimes shy away from talking about it. At first Lisa Moore, 25, of Austin, Texas, wouldn't tell anyone. "It was probably a mixture of being a self-conscious girl in a society where looks are so important and the stigma of diabetes," she explains.
She felt that if she told people, then they would think it was her faultthat if she had worked out harder or eaten better, she might have prevented it. But when she did decide to tell her friends, she found them to be very supportive.