How much sugar should a diabetic consume daily. What are the recommended sugar limits for people with diabetes. How does sugar intake affect blood glucose levels in diabetics. What strategies can diabetics use to reduce their sugar consumption.

Understanding Type 2 Diabetes: Causes, Risk Factors, and Prevalence

Type 2 diabetes is a chronic condition characterized by elevated blood sugar levels due to the body’s inability to effectively use insulin or produce enough of it. This form of diabetes accounts for approximately 90% of all diabetes cases in adults. The prevalence of diabetes is rising at an alarming rate, with projections indicating that by 2025, 5 million people in the UK alone will have been diagnosed with the condition.

Several factors contribute to the development of Type 2 diabetes:

• Genetic predisposition
• Environmental influences
• Ethnicity (with South Asian populations at higher risk)
• Obesity (accounting for 80-85% of total risk)
• Age (individuals over 40 are at increased risk)
• Presence of cardiovascular disease
• Certain medical conditions (e.g., polycystic ovary syndrome)
• Medications for schizophrenia or bipolar disorder

Is obesity the most significant risk factor for Type 2 diabetes. Indeed, obesity is considered the most potent risk factor, responsible for 80-85% of the total risk of developing Type 2 diabetes. With nearly two-thirds of the UK population being overweight or obese, the likelihood of developing this condition is substantial unless preventive measures are taken.

The Sugar-Diabetes Connection: How Sugar Intake Influences Type 2 Diabetes Risk

The relationship between sugar consumption and Type 2 diabetes is both direct and indirect. High sugar intake contributes to the development of Type 2 diabetes through multiple mechanisms:

1. Increased insulin resistance
2. Impaired insulin production
3. Promotion of obesity, a major risk factor for diabetes

Research has shown a particularly strong link between sugar-sweetened beverages and the incidence of Type 2 diabetes. A meta-analysis conducted by the Scientific Advisory Committee on Nutrition (SACN) revealed a significant relationship between the consumption of sugary drinks and the development of Type 2 diabetes.

Can reducing sugar intake lower the risk of developing Type 2 diabetes. While genetics play a role in diabetes risk, reducing sugar intake can significantly lower the risk of developing Type 2 diabetes, especially when combined with other lifestyle modifications such as maintaining a healthy weight and engaging in regular physical activity.

Current Recommendations for Sugar Intake: General Population vs. Diabetics

The current recommendations for sugar intake have been revised in recent years to address the growing concern over excessive sugar consumption and its health implications. For the general population, the guidelines are as follows:

• Adults: No more than 5% of daily energy intake from free sugars (approximately 30g or 7 teaspoons per day)
• Children aged 5-11: Maximum of 24g of sugar per day
• Children aged 4-6: Maximum of 19g of sugar per day

For individuals with diabetes, the recommendations may be more stringent. While there isn’t a one-size-fits-all approach, many healthcare professionals advise diabetics to limit their sugar intake even further, often suggesting a maximum of 25g (6 teaspoons) of sugar per day.

Do diabetics need to completely eliminate sugar from their diet. Contrary to popular belief, diabetics do not need to entirely eliminate sugar from their diet. Instead, they should focus on managing their overall carbohydrate intake, including sugars, to maintain stable blood glucose levels. This often involves working with a healthcare provider or registered dietitian to develop a personalized meal plan.

Strategies for Reducing Sugar Intake in Diabetic Diets

Managing sugar intake is crucial for individuals with diabetes. Here are several effective strategies to reduce sugar consumption:

1. Read food labels carefully to identify hidden sugars
2. Choose whole, unprocessed foods over packaged and processed items
3. Opt for sugar-free or no-added-sugar alternatives when available
4. Reduce or eliminate sugar-sweetened beverages
5. Use natural sweeteners in moderation (e.g., stevia, monk fruit)
6. Gradually decrease sugar in recipes and beverages to allow taste buds to adjust
7. Incorporate more fiber-rich foods to help stabilize blood sugar levels

Are artificial sweeteners a good alternative for diabetics. While artificial sweeteners can be a useful tool for reducing sugar intake, their long-term effects on health are still being studied. Some research suggests that they may affect gut bacteria and insulin sensitivity. It’s best to use them in moderation and consult with a healthcare provider for personalized advice.

The Role of Carbohydrates in Diabetes Management

When managing diabetes, it’s essential to consider not just sugar intake but overall carbohydrate consumption. Carbohydrates have the most significant impact on blood glucose levels compared to other macronutrients. Understanding how different types of carbohydrates affect blood sugar can help individuals make informed food choices.

Types of Carbohydrates:

• Simple carbohydrates (sugars): Rapidly absorbed, causing quick spikes in blood glucose
• Complex carbohydrates: Slower to digest, leading to more gradual changes in blood sugar
• Fiber: A type of carbohydrate that doesn’t raise blood sugar and can help manage glucose levels

How does the glycemic index (GI) relate to diabetes management. The glycemic index is a measure of how quickly a food raises blood glucose levels. Foods with a lower GI are generally preferable for diabetics as they cause a slower, more gradual rise in blood sugar. Incorporating low-GI foods into meals can help with better blood glucose control.

Monitoring Blood Glucose Levels: Essential Tools and Techniques

Regular monitoring of blood glucose levels is crucial for effective diabetes management. This practice helps individuals understand how different foods, activities, and medications affect their blood sugar, allowing for better decision-making and improved overall control.

Common Blood Glucose Monitoring Methods:

1. Traditional glucose meters with test strips
2. Continuous Glucose Monitoring (CGM) systems
3. Flash Glucose Monitoring devices

How often should a person with diabetes check their blood sugar. The frequency of blood glucose monitoring varies depending on the individual’s treatment plan, type of diabetes, and overall health status. Some may need to check several times a day, while others might monitor less frequently. It’s essential to work with a healthcare provider to determine the most appropriate monitoring schedule.

Exercise and Physical Activity: A Key Component in Diabetes Management

Regular physical activity plays a vital role in managing Type 2 diabetes. Exercise can help improve insulin sensitivity, lower blood glucose levels, and contribute to weight management – all crucial factors in diabetes control.

Benefits of Exercise for Diabetics:

• Improved glucose uptake by muscles
• Enhanced insulin sensitivity
• Better cardiovascular health
• Assistance with weight management
• Reduced risk of diabetes-related complications

What type of exercise is best for people with diabetes. A combination of aerobic exercise and strength training is generally recommended for individuals with diabetes. Aerobic activities like walking, swimming, or cycling help improve cardiovascular health and glucose control, while strength training enhances muscle mass and metabolic rate. The current recommendation is at least 150 minutes of moderate-intensity aerobic activity per week, spread over at least three days, with no more than two consecutive days without exercise.

Complications of Type 2 Diabetes: Prevention and Management

Type 2 diabetes, if not properly managed, can lead to various serious complications affecting multiple body systems. Understanding these potential complications is crucial for motivating proper care and prevention strategies.

Common Complications of Type 2 Diabetes:

• Cardiovascular disease
• Kidney disease (nephropathy)
• Eye problems (retinopathy)
• Nerve damage (neuropathy)
• Foot problems, potentially leading to amputations
• Skin conditions
• Hearing impairment
• Alzheimer’s disease and vascular dementia

Can diabetes-related complications be prevented or reversed. Many diabetes-related complications can be prevented or their progression slowed through proper blood glucose management, regular medical check-ups, and a healthy lifestyle. Some complications, if caught early, may be reversible to some extent. However, prevention through consistent diabetes management is the most effective approach.

Strategies for Preventing Diabetes Complications:

1. Maintain target blood glucose levels
2. Control blood pressure and cholesterol
3. Attend regular medical check-ups and screenings
4. Practice good foot care
5. Quit smoking
6. Manage stress effectively
7. Stay up-to-date with vaccinations

Regular monitoring and early intervention are key to preventing or minimizing the impact of diabetes-related complications. Working closely with a healthcare team can help individuals develop a comprehensive management plan tailored to their specific needs and risk factors.

The Future of Diabetes Management: Emerging Technologies and Treatments

The field of diabetes management is continuously evolving, with new technologies and treatments emerging to improve the lives of those affected by the condition. These advancements aim to make diabetes management more effective, convenient, and less burdensome for patients.

Promising Developments in Diabetes Care:

• Artificial pancreas systems
• Smart insulin patches
• Gene therapy approaches
• Stem cell treatments
• Improved continuous glucose monitoring systems
• Advanced data analytics for personalized treatment plans

How might artificial intelligence impact diabetes management in the future. Artificial intelligence (AI) has the potential to revolutionize diabetes care by analyzing vast amounts of patient data to predict blood glucose trends, optimize treatment plans, and even prevent complications before they occur. AI could also assist in developing more personalized nutrition and exercise recommendations based on individual responses to different foods and activities.

Challenges in Implementing New Diabetes Technologies:

1. Cost and accessibility
2. Patient education and training
3. Integration with existing healthcare systems
4. Data privacy and security concerns
5. Regulatory approval processes

While these emerging technologies hold great promise, it’s important to note that they are not yet widely available or suitable for all individuals with diabetes. Traditional management strategies, including proper diet, exercise, and medication adherence, remain crucial components of effective diabetes care.

Nutritional Strategies Beyond Sugar Reduction for Diabetes Management

While managing sugar intake is a crucial aspect of diabetes care, a comprehensive nutritional approach involves considering various dietary factors that can impact blood glucose levels and overall health.

Key Nutritional Considerations for Diabetics:

• Balanced macronutrient intake
• Emphasis on high-quality, nutrient-dense foods
• Portion control
• Meal timing and frequency
• Adequate hydration

What role does protein play in diabetes management. Protein is an important macronutrient for individuals with diabetes. It can help stabilize blood sugar levels, promote satiety, and support muscle health. Including lean protein sources in meals can help balance the glycemic impact of carbohydrates and contribute to better overall blood glucose control.

Beneficial Food Choices for Diabetics:

1. Non-starchy vegetables (e.g., leafy greens, broccoli, cauliflower)
2. Lean proteins (e.g., chicken, fish, tofu)
3. Healthy fats (e.g., avocado, nuts, olive oil)
4. Whole grains (e.g., quinoa, brown rice, oats)
5. Legumes (e.g., lentils, chickpeas, beans)
6. Low-fat dairy or dairy alternatives
7. Berries and other low-glycemic fruits

Incorporating these foods into a balanced diet can help manage blood glucose levels, provide essential nutrients, and support overall health. It’s important to work with a registered dietitian or healthcare provider to develop a personalized meal plan that takes into account individual preferences, cultural considerations, and specific health needs.

The Psychological Impact of Diabetes: Strategies for Mental Well-being

Living with diabetes can have significant psychological effects on individuals. The constant need for self-management, fear of complications, and lifestyle adjustments can lead to stress, anxiety, and depression. Addressing the mental health aspects of diabetes is crucial for overall well-being and effective disease management.

Common Psychological Challenges in Diabetes:

• Diabetes distress
• Depression and anxiety
• Eating disorders
• Fear of hypoglycemia
• Burnout from constant self-management

How does stress affect blood glucose levels in diabetics. Stress can have a direct impact on blood glucose levels by triggering the release of hormones that can cause blood sugar to rise. Additionally, stress may indirectly affect diabetes management by influencing behaviors such as eating habits, medication adherence, and exercise routines.

Strategies for Maintaining Mental Well-being with Diabetes:

1. Seek support from mental health professionals specializing in chronic illness
2. Join diabetes support groups or online communities
3. Practice stress-reduction techniques (e.g., mindfulness, meditation, yoga)
4. Maintain open communication with healthcare providers about emotional challenges
5. Set realistic goals and celebrate small victories in diabetes management
6. Engage in regular physical activity, which can boost mood and reduce stress
7. Prioritize sleep and establish healthy sleep routines

Addressing the psychological aspects of diabetes is essential for comprehensive care. Healthcare providers should regularly screen for mental health issues and provide appropriate referrals when necessary. Integrating mental health support into diabetes care can lead to improved outcomes and better quality of life for individuals living with the condition.

Sugars and type 2 diabetes

What is type 2 diabetes?

Diabetes is a lifelong condition that causes a person’s blood sugar to be too high. There are two forms of diabetes: type 1 and type 2 [1]. Insulin is a hormone that is key in regulating blood glucose levels. Type 2 diabetes can occur either as a result of insulin receptors becoming desensitised and as a result no longer responding to insulin; or, due to the beta cells of the pancreas no longer producing insulin. Often it is a combination of these two factors that leads to this condition known as type 2 diabetes.

Type 2 diabetes is by far the most common type – of all the adults who have diabetes, 90% of them have type 2. Diabetes is an increasing health problem in the UK with 3.2million people diagnosed with diabetes and a further 850,000 estimated to be undiagnosed [1]. Diabetes is a growing health burden and it is estimated that by 2025, 5 million people will have been diagnosed in the UK [2]. Diabetes is the leading cause of blindness in the UK and the disease’s complications cause more than 100 amputations to take place each week. Each year, 24 000 people die early from diabetes-associated complications [3]. Its total cost is estimated at £13.8billion each year [4]. It is predicted that the annual NHS cost of the direct treatment of diabetes in the UK will increase to £16.9 billion over the next 25 years, which is 17 per cent of the NHS budget [5], believed to potentially bankrupt the NHS

What are the causes of Type 2 diabetes?

There is a complex combination of genetic and environmental risk factors that play a part in the development of diabetes – it tends to cluster in families, but there is also a strong link to environmental risk factors. Ethnicity also plays a major role in its development, with people of South Asian descent being six times more likely to contract the disease [1].

Obesity is the most potent risk factor, accounting for 80-85% of the total risk of developing type 2 diabetes [5]. Given that almost 2 in 3 people in the UK are obese or overweight; their chances of developing Type 2 diabetes at some point are high unless they take evasive action[6].
Other risk groups include [1]:

• People over the age of 40
• People with cardiovascular disease
• Women with polycystic ovary syndrome (PCOS)
• People who are taking medication for schizophrenia or bipolar disorder

How does sugar contribute to the risk of Type 2 diabetes?

Type 2 diabetes occurs as a result of a lack of insulin production or an increased resistance to insulin [1]. Insulin is a hormone produced by the pancreas that allows for the regulation of the uptake of glucose. It is released in response to increased glucose levels in the blood and allows for individual cells to take up glucose from the blood to metabolise it.

A high-sugar diet has been linked with an increased incidence of type 2 diabetes due to the links between high sugar intake and obesity. The Scientific Advisory Committee on Nutrition (SACN) also conducted a meta-analysis, which includes nine cohort studies in 11 publications that suggest that there is a relationship between sugars-sweetened beverages and the incidence of type 2 diabetes [7]. The link between sugar consumption and diabetes is both direct and indirect – with sugars-sweetened beverages being directly linked to the incidence of type 2 diabetes, and equally sugar consumption leading to obesity, one of the main risk factors for type 2 diabetes.

Complications associated with type 2 diabetes:

There are several complications associated with type 2 diabetes. The most common are [5]:

• Kidney disease
• Eye disease including blindness
• Amputation
• Depression
• Neuropathy
• Sexual dysfunction
• Complications in pregnancy
• Dementia

Current sugar intake and advice on how to prevent type 2 diabetes:

The current recommendation for sugar intake is that it does not exceed 10% of daily energy intake. The recent review published by the SACN has highlighted the need for this percentage to be further reduced to 5% (30g of sugars). The recommendation for children is 24g/day for children aged 5-11 and 19g/day for children aged 4-6. At present, we consume a much higher proportion of sugar each day, with percentage sugar consumption between 1.5 to 3 year olds at 11.9%; 4 to 10 year olds at 14.7% and 11 to 18 year olds at 15.6% [8].

It is also important to maintain a healthy lifestyle and diet by [9]:

• Not exceeding the maximum amount of calories per day – 2,000 calories per day for women and 2,500 calories per day for men.
• Reducing sugar intake to a maximum of 6 teaspoons per day (25g).
• Reducing the consumption of sugars-sweetened beverages.
• Exercise for half an hour, 5 times a week (moderate intensity exercise).
• Maintaining body weight at a healthy BMI (between 18.5kg/m2 and 24.9kg/m2).
• Maintaining a healthy waist-to-hip ratio, as it is a good indicator of abdominal fat and thus diabetes.

References:
[1] NHS Choices. 2014. “Diabetes.” URL: <http://www.nhs.uk/conditions/diabetes/pages/diabetes.aspx>. [Accessed 27th January 2015].

[2] Diabetes UK. 2014. “Diabetes Prevalence 2013,” URL: <http://www.diabetes.org.uk/About_us/What-we-say/Statistics/Diabetes-prevalence-2013/>. [Accessed 27th January 2015].

[3] Diabetes UK. 2014. “The Cost of Diabetes Report”. URL: <http://www.diabetes.org.uk/Documents/Diabetes%20UK%20Cost%20of%20Diabetes%20Report.pdf>. [Accessed 27th January 2015].

[4] Kanavos, van den Aardweg and Schurer. 2012. “Diabetes expenditure, burden of disease and management in 5 EU countries,” LSE.

[5] Diabetes UK. 2014. “Diabetes Facts and Stats,” URL: <http://www.diabetes.org.uk/Documents/About%20Us/Statistics/Diabetes-key-stats-guidelines-April2014.pdf>. [Accessed 27th January 2015].

[6] Health and Social Care Information Centre (HSCIC). 2014. “Statistics on Obesity, Physical Activity and Diet. ” URL: <http://www.hscic.gov.uk/catalogue/PUB13648/Obes-phys-acti-diet-eng-2014-rep.pdf>. [Accessed 27th January 2015].

[7] Scientific Advisory Committee on Nutrition. 2014. “Draft Carbohydrates and Health Report” pp.89-90 & 95-96.

[8] Health and Social Care Information Centre (HSCIC). 2014. “Statistics on Obesity, Physical Activity and Diet.” URL: <http://www.hscic.gov.uk/catalogue/PUB13648/Obes-phys-acti-diet-eng-2014-rep.pdf>. [Accessed 27th January 2015].

[9] Mayo Clinic Staff. 2014. “Obesity” URL: <http://www.mayoclinic.org/diseases-conditions/obesity/basics/treatment/con-20014834>. [Accessed 27th January 2015].

[10] Key statistics on health inequalities: Summary paper. 2007. The Scottish Government. URL: <http://www.scotland.gov.uk/Publications/2008/06/09160103/3>. [Accessed 27th January 2015].  

How Much Sugar Is Allowed for People with Diabetes?

Sugar is often portrayed as a villain or main culprit when the topic of diabetes comes up.

While sugar does play an important role in the context of this condition, several misconceptions exist about people with diabetes being able to consume sugar.

People with diabetes can eat food and drink beverages that contain sugar. But just like everything, moderation is key.

This article will give you more information about the role that sugar plays in diabetes and glucose management, and how to approach it in appropriate and balanced ways.

Clinical guidelines or recommendations about anything, including sugar consumption by people with diabetes, are just that: guidelines. They are meant to guide many people to stay as healthy as possible.

Expert opinions differ on how much sugar is recommended each day.

• The World Health Organization (WHO) recommends that only 5 to 10% of your calories be from added sugars, or “free sugars.”
• In the United States, that recommendation is the same, according to the Dietary Guidelines for Americans. That translates to 12 teaspoons per day when following a 2,000-calorie diet.
• However, the American Heart Association advises limiting sugar to 6% of total calories per day. That means a limit of 7.5 teaspoons per day for a 2,000-calorie diet.

The Centers for Disease Control and Prevention (CDC) mentions that the average intake of added sugars was 17 teaspoons per day — or 19 teaspoons for men and 15 teaspoons for women — for Americans ages 20 and over in 2018.

If you’re used to eating a lot of sugar, you may want to reduce your intake to help manage blood glucose levels and keep them in target range.

Carbohydrates count, too

Calories and sugar are not the only things that matter when looking at a nutrition label. Carbohydrates are just as important for people with diabetes.

It’s important to keep in mind that carbs break down into sugars. So just because you see “no sugar” on a nutrition label, that doesn’t mean it’s free of any blood sugar effect. Carbs impact glucose levels just like forms of sugar do.

The American Diabetes Association does not recommend a specific daily carb limit for people with diabetes because it’s so individualized. However, the average American diet contains about 250 grams of carbs per day, and that’s too high for most people with diabetes.

If you decide to try carb counting, you’ll need to know the total grams of carbs in the foods or drinks you’re planning to consume and have a reasonably accurate estimation of the serving size.

One carb serving contains about 15 grams. However, a carb serving might not match what you’d normally consider a serving of food, so you’ll need to carefully balance carb servings and serving sizes.

You can learn more about carb counting here.

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Of course, everyone is different. Your weight, activity level, nutritional needs, and your body’s reaction to factors that affect your blood sugar levels will differ from those of another person with diabetes.

You and your diabetes care team should discuss your situation, including your history of managing your blood sugar levels, to determine how much sugar you can eat in a typical day. This can vary, too, depending on what type of diabetes you have and any medications you take.

Some people may worry that eating sugar will lead to diabetes, but diabetes is much more complex. Plus, your body does need some sugar to function. According to the National Institutes of Health, one type of sugar called glucose is an important source of fuel for your body and your brain.

The sugar in your body comes, in part, from carbohydrates. After you eat, your body breaks down the food you eat as you’re digesting, which sends glucose into your bloodstream.

Simple carbohydrates like candy or fruit break down quickly, sending a quick burst of sugar into your bloodstream. More complex carbohydrates like pasta break down more slowly and deliver a steadier dose of sugar over time.

If you don’t have diabetes, your pancreas will respond to the influx of sugar by releasing a hormone called insulin, which works to move that sugar out of your blood and into your cells to use as fuel.

However, if you have diabetes, your pancreas may not respond by producing enough (or any, in some cases) insulin to do the job. The sugar can build up in your bloodstream, which can eventually damage your blood vessels and cause other complications.

Different types of diabetes

Here’s what to know about each of the main types of diabetes:

• Type 1 diabetes (T1D): This autoimmune condition is when your pancreas is no longer able to produce any or enough insulin to help you naturally regulate your blood sugar (glucose) levels. You must take insulin (injection, insulin pump, inhaled) so your body can move the glucose into your cells from the bloodstream for energy. Roughly 5% to 10% of people with diabetes have this type.
• Latent autoimmune diabetes in adults (LADA): Sometimes known as type 1.5 diabetes, this is another name for type 1 diabetes diagnosed in adults.
• Type 2 diabetes (T2D): Those with T2D have developed a resistance to insulin, so it doesn’t work efficiently to move sugar from the bloodstream into your cells. Over time, your pancreas may also stop producing insulin. While many people use lifestyle measures (diet, exercise) to manage their T2D and keep blood sugars steady, many also take medications (like insulin or metformin) to manage their condition. T2D is the most common form, with roughly 90% of people with diabetes living with this type.
• Gestational diabetes: Some people develop diabetes during pregnancy, which often requires them to take insulin until delivery.

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It’s a common misconception that people with diabetes need to give up sugar and go sugar-free for the rest of their lives.

In other words, yes, people with diabetes actually can still eat sugar. They can eat foods with added sugars and also other foods containing carbohydrates that get broken down into sugar inside the body.

People with diabetes need to be careful about how much sugar they consume. The key word is “moderation,” according to the Association of Diabetes Care and Education Specialists.

Addressing diabetes stigma

No one chooses to have diabetes — regardless of the type. Food choices and lifestyle habits can play a part in developing type 2 diabetes, but science is also clear that genetics play a part in the development of this condition.

The most common diabetes stigma is the perception that people with diabetes are responsible for developing diabetes. Eating too much sugar does not directly cause diabetes.

Stigmatizing people by mentioning they are “eating too much sugar” or taking other actions to cause their diabetes can be damaging to that person’s mental health. A 2020 study shows a link between stigma to symptoms of depression, anxiety, and distress.

You can consider joining the American Diabetes Association’s online support community or visit diaTribe’s dStigmatize page for more information and resources.

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Limiting sugar content overall is a smart choice. A few commonly recommended strategies include:

• Try eating smaller portions to reduce your daily calorie count.
• Eat a variety of foods, including vegetables, fruits, grains, and low fat dairy, to get the most nutritional bang for your buck.
• Choose foods with lower amounts of fat.
• Watch out for highly processed foods, which may contain a lot of added sugars.
• Limit sugar-sweetened beverages. Instead, try substituting with a lower sugar option or choosing water more often.

You can also learn how to count carbohydrates. Many people with diabetes count carbs to help them keep track of what they’re eating so they can manage their blood sugar levels better.

According to the CDC, if you are overweight, you may help reverse prediabetes and delay or prevent type 2 diabetes by shedding 5% to 7% of your body weight. As this is not the only way to prevent type 2 diabetes and it may not be necessary for everyone, it’s best to speak with your doctor first.

If you have diabetes, you don’t have to resign yourself to a life without sugar. But you do need to be mindful of how much sugar you consume and how it affects your ability to control your glucose levels.

This includes not only sugary sweets but beverages and anything with carbohydrates, as those convert into sugar in your body. Your diabetes care team can help you design a plan that helps you achieve a healthy balance.

90,000 Today, more than a million children in the world have diabetes. And this alarming figure is steadily growing: for example, over the past 15 years, the number of babies with serious endocrine pathology has doubled.

Today, more than a million children in the world have diabetes. And this alarming figure is steadily growing: for example, over the past 15 years, the number of babies with serious endocrine pathology has doubled.

Professor Lyudmila Tyrtova, Head of the Endocrinology Department of St. Petersburg State Pediatric Medical University, spoke about why diabetes mellitus challenges the world community and how to resist this challenge.

Lyudmila Viktorovna, what can we say about the prevalence of diabetes today? How relevant is this issue?

– Diabetes is the 4th leading cause of death. Unfortunately, in the developed world, the number of diabetics is doubling every 15 years. According to the forecast, by 2025 there will be 500 million of them, and by 2045 – 629million. At the same time, type 1 diabetes mellitus accounts for about 10-15% of all cases of the disease in adults. Among children, the picture is the opposite.

What is the difference between type 1 and type 2 diabetes?

– Type 1 diabetes mellitus is an autoimmune disease of a genetic nature. It is considered hereditary. In a sick person, the pancreas does not function properly: either it does not produce the hormone insulin at all, or it does not produce it in sufficient volume. Because of this, even a small amount of glucose that enters the body with food is not absorbed, and its level in the blood increases. With the progression of the disease and with an increase in blood glucose of more than 11 mmol / l, glucose appears in the urine. Diabetes mellitus is also called diabetes mellitus.

In the 21st century, for the first time in the history of mankind, cases of type 2 diabetes mellitus began to be registered in children and adolescents. In this form of the disease, the pancreas produces insulin, but the body cannot use it effectively, which is also due to a genetic predisposition. In addition, genes that regulate appetite, energy consumption, and fat accumulation may be involved in the development of type 2 diabetes. Therefore, this disease is often associated with obesity, but there are cases when it occurred in children with normal body weight.

Is obesity a consequence or a cause of type 2 diabetes?

– Obesity itself is not considered as a consequence of diabetes. In turn, with progressive obesity, the development of type 2 diabetes is inevitable. It will be based not on a primary insulin deficiency, but on a decrease in sensitivity to this hormone due to excess subcutaneous fat.

Is it possible to predict the development of diabetes in an unborn child?

– Children who have relatives with diabetes are more likely to encounter this pathology. But even if the baby has a genetic predisposition, he may never get sick if so-called “provocative events” do not occur. Such events include, first of all, transferred viral diseases. Among provocative viruses, coxsackie, rubella, measles, mumps, reoviruses (for example, rotaviruses), cytomegaloviruses, Epstein-Barr virus and others should be distinguished.

Diet is an important factor. There are studies that confirm that artificial feeding, the use of cow’s milk in early childhood (up to two years) can provoke the development of diabetes in genetically predisposed children. Eating smoked foods containing so-called nitrosamines can cause the destruction of insulin cells. A similar effect is caused by food cyanides, which are found in apricot kernels, almonds, and bamboo.

Are there any “alarm bells” that indicate that the child may have diabetes in the future? What should parents pay attention to?

– Diabetes mellitus can be asymptomatic for a long time. However, even with the latent stages of the disease, the child may experience recurrent pustular diseases of the skin and mucous membranes (furunculosis, stomatitis, barley). In acute illnesses, stressful situations, injuries, surgeries, a child with hidden disorders of carbohydrate metabolism may experience temporary increases in blood sugar.

Parents need to know that if a child has frequent urination, thirst, increased fluid intake; the child has lost weight, he has dry skin, you should immediately consult a doctor. Late diagnosis of diabetes mellitus leads to serious complications.

What tests can help detect diabetes at an early stage?

– In risk groups (that is, if relatives have diabetes), we recommend periodically monitoring blood sugar levels – especially after illnesses and injuries. Normally, fasting blood sugar is 3.3-5.5 mmol/l, and after eating it should not exceed 7.8 mmol/l. There should be no sugar in the urine. If there are any deviations, then it is necessary to pass an analysis for antibodies to insulin cells, a glucose tolerance test and, if possible, undergo a molecular genetic study to clarify the nature of diabetes mellitus.

Can diabetes be controlled?

– Undoubtedly it is possible and necessary! Less than a century ago, the discovery of insulin made it possible for diabetics to not die from the disease. The main goal of insulin therapy is to mimic physiological insulin secretion as much as possible without the development of unwanted side effects. At the onset of the disease, we teach patients the technique of injecting insulin. Patients learn how to follow a diet, how to avoid complications. Compliance with all the rules gives diabetics the opportunity to live and, for a while, forget about their illness.

Is it possible to stop the growth of this disease, especially in children?

– Diabetes is a truly formidable challenge to the world community. Humanity must reconsider its way of life and culture of eating behavior. Children from an early age are accustomed to sweet carbonated drinks, fast food, sweets, move little and spend a lot of time at computers. All this contributes to the progression of obesity and the development of type 2 diabetes.

Date of publication: 11/18/2020

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Checking myths

06/07/23

Konstantin Strokov

endocrinologist, diabetologist

Author profile

I am an endocrinologist and diabetologist, mainly working with adults diagnosed with type 1 or type 2 diabetes.

Because of the misconceptions surrounding these diseases, it is often difficult for people to accept the diagnosis and adhere to the treatment. This is especially true for those who developed diabetes in adulthood.

I will break down the most popular myths about diabetes and tell you what is wrong with them.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we give recommendations. Relying on our point of view or not is up to you.

Myth No. 1

Diabetes mellitus occurs due to an excess of sweets in the diet

Type 1 diabetes mellitus is primarily due to genetic causes. This is an autoimmune disease that usually develops at a young age, and sweets have nothing to do with it.

Classification of Diabetes Mellitus – Uptodate

Environmental Factors and Type 1 Diabetes – Uptodate

Type 1 diabetes affects the cells of the pancreas, causing it to stop producing insulin.

Type 2 diabetes mellitus develops according to a different mechanism. It manifests itself in people aged 35-40 years and older, as a rule, against the background of risk factors or concomitant diseases: obesity, overweight, arterial hypertension, dyslipidemia.

Type 2 Diabetes Risk Factors – Uptodate

That is, excessive sugar consumption alone will not lead to diabetes, there is no direct link. However, malnutrition can lead to obesity, and this can already be a trigger for diabetes.

How many Russians have diabetes

In general, diabetes will not develop due to sugar consumption in a healthy person without risk factors.

Source: Rosstat Source: Rosstat

Myth No. 2

With diabetes, you can’t eat sweets at all

All people with type 1 and type 2 diabetes can eat sweets. However, there is one “but” – it concerns the amount of sweet that can be eaten at a time. If you eat too much of it, your glucose levels can rise dramatically.

The Mayo Clinic Diabetes Diet

People with diabetes need to monitor their blood glucose levels to understand how they are during the day. If glucose rises above the norm – on average, it should be from 6 to 9 mmol / l – you need to adjust the diet or review hypoglycemic therapy.

How to treat diabetes and how much it costs

Myth No. 3

Sweets on fructose can be eaten without restrictions

Increased consumption of fructose contributes to weight gain, increased levels of cholesterol and triglycerides in the blood, which can subsequently lead to atherosclerosis. Also, an excess of fructose leads to liver damage – fatty degeneration, which is quite difficult to treat.

Because of this, fructose should also be limited, despite the fact that it raises blood sugar more slowly than glucose. In general, there is no need to replace regular sugar with fructose: there is not much benefit in this.

How Excess Fructose Can Cause Fatty Liver Disease – National Institutes of Health, USA

Fructose sweets are touted as being more beneficial for people with diabetes. In fact, you can eat ordinary ones – the main thing is to observe the measure. Source: ozon.ru

Myth No. 4

If you take sugar-reducing pills or inject insulin, then dietary restrictions are not needed

One of the treatments for diabetes is nutritional control. Two more are physical activity and the correct, timely and regular intake of hypoglycemic drugs or insulin therapy.

How to compensate for diabetes at the expense of the state

If a person does not adhere to the rules of a healthy diet, or, suppose, irregularly takes sugar-lowering drugs, then his blood sugar level will increase. This can lead to decompensation of diabetes mellitus, and then to its complications – for example, damage to the eyes, blood vessels, kidneys.

Complications of Diabetes – MSD Handbook

If a person follows the doctor’s recommendations, including nutrition, complications will develop later or not at all, and the quality of life will be improved.

With type 1 diabetes, a person has a little more freedom: he can deliver more insulin if he plans to eat, for example, a cake. With type 2 diabetes, the diet is stricter. However, both types of the disease require monitoring of nutrition.

How to recognize diabetes and get medical care for free

Myth No. 5

In type 2 diabetes, insulin is not needed and is addictive

In type 2 diabetes, unlike type 1 diabetes, the pancreas produces insulin, but the cells of the body are immune to it. As a result, glucose remains in the blood, does not enter the cells, and its level rises. Since there is insulin in the body, at the beginning of the disease, it usually really does not need to be administered additionally. Most often, hypoglycemic drugs are enough.

Unfortunately, diabetes is a progressive disease. Over time, the pancreas may begin to produce less insulin. If the doctor’s recommendations are not followed, diabetes may decompensate, the pills will stop helping. Then insulin therapy is needed.

How I got an insulin pump according to OMS

There is an important analysis – for C-peptide, which shows how much insulin the pancreas produces. According to him, the doctor determines whether it is time to switch to insulin injections or you can try to revise hypoglycemic therapy with pills.

Type 2 Diabetes Treatment – Medscape

C Peptide Test – Medscape

Insulin is non-addictive and taken as needed. When your own insulin is not available, the only way to help a person with diabetes is to give it from outside.

Myth No. 6

Obese people always have diabetes mellitus, but thin people do not have it

There is a relationship between obesity and diabetes.

Risk Factors for Diabetes – American Center for Disease Control and Prevention

First, obesity is a risk factor for type 2 diabetes, although obese people will not always have diabetes.

Secondly, overweight people are more likely to be diagnosed with prediabetes:

• when the blood glucose level is elevated on an empty stomach, but not yet to such values ​​that one can talk about diabetes mellitus;
• when the glucose level rises too much after a meal, and on an empty stomach is normal – this is called impaired glucose tolerance.

Prediabetes can develop into diabetes over time.

Thirdly, if an obese person has type 2 diabetes mellitus, with weight loss, he can go into remission. Then you will no longer need hypoglycemic drugs, proper nutrition will be enough to control the disease.

How many Russians suffer from obesity

People who are not overweight usually have type 1 diabetes. Let me remind you that this is an autoimmune disease that, as a rule, develops in young people – and usually they are not obese.

Also, people who are not overweight can also have type 2 diabetes if there is a hereditary predisposition.

Source: Rosstat Source: Rosstat

Myth No. 7

Some Foods Lower Blood Sugar Like Insulin

Products cannot lower blood glucose levels like insulin does. Insulin is the only physiological drug that lowers blood sugar.

Glycemic Index – Mayo Clinic

However, different foods have different effects on increasing glucose levels. There are foods with a low glycemic index, that is, a minimal effect on blood sugar. They either do not affect at all, or do not increase it as much as other foods.

Wine and sweets: do’s and don’ts for diabetes

The lower the glycemic index, the less the product affects blood glucose

Myth No. 8

Diabetes mellitus is inherited: if parents get sick, then children will also get sick

Diabetes is not always inherited. There is a certain chance that children can get type 1 diabetes due to hereditary predisposition combined with risk factors:

• if both parents have diabetes, then the probability of the disease in a child reaches 35%;
• if the father has diabetes, then the probability of the disease in the child is 6-7%;
• if a mother has diabetes mellitus, then the probability of the disease in a child is 3-4%.

Diabetes Mellitus and Genetics – American Diabetes Society

Type 2 diabetes is also genetically predisposed, but risk factors play a much larger role.

For example, one of the parents has type 2 diabetes. The child has grown up, he is 35-40 years old, he is obese, he does not move much – he may develop type 2 diabetes. And if there are no risk factors, then the likelihood of getting sick will be much lower.

Course: how to eat right

Myth No. 9

With diabetes, severe complications always develop.

Of course, diabetes is a progressive disease. With a “bad” attitude towards him – if a person does not follow the diet, moves a little, does not control the level of glucose in the blood, takes drugs irregularly – complications will arise.

6 useful gadgets for people with diabetes

Those who follow the doctor’s recommendations develop complications later or are avoided.

The major severe complications of diabetes include:

1. Retinopathy is an eye disease that can cause blindness.
2. Polyneuropathy is a lesion of the nervous system with loss of sensation, usually in the legs. It happens that a person can step on a nail and not even feel it.
3. Nephropathy is kidney damage that can lead to kidney failure and the need for hemodialysis.

All these complications can be, but the correct attitude to the disease greatly reduces the likelihood of their occurrence.

Global Trends in Diabetes Complications — Journal of Diabetology

Prevalence of Complications in People with Type 2 Diabetes — Journal of Physical Therapy

Prevalence of Miscellaneous Complications in People with Type 2 Diabetes

Complication	Percentage of complications
Chronic renal failure	27.8
Leg problems	22.9
Eye injury	18.9
Heart attack	9.8
Chest pain	9.5
Ischemic heart disease	9.1
Chronic heart failure	7. 9
Stroke	6.6

Complication

Percentage of complications

Chronic renal failure

27.8

Leg problems

22.9

Eye injury

18.9

Heart attack

9.8

Chest pain

9.5

Ischemic heart disease

9.1

Chronic heart failure

7.9

Stroke

6.6

Myth No. 10

Women with diabetes should not get pregnant and give birth

Science does not stand still, so women with diabetes safely bear and give birth to children.

Diabetes and Pregnancy – American Center for Disease Prevention and Control

However, if a woman has type 2 diabetes, oral antidiabetic drugs should not be taken during pregnancy. They have a teratogenic effect – they cause fetal developmental disorders. The only way to lower blood glucose levels is to administer insulin.