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.

Was this helpful?

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.

Was this helpful?

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.

Was this helpful?

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.

Blood sugar levels – targets and recommendations

Understanding blood glucose levels is a key skill in diabetes self-management. In this article, we look at target blood sugar ranges for people without diabetes and for adults and children with type 1 and type 2 diabetes.

If you are self-monitoring with a glucometer, you need to understand what the numbers (blood sugar readings) are saying.

Recommended blood sugar levels are subject to individual interpretation, so you should discuss your target blood sugar ranges with your doctor.

The following ranges are guidelines provided by the National Institute for Clinical Excellence (NICE), but each person’s target range should be agreed upon by their physician or diabetes advisor.

Recommended Blood Glucose Levels

The NICE recommended blood glucose levels are listed below for adults with type 1 diabetes, type 2 diabetes, and children with type 1 diabetes.

In addition, the target group of the International Diabetes Federation for people without diabetes is indicated.

The table gives general recommendations. The individual goal set by your doctor is the one you should aim for.

Normal and diabetic blood sugar levels

For most healthy people, normal blood sugar levels look like this:

• 4.0 to 5.4 mmol/l during fasting.
• up to 7.8 mmol/l 2 hours after eating.

For people with diabetes, blood sugar levels are as follows:

• Before meals : 4 to 7 mmol/l for people with type 1 or type 2 diabetes.
• After a meal : up to 9 mmol/l for people with type 1 diabetes and less than 8.5 mmol/l for people with type 2 diabetes.

Blood sugar level in the diagnosis of diabetes

The following table lists the criteria for diagnosing diabetes and prediabetes.

A blood sample for a random plasma glucose test can be taken at any time. It does not require such planning and is therefore used in the diagnosis of type 1 diabetes when time is of the essence.

Fasting plasma glucose test

Fasting plasma glucose test is taken after at least eight hours of fasting and is therefore usually taken in the morning. The NICE guidelines consider a fasting plasma glucose result of 5.5 to 6.9 mmol/L, because someone has a higher risk of developing type 2 diabetes, especially when accompanied by other risk factors for developing type 2 diabetes.

Glucose Tolerance Test (OGTT)

An oral glucose tolerance test involves first taking a fasting blood sample and then taking a very sweet drink containing 75 g of glucose.

After drinking this drink, you must remain still until another blood sample is taken 2 hours later.

HbA1c Test for Diabetes Diagnosis

The HbA1c test does not directly measure blood glucose, but the test result depends on how high or low the blood glucose is, typically lasting 2 to 3 months.

Indications for diabetes or pre-diabetes are given under the following conditions:

• Normal: below 42 mmol/mol (6.0%)
• Prediabetes: 42 to 47 mmol/mol (6.0 to 6.4%)
• Diabetes: 48 mm ol/mol (6.5% or more)

Diabetes Diet | Sanatorium Gorny

Diabetes mellitus is a disease associated with a lack of insulin production by the pancreas or a violation of its recognition by receptors. Depending on the cause of the disease, diabetes mellitus (DM) is divided into type 1 diabetes and type 2 diabetes.

In addition to drug therapy for diabetes of any type, it is necessary to follow a diet.

General rules. duration of the diet.

Nutrition for diabetes is an essential component of treatment. In mild forms of diabetes, sometimes one diet is enough to reach the target blood glucose level. In more severe cases, drug therapy (oral hypoglycemic agents, insulin) comes to the rescue.

General rules of the diet for diabetes:

• Meals should be frequent and fractional (5-6 times a day), in small portions. This will help avoid large jumps in glycemic levels.

• Meals should be taken at the same hours. The same applies to taking hypoglycemic agents and insulin injections.

• Strict diets and hunger strikes are prohibited

• Cooking methods such as stewing, boiling, steaming and baking are preferred.

• Easily digestible carbohydrates should be excluded from food (sugar, honey, confectionery, jam, bakery products, from white flour).

• The food should contain a large amount of fiber, since such carbohydrates are absorbed more slowly and do not raise blood sugar as sharply.

• Limit the consumption of animal fats (butter, lard, fatty meats).

• It is desirable that the calorie content of food and the amount of carbohydrates be approximately the same on different days, this is especially important when choosing the dose of insulin.

Nutrition for type 1 diabetes:

With type 1 diabetes, it is strictly forbidden to eat simple carbohydrates. These are sugar, honey, flour, chocolate. When you eat these foods, a person’s blood sugar level rises sharply. When compiling the menu, you need to take into account the calorie content of foods and give preference to low-calorie ones. Food should be eaten often, but in small portions, 5-6 meals a day. The basis of the diet should be protein foods, fruits and vegetables.

Nutrition for type 2 diabetes:

In type 2 diabetes, it is recommended to normalize weight and control blood sugar levels.

With this diet for diabetes, it is necessary to completely abandon simple carbohydrates (sweets, pastries), sweet fruits (apricots, banana, grapes, cherries, pineapple, watermelon, melon).

You can only eat foods that have a low glycemic index.

Types of diets for different types of diabetes:

For diabetes, diet number 9 is recommended.

What can be done with diabetes? List of allowed products.

In diabetes diet, it is necessary to choose foods with a low glycemic index.

VEGETABLES: Tomatoes, cucumbers, cabbage, zucchini, green beans.
FRUITS AND BERRIES: Cherry, cranberry, lingonberry, pear, apple.
porridge: Barley, rice, oatmeal, buckwheat.
MEAT: Rabbit, turkey, veal.
FISH: River fish, lean.

What not to do with diabetes? List of fully or partially restricted products.

DAIRY PRODUCTS: Kefir, milk.
VEGETABLES: Beets, carrots, potatoes.
GREAT: Wheat, semolina.
FRUITS AND BERRIES: Watermelon, grapes, bananas, raspberries, raisins, melons, kiwis.
MEAT PRODUCTS: Sausages, sausages, pork, fatty meats, first meat broths.
SUGAR FOODS: Candy, chocolate, sweet pastries, sugar.

Meal menu for diabetes (Meal plan)

Diet is very important in the treatment of diabetes. If you follow the diet, you can avoid unpleasant relapses. Food should be fractional, 5-6 times a day. If you are overweight, you need to reduce the total daily calorie content of meals.

Recipes for dietary meals for diabetes.

Sample menu for a day with diabetes:

Breakfast: Buckwheat porridge on the water. Baked apple. Unsweetened tea.

Second breakfast: Low-fat cottage cheese pancakes. Rosehip decoction.

Lunch: Fish soup. Steam cutlet with vegetables. Kissel.

Afternoon snack: Fruit salad.

Dinner: Lazy cabbage rolls. Unsweetened tea.

Nutritionists’ comments. Pros and cons of the diet.

Compliance with the diet and diet in diabetes mellitus helps to avoid an unwanted rise in blood sugar levels.