Is it a myth that people with diabetes shouldn’t eat sugar?

Older patients report they have ‘sugar diabetes’ and the media demonises sugar as the root of all dietary evil. It’s no wonder sugar myths are high on the diabetic diet myth list.

In fact, people with diabetes can eat a moderate amount of sugars in their diet. 

To clarify the term – ‘sugar’ generally refers to sucrose (brown, raw and white table sugar) although there are many different types of sugars and nutritive sweeteners (Box 1) found in foods. 

Sugars were once described as ‘simple’ – a simple chemical structure digested quickly. However glycaemic index (GI) research has since negated this.1

GI foods are ranked as low GI: 0–55, moderate GI: 56–69 and high GI: 70–100. Some sugars – sucrose (GI 68), lactose (GI 46) and fructose (fruit and honey sugars, GI 19) – are not rapidly digested and have a low to moderate GI. Glucose and maltose are examples of high GI sugars, having rankings of 100 and 105 respectively.

Similarly ‘complex’ is no longer used to describe carbohydrates. Some ‘complex’ carbohydrates have higher GI rankings than some sugars. 

Sugars are nutritive sweeteners providing around 16kJ of energy per gram. Provided sugars are eaten as part of healthy low GI foods, patients can derive more enjoyment and variety, thus leading to better patient compliance.2-5  For example, two teaspoons of brown sugar or honey added to a bowl of porridge, or sweetened natural yoghurt or 100% fruit jam on wholegrain bread. 

Foods that supply concentrated sugar, or sugar and fat combined, should be minimised. These can include foods such as lollies, soft drinks, ice blocks, cakes, muffins and biscuits. 

Processed foods, especially those that are low fat and/or reduced sugar, can also contain a number of refined starches – another form of carbohydrate.

Refined starches have additive codes in the 1400s. Reading ingredients lists and nutrition information panels (NIP) on product labels is necessary to determine the type and amount of sugars and carbohydrates the product contains. 

Unfortunately the NIP is only required to label total carbohydrates and total sugars, so unless the ingredients list is also read it is hard to identify the sources of carbohydrates and sweeteners. Box 2 illustrates this point. 

When more than one in four Australian adults over the age of 25 have either diabetes or impaired glucose tolerance6 ‘diabetic friendly’ products are big business.

A sensible recommendation for diabetic patients is to follow a balanced diet that can be successfully adhered to in the long term and: 

Consume foods with natural sugars from fruit, dairy, honey and a little table sugar to make low GI foods taste better

Include low GI carbohydrates at all meals 

Watch carbohydrate portion sizes and 

Exercise 30–60 minutes daily.

For more information, visit www.australiandiabetescouncil.com/Living-With-Diabetes/Healthy-Eating.aspx