From verywellhealth.com
Eating too much sugar doesn’t directly cause diabetes. However, there is a correlation (association) between being overweight or having obesity and type 2 diabetes. Over time, consuming too many foods and beverages, including those high in sugar, may lead to weight gain. Excessive weight gain can increase your risk of developing type 2 diabetes.
Correlation means there is an association between two variables. However, it doesn’t mean that a change in one variable will always lead to the other variable. Causation means there is a cause-and-effect relationship or that a change in one thing causes a change in another thing.
This article discusses sugar and its association with diabetes, symptoms of too much or too little sugar, and sugar intake in people with diabetes.
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In Type 1 or 2 Diabetes, Sugar Isn’t a Direct Cause
Because diabetes is associated with high blood glucose (blood sugar) levels, it seems reasonable to assume that consuming too much sugar causes it. However, no quality literature cites sugar intake as a direct cause of type 1 or type 2 diabetes.
How Can People Get Diabetes?
Type 1 diabetes is not associated with diet and lifestyle habits. Rather, genetics and environmental risk factors are thought to play a role.
Having a parent or sibling with type 1 diabetes means you have a higher risk for type 1 diabetes. In the United States, white people are more often diagnosed with type 1 diabetes than African American and Hispanic or Latino people.
Can Type 1 Diabetes Be Prevented?
Scientists have long been searching for a way to help cure or prevent the onset of type 1 diabetes. In November 2022, the Food and Drug Administration (FDA) approved a drug to delay the onset of type 1 diabetes. The new drug, called Tzield (teplizumab), is administered by intravenous (IV) infusion once daily for 14 consecutive days. It is indicated for use in people with stage 2 type 1 diabetes (dysglycaemic—in which blood sugar levels go too low or too high—but presymptomatic) to help delay progression to stage 3 type 1 diabetes (dysglycaemic and symptomatic).
Type 2 diabetes is a complex, multifactorial disease with many different causes and risk factors. Some risk factors are lifestyle-related, such as being physically inactive or being overweight.
Other risk factors for type 2 diabetes include:
- Having prediabetes (in which average blood sugar levels are high but not high enough to diagnose diabetes)
- Being 45 years of age or older
- Having an immediate family member (parent or sibling) with type 2 diabetes
- Having had gestational diabetes (diabetes that begins during pregnancy)
People of African American, Hispanic or Latino, American Indian, Alaska Native, Pacific Islander, or Asian American heritage are more often diagnosed with type 2 diabetes than white people in the United States.
Type 2 diabetes may be prevented or delayed by making positive lifestyle changes. These include following a healthy eating pattern, participating in regular physical activity, and losing weight if you’re overweight.
Verywell Health prefers to use inclusive terminology. But when citing health authorities or research, the terms for gender, sex, or racial groups from those sources are used.
Type 1 vs. Type 2 Diabetes
Type 1 diabetes is an autoimmune condition in which the immune system damages the body’s ability to make insulin. Insulin is a hormone that helps the body use blood glucose for fuel and lowers blood glucose levels. Type 1 diabetes often occurs in childhood or adolescence but can develop at any age.
Type 2 diabetes is a chronic medical condition that develops over time. With type 2 diabetes, there is often insulin resistance, meaning your body doesn't use insulin properly—which often results in high blood glucose levels.
Over time, people with type 2 diabetes can also develop decreased insulin production and require insulin as part of their treatment plan. Type 2 diabetes is most commonly diagnosed in adults. However, more and more children and adolescents are being diagnosed with type 2 diabetes.
What Are the Symptoms of Too Much Sugar?
In people without diabetes or prediabetes, the body is pretty good at regulating blood glucose levels and keeping them in a normal range. However, if blood glucose levels get too high (hyperglycaemia) due to insulin resistance, not enough insulin, or other reasons, there are some symptoms to watch out for.
Common symptoms of high blood glucose levels include:
- Excessive thirst
- Increased urination
- Increased hunger
- Blurry vision
- Fatigue
- Frequent yeast infections
In more severe cases, hyperglycaemia may also cause:
- Unexplained weight loss
- Sweet-smelling or “fruity” breath
- Stomach pain, nausea, or vomiting
- Cuts or sores that take a long time to heal
- Numbness or tingling in your hands or feet
Symptoms of Too Little Sugar
On the opposite end of the spectrum, not eating sugar also does not have a direct effect on the development of diabetes. However, too little glucose in the blood (hypoglycaemia), or low blood sugar, can be dangerous. Here are some symptoms to look for:
- Fast heartbeat
- Shaking
- Sweating, chills, or clamminess
- Feeling nervous or anxious
- Feeling irritable or confused
- Feeling dizzy
- Increased hunger
If you are at risk for developing low blood glucose levels, be sure to become familiar with the signs and symptoms, as well as how to treat it.
People With Diabetes Can Have Sugar
If you have diabetes, it doesn’t mean you can no longer eat sugar. Sugar, like any other food, can fit into a well-balanced diet when consumed in moderation. When eating sugary foods, you can minimize the blood glucose response and increase your feeling of satiety by adding sources of protein and fat.
Below are more tips for incorporating some of your favourite foods into your diet with diabetes while still successfully managing your blood glucose levels.
Mindful Intake
Being mindful of your food and beverage intake means focusing on your thoughts, emotions, and physical sensations while eating. Paying attention to your hunger and fullness cues is another important aspect of mindful eating.
For example, eat when you are hungry but not starving, and stop eating when you are no longer hungry and before you are overfull. Here are some tips for eating more mindfully:
- Eat slowly.
- Take smaller bites.
- Don’t skip meals.
- Serve smaller portions.
- Use smaller plates and bowls.
- Utilize all your senses to notice the sight, sound, smell, taste, and texture of your food.
- Think about where the food came from and who prepared it.
- Avoid distractions, such as cell phones or TV.
How Much Sugar Is Recommended to Eat Per Day?
There is no specific amount of sugar that people with diabetes are recommended per day. However, your healthcare provider may advise a specific limit based on your needs. Both the Department of Agriculture (USDA) and the American Heart Association (AHA) have developed added sugar limit recommendations for the general population.
The USDA recommends Americans 2 years and older consume less than 10% of their total daily calories from added sugars. For example, a 2,000-calorie diet would be no more than 200 calories or about 12 teaspoons.
The American Heart Association recommends limiting added sugar to no more than 6% of your calories daily. This would be about 36 grams (9 teaspoons or 150 calories) for men and 25 grams (6 teaspoons or 100 calories) for women.
It is not recommended for children under age 2 to consume any added sugars from foods or beverages.
Foods Swaps
Sometimes you may be craving something sweet, but there are several ways to still indulge without overdoing it. One such way is through food swaps or choosing a similar, healthier food option that will still satisfy your craving.
For example, instead of milk chocolate, choose dark chocolate. Another swap could be enjoying plain Greek yogurt sweetened with a slight drizzle of honey mixed with some berries and a dash of ground cinnamon rather than ice cream. Instead of topping your pancake with butter and syrup, try topping it with some nut butter and fresh fruit.
The options are endless, and you might find a new favourite way to indulge your sweet tooth while still adding some nutrients to your diet.
Is Fruit OK for People With Diabetes?
You may have heard that you need to avoid certain fruits or fruits altogether if you have diabetes due to their sugar content. However, this is not true. Whole, fresh fruit contains many beneficial nutrients, such as fibre, vitamins, minerals, and antioxidants.
While whole fruits contain sugar, it is a natural sugar and brings all the other good-for-you nutrients. Therefore, fruit is a nutrient-dense food group that can be included as part of a healthy diabetes diet.
Sugar Alternatives
If you walk down the baking aisle or the grocery store's health supplement section, you will find many sugar alternatives. These include artificial sweeteners, sugar alcohols, and novel (natural) no- or low-calorie sweeteners.
Artificial sweeteners, also called non-nutritive sweeteners, can be 200 to 700 times sweeter than table sugar. They are synthetically created and do not contain any calories, sugar, vitamins, or minerals. The FDA has approved several as food additives.
Some artificial sweeteners include aspartame (NutraSweet or Equal), saccharin (Sweet and Low, Sweet Twin), and sucralose (Splenda).
Sugar alcohols are also created synthetically, usually from sugars themselves. They are not as sweet as artificial sweeteners, but still sweeter than table sugar. They are considered low-calorie sweeteners. They can cause stomach pain, bloating, gas, or dirrhoea if consumed in large quantities.
Examples of sugar alcohol sugar substitutes include xylitol, erythritol, maltitol, and sorbitol.
Novel sweeteners are created from natural plant sources, though they are still processed to become what you see on store shelves. They are also considered low-calorie sweeteners and won't contribute to big spikes in blood sugar. Some examples include allulose, monk fruit extract, and stevia.
Grocery Shopping and Nutrition Labels
Following a healthy diet is important whether you have diabetes or not. However, sometimes it can get a bit trickier trying to find out how to eat to best manage your diabetes. You might need to pay more attention to nutrition labels and ingredients when shopping at the grocery store.
If your healthcare provider has recommended you stay within a certain amount of carbohydrates per day, learning how to read a nutrition facts label is critical. Look at the grams of total carbohydrates, but also aim to include foods that are higher in fiber and have lower added sugars.
Knowing where carbohydrates come from is just as important as how many carbohydrates you eat. If you have any questions about how many carbohydrates are right for you or learning how to read a nutrition label, a registered dietitian or diabetes educator can help you.
What Are Refined Sugars and Carbohydrates?
You may have heard that you are supposed to limit the amount of refined sugars and carbohydrates in your diet—but what does that mean? When it comes to sugar, there are two broad categories: natural sugars and added sugars. Natural sugars come from fruits and dairy products.
Refined sugars/carbohydrates fall under the added sugars category. Refined sugars have been processed. Examples include table sugar, high-fructose corn syrup, powdered sugar, brown sugar, and even “natural processed sugars,” such as agave, honey, and maple syrup.
Fill your grocery cart with plenty of whole fruits, vegetables, whole grains, low-fat dairy, and lean protein sources. Include healthy fats such as olive oil, avocados, nuts, and seeds. Limit foods high in added sugars, saturated fats, and sodium.
Summary
Eating too much sugar is not a direct cause of diabetes. Consuming too many calories may lead to weight gain over time, which can increase your risk of developing type 2 diabetes.
Type 1 diabetes is an autoimmune condition thought to be associated with genetics and environmental triggers. There is a genetic component to type 2 diabetes, too. But, lifestyle-related risk factors can also increase the risk, such as being overweight or not exercising.
People with diabetes may experience symptoms of high or low blood sugar levels. Symptoms of high blood sugar include blurry vision or increased hunger, urination, and/or thirst. Symptoms of low blood sugar include dizziness, shakiness, irritability, fast heartbeat, and confusion.
People with diabetes may still include sugar and sweet foods in their diets and control their blood sugar levels by eating mindfully, using sugar alternatives, and paying attention to nutrition labels at the grocery store.
A Word From Verywell
If you are concerned about your sugar intake and risk for diabetes, meet with your healthcare provider and a registered dietitian. They can help assess your risk for diabetes, as well as find ways to create healthier eating habits.
Focus on your overall dietary pattern, aiming to include a variety of nutritious foods. Also, incorporate physical activity and movement into your daily routine.
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