Diabetes

Diabetes : Does excessive sugar intake causes diabetes ?

It is a common misunderstanding  that  free sugars or sweet tasting  food can rapidly elevate the blood glucose and is responsible for diabetes. we discuss the recent scientific evidence which says that weight gain not free sugar, which is the main culprit.

Content

Diabetes: presentation

Elevated blood glucose in diabetes may cause signs and symptom

Thirst 

Excess urination (polyuria). 

Fatigue

Cardiovascular diseases.

Renal disorders

T2DM arises as a function of age and of fatness, in individuals predisposed by genetic and environmental factors that promote ‘ectopic’ fat storage within the abdomen and in muscle, liver and pancreas.

Some useful links

Diabetes is  part of the metabolic syndrome spectrum with has following pathological disorder.

Large waist circumference.

High blood pressure

Dyslipidaemia

Fatty liver.

Type 2 diabetes and obesity

The global trends of  T2DM is closely closely following  the epidemic of overweight and obesity.

It is very uncommon in people with  BMI less than 22 kg/m2, the risk of having the diabetes rapidly rises as a person gains the weight and acquires a higher  BMI. 2 particularly among Asians.

Recent scientific evidence shows that the diabetes can go in remission if the person reduces the weight substantially (10-15 kg)  and bring the BMI between between 22-25 kg/m2. Studies show that the metabolic abnormalities like dyslipidemia and fatty liver can also  be reversed.

 

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women.

Studies have found evidence that the weight control is a dominant factor in the management of type 2 diabetes.

Some useful links

Sugar intake in diabetes

Types of dietary sugar that could influence T2DM either directly or indirectly

lactose in milk

Sucrose in fruits and vegetables.

Commercial ‘sugar

Sugar consumption in our body

Sugar in the body and blood is almost exclusively glucose . It is mostly derived from digestion  of lactose, sucrose and commercial ‘sugar’ and little bit from proteins.

It is a common misunderstanding  that blood glucose is derived directly from the diet, and that free sugars or sweet tasting  food can rapidly elevate the blood glucose. it is only the pure glucose which can cause a rapid rise in blood glucose (high glycemic index) . Other types of sugars and food sources does not cause rapid rise . The rise in blood sugar by a food depends upon its glycemic index. Most of the food we consume have moderate to low glycemic indices.

The Glycemic Index (GI) is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels. Carbohydrates with a low GI value (55 or less) are more slowly digested, absorbed and metabolised and cause a lower and slower rise in blood glucose and, therefore usually, insulin level

Recent scientific publications report that majority of clinical studies do not  provide any consistent evidence of an association between dietary sugars and diabetes incidence. In other words , clinical evidence which proves that excessive intake of sugar can lead to diabetes is missing. Studies report that consumption  of energy-dense foods containing sugars are typically associated with excessive weight gain and obesity which is in turn associated with physical inactivity. The current hypothesis is that type 2 diabetes is part of the disease syndrome which have obesity , dyslipidemia  and hypertension as other disorders. Diabetes is presumed to be result of gain in weight and physical inactivity, with excessive sugar intake contributing to weight gain.

Does excessive sugar intake cause diabetes ?

Sugar does not cause diabetes , but extra calories from any source will lead to weight gain, promoting or worsening diabetes. Larger number of calories, even from a non sugar source will result in weight gain, and worsening of diabetes. 

 

Should people who are  at risk  having diabetes,  avoid taking  sugar?

Current  recommendation is to limit sugar intake to <10% of total calories intake .  It is wise to restrict the free sugar intake as it will help in restricting total calories intake which will in turn control the weight. Restricting of total calories intake is more important.

Does sugar intake increases the blood sugar levels in a diabetic patient.  

Present scientific evidence do not show that sugar consumption causes the rise in blood sugar level in the diabetic patients. It is total calories intake in a day which is more important.

Does sugar intake increases the risk of cardiovascular disease ( heart attack or MI)  in patients of diabetes

There is credible  evidence that excess intake of  33 dietary sugars causes rise in  serum triglycerides and total cholesterolHigh sugar intake is also known to increases blood pressure in patients of diabetes. 

Rise in  serum triglycerides and total cholesterol  along with elevated  blood pressure, are serious risk factors for cardiovascular disease.

These adverse effects are besides the increase in the  body weight resulting from excess calories intake.

Does reduction sugar intake will reduce the  risk of cardiovascular disease ( heart attack or MI)  in patients of diabetes ?

The current scientific evidence supports recommendation that free sugar intake should be limited  to 10% of total calories intake to reduce the risk of cardiovascular abnormalities ( heart attack) in patients with type 2 diabetes.

Does sugar intake increases the risk of renal complications ( kidney disease ) in patients of diabetes.

There is weak but positive scientific evidence that say dietary sugars accelerate chronic kidney disease in patients with type 2 diabetes. Some studies suggest that  Caramel coloring and phosphoric acid  used in different cola drinks may also promote kidney disease. 

Should people with diabetes avoid sugar for this reason?

Yes, it is always better to avoid excess sugar and sweetened cola drinks in diabetic patients.

Links to some useful books on this issue.

Conclusion: Excessive sugar intake may not be responsible for causing diabetes, but it is wise to restrict sugar intake as it causes obesity , lipid abnormalities cardiovascular and kidney abnormalities.

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