How Sweet It Is: A Look at Sugars and Sweeteners

The use of sugar, sweeteners, and sugar substitutes has often been a topic of hot debate. Until recently, using sugar has been discouraged in diabetic meal planning. Current scientific studies have not supported the necessity of completely abstaining from sugar, and now it’s becoming widely accepted that sugar may be used in moderation without causing deterioration in blood sugar control. Countless studies have investigated the safety profiles of artificial sweeteners.

Misinformation is rampant regarding the safety and acceptability of using both sugar and artificial sweeteners. A fair amount of alarmist propaganda is out there, mixed in with medical facts. Listen with a critical ear. Try to review the scientific studies, not the hearsay. Consider the source of the information. In the end, the decision of what to use is up to you.

Sugar Historically, people with diabetes were advised to completely avoid eating sugar, in hopes that this would control their blood sugar. More recently, it’s become clear that strict avoidance of dietary sugar is unnecessary. Studies have shown that when sugar is eaten in reasonable amounts and in the context of a healthful diet, blood sugar control is not jeopardized. Keep in mind that all carbohydrates (except fiber) are digested and then absorbed as sugar into the bloodstream. Blacklisting one form of carbohydrate will not cure diabetes. What’s more important is eating a reasonable amount of total carbohydrate. How much carbohydrate you eat and how it is spaced throughout the day are much more influential on the blood sugar than the specific type of carbohydrate you choose. Although you may include refined sugar in the diet, it’s wise to moderate the amount of sugar that you consume. Sugary foods are often low in nutritional value, high in fat or calories, or all three.

There are naturally occurring sugars, as well as added sugars. Fruit and milk both have natural forms of sugar (fructose and lactose, respectively). Naturally occurring sugars and added sugars affect the blood sugar similarly. Lightning won’t strike you down for eating the occasional cookie, but the diet police (well-intentioned family, friends, and strangers) may swarm around you, scolding that people with diabetes can’t eat sugar. Everyone has been so conditioned to believe that sugar is evil that it’s been hard to dispel this myth.

Some sugar-sweetened items do tend to raise the blood sugar quickly. For example, it doesn’t take long to digest liquids, so the sugar from regular sodas and sugary drinks can enter the bloodstream rapidly. A 12-ounce can of soda (45 grams carbohydrate) is roughly equal to 9 teaspoons of sugar. Fruit juice has almost the same amount of sugar; it’s just a different type of sugar. Use caution with both regular soda and fruit juice. You may find that your blood sugar is easier to control if you use diet drinks instead. Also, be aware that goopy, frosted goodies can have a large amount of carbohydrate concentrated in a relatively small portion.

Other Calorie-Containing Sweeteners Honey, maple syrup, pancake syrup, malt syrup, corn syrup, Karo syrup, corn sweeteners, molasses, jelly, jam, and marmalade are all concentrated forms of sweeteners. There’s no advantage or disadvantage to using any one of these over another. They’ll all affect the blood sugar similarly. They each contribute approximately 15 grams of carbohydrate per tablespoon, which is about the same as white sugar.

Fructose Powdered fructose may have some advantage over white sugar because it produces a smaller rise in blood sugar than the same amount of white sugar. Since fructose tastes sweeter than sugar, less can be used. Fructose can be used in baking.

Fructose doesn’t require digestion in the intestines. It gets absorbed into the bloodstream as fructose, not glucose. Fructose is then transported to the liver, where it’s converted to glucose and stored as glycogen for later use. It’s released into the bloodstream as needed.

Studies have shown that when a very large intake of fructose was eaten (20 percent of total calories), the LDL cholesterol went up. Don’t give up fruit if you have high cholesterol, though. Just use moderation in the amount of fructose-sweetened products you use.

Sugar Alcohol

Artificial Sweeteners