Type 2 diabetes, is it all about the sweet stuff? 6 May 2019 What is the relationship between type 2 diabetes and sugar? How many times have you heard people say, “ah diabetes, that’s because you eat too much sugar isn’t it?” Like everything in life, people love a simple explanation and health is no exception. It’s often an unconscious judgement we make in order to make sense of the world around us. But it can be very frustrating when living with a chronic condition like diabetes as it means different people in your life have strong opinions on what you should, and should not, do or eat. Although their intentions may be good, it can lead to stress and confusion. Eating ‘sugar-free’ to manage diabetes is one of the biggest myths around. And if you live with diabetes you are likely to have faced it at some point in time. So why isn’t it this simple? Let’s firstly explore how you may have developed type 2 diabetes in the first place. How type 2 diabetes develops and impacts our body is significantly more complex than simply eating too much sweet food over our lifetime. It is more likely to be due to a series of varying factors, some of which are in your control, while others are not. It has been said that “genetics loads the gun and the environment pulls the trigger” in conditions like type 2 diabetes. Let’s explore this analogy further (although it is important to recognise that science still does not have all the answers). You are at a much greater risk of type 2 diabetes if: it runs in your family you have had chronic stress or depression you are over 50 years of age you were diagnosed with gestational diabetes you have polycystic ovaries you have had damage to, or an infection of, your pancreas in the past you have taken high doses of steroids in your life. These things in most cases are out of your control. So what are the factors seemingly in your control that may have increased your risk? Having a sweet tooth and eating foods high in sugar may only be a tiny fraction of the story. Although type 2 diabetes is a condition where the body cannot process glucose properly, the root cause is not because we ate too much sugar to begin with. Along with the reasons mentioned above, there are modifiable factors such as being less active and having a diet high in excess energy (too much food in total) which is high in saturated fat. This often increases weight around our middle and is why your GP might be keen for you to reduce your waistline if needed once you are diagnosed. So back to sugar. Is reducing sugar intake the best way to manage your diet if you are living with diabetes? The short answer is no, as this is only part of the puzzle. Before we go further, let’s take a moment to consider what sugar actually is. Sugar can be used to describe both ‘added sugar’ or table sugar (sucrose) and ‘natural sugar’, found in fruit (fructose) and dairy products (lactose). Not only that, it’s important to understand that it’s not just sugar that makes your blood glucose levels (BGLs) rise. The overall term to describe foods that break down to glucose and therefore affect our BGLs is carbohydrates. This also includes starch found in foods like potato, sweet potato, corn, pasta, rice etc. If we consider this, it clearly highlights that just reducing or eliminating foods containing sugar to manage diabetes is the wrong conclusion. Also, not all carbohydrates are equal – there are many sources that form an important part of healthy diet as they contain fibre and essential vitamins and minerals. Because we also know the root cause of type 2 diabetes from a food perspective is impacted by perhaps too much food in total, in particular food high in saturated fat, again this shows we need to review our diet more generally for the long-term rather than just focussing on the sugar. Swapping out the ‘naughty’ or ‘junk’ foods that contain high amounts of fat, sugar and salt in our diet may help to manage our diabetes better. But if you do this and replace these foods with wholegrains, lots of veggies, a small amount of fruit, lean meats and dairy products, it is startling to see the results you can achieve. In summary, perhaps if we can stop analysing our diet on a magnified level and instead step back and try and eat more healthy whole foods, our ability to positively manage diabetes may thrive. As for the opinion of others, remember you are a powerful link in re-educating those around you. If you would like more individualised advice on this topic, book in to speak to an Accredited Practising Dietitian or Credentialled Diabetes Educator. APD dietitiansaustralia.org.au/find-an-apd/ CDE www.adea.com.au Registering to attend a free three-hour NDSS Carb smart session might be another option to begin increasing your knowledge and confidence in the area. Have a look at the events page here.