What To Know About Diabetes + Sugar: A Dietitian’s Perspective

Blog, Wellness

By Melinda Maryniuk, MEd, RD, CDCES

As your team dietitian, I hear a lot of questions (and strong opinions!) about a popular topic: sugar! I wanted to share my thoughts about whether or not people can eat sugar… or things containing sugar like dried fruit, candy, etc.

As many of you already know, the answers to most questions related to food are: “In moderation.” For most people, there are no forbidden foods. Then why, do doctors and dietitians tell people to “stay away from____ (fill in the black – sugar/dried fruit/candy/sweets/white refined grains, etc)?”   The quick answer is… it’s easier. It’s easier to say to avoid those foods than to teach people how to count carbs to fit a favorite food within a meal plan. Or your doctor/dietitian might (incorrectly) judge you as someone who will have difficulty limiting yourself to a small serving (2-3 chocolate kisses, 2-3 dried apricots, a 4-ounce glass of juice) – so they tell you to just skip it all together (Of course, it’s better when this is discussed with you and you understand and agree with the rationale!)

The other truth is – everyone really is different.  And as we learn more about how foods are digested and used in our bodies, we do see that not everyone’s blood glucose responds in the same way to the same foods.  New science is showing that there are many factors that influence how high your blood glucose will rise – even including the amount and types of bacteria in your gut – your microbiome.   The only way to really know how a food affects you is by doing paired blood glucose checking – before and two hours after a meal.  (for more information about how to do that, click here.)    

Last, keep in mind that “sugar” is a very broad term. The sugar we are really concerned about in diabetes is “added sugar” – not as much the natural sugar (also known as carbohydrates (carbs) that are part of foods like milk, yogurt, fruit, vegetables and grains).  All carbs will raise your blood sugar.  Carbs in combination with protein and fat will raise it more slowly than just eating pure carbs. This link has some great information about avoiding added sugar.. 

Can people with diabetes eat sugar?  Yes… as long as it is “in moderation.” For many people, that might mean, “a little less than you’re used to.” I generally look at the amount of added sugar in someone’s usual diet – and recommend places to reduce it, if blood glucose levels run high. Many people don’t need to buy special products like sugar-free catsup or sugar-free peanut butter – but some folks are very sensitive to the added sugar, and they do better avoiding it. There are no hard and fast rules.  

What about chocolate?  Which kind is best – milk?  dark? While there are small differences in nutrition values for chocolate, the differences are small, so my usual answer is –enjoy the one you like best. (And check the labels so you know what you’re eating!)   

Should I buy sugar-free chocolate? Sugar-free chocolate is made with a different kind of carbohydrate (known as sugar alcohol) – it still has calories and is often more expensive.  Too much sugar-free candy can lead to an upset stomach (gas, bloating and diarrhea). So, I say – if you love it, it’s fine to have, but don’t buy it because you think it is better for your diabetes.  

What about dried fruit?  My next question would be – how much? A few dried apricots?  Sure. No problem.  A cup of dried apricots?  That’s way too many carbs.   Remember – a piece of dried fruit has the same nutrients as the equivalent whole/fresh fruit. Just as we would not recommend you eat 10 whole apricots at once, it’s not recommended to eat 10 dried apricots at once.