Carefully monitoring carbohydrate and sugar intake is vital when managing diabetes because of its potential impact on blood glucose, or sugar, levels. As a result, there is a popular misconception that people with diabetes must avoid all sweets and sugary foods.
However, it is still possible to eat sweets, chocolate, or sugary food, as long as it is part of a healthful diet plan.
In this article, we look at eating sweets as part of a healthful diet, types of sugars and sugar substitutes, and how to read the nutrition label on food packaging.
Diabetes, sweets, and the diet
People with diabetes should consider sugary foods to be a treat and eat them in small portions.
The amount of carbohydrate and sugars a person with diabetes can eat depends on factors, including:
- their activity levels
- whether they are trying to lose weight or maintain a healthy weight
- whether they are trying to lower their blood glucose levels
A doctor or dietician can help people set personal goals and advise on a diet plan to suit their needs.
According to the American Diabetes Association, people with diabetes can still have sweets, chocolate, or other sugary foods as long they are eaten as part of a healthful meal plan or combined with exercise.
They consider a healthful meal plan to:
- have limited saturated fat
- contain moderate amounts of salt and sugar
- include lean protein, non-starchy vegetables, whole grains, fruits, and healthy fats
However, it is best to save sugary foods for an occasional treat and enjoy them in small portions.
When choosing any food, it is essential for a person with diabetes to understand how it can affect their blood glucose levels. Knowing how to read the nutrition labels on food packaging can make this easier.
Many foods claim to be "sugar-free" or have "no added sugar." However, these foods can still contain calories and types of carbohydrate that can impact a person's blood sugar levels.
Types of sugar
There are three main types of carbohydrates:
- simple carbohydrates, or simple sugars
- complex carbohydrates, or starches
- fiber, which is from plant foods and mostly indigestible
Both natural and added sugars are present in foods. Examples of natural sugars include:
- fructose, which is in fruits
- lactose, which is in dairy products
Manufacturers use more than 60 different names for added sugar on the ingredients list of food labels. Some common names include:
- sucrose, also known as table sugar
- high-fructose corn syrup
- corn syrup
- brown rice syrup
- agave nectar
- maple syrup
- malt syrup
- barley malt
- beet sugar
When a person eats, their digestive system breaks down the carbohydrates from the food into glucose, which is a simple sugar. The body then absorbs this glucose into the bloodstream.
Glucose is the body's primary energy source. A hormone called insulin instructs the cells to absorb glucose from the blood.
People with diabetes either do not produce enough insulin or their cells do not respond to the hormone appropriately. This causes blood glucose levels to become too high.
Simple sugars tend to raise blood glucose levels faster and higher than complex carbohydrates, such as whole wheat and oatmeal.
Artificial sweeteners can contain calories and carbohydrates.
Sugar substitutes are low or no-calorie alternatives to sugar that usually have less impact on a person's blood glucose levels.
Manufacturers commonly add them to many foods, especially products they describe as "low sugar," "reduced sugar," "diet," or "low calorie." However, other ingredients in these products may still add calories or carbohydrates to total intake.
Before buying a reduced-sugar product, it is important to check the nutrition details on the label.
Sugar substitutes may also cause a person to a large amount of food later on. They can also possibly alter a person's sense of taste, making naturally sweet foods less appetizing.
The following are common sugar substitutes.
Artificial sweeteners, also known as nonnutritive sweeteners, are synthetic sugar substitutes that typically contain zero or very few calories.
According to the American Diabetes Association, the U.S. Food and Drug Administration (FDA) have approved six artificial sweeteners:
- acesulfame potassium or acesulfame k
People can also buy many of these artificial sweeteners to use as substitutes for table sugar or in cooking and baking.
Sugar alcohols are a type of carbohydrate that occurs naturally in plants. However, manufacturers need to process them before using them in foods as sweeteners.
Sugar alcohols have fewer calories than regular sugar but can still increase a person's blood glucose levels.
Common sugar alcohols include:
In some people, sugar alcohols can have a laxative effect, which can cause diarrhea and gas.
Stevia is a "generally recognized as safe" or GRAS sweetener.
However, manufacturers need to extract and purify the sweetener from the Stevia rebaudiana plant using a chemical process. Stevia is also known as Rebaudioside A, Reb-A, or rebiana.
Stevia contains no sugar or calories, and manufacturers add it to many different food and drink products as a sugar substitute. These products may describe themselves as being "naturally sweetened." Stevia is also available as a tabletop sweetener.
Stevia sweeteners are available to purchase online.
The monk fruit, or luo han guo, is a plant native to Southeast Asia. The juice from monk fruit is extremely sweet, around 150–250 times sweeter than table sugar. Manufacturers add it to a range of foods and drinks as a sugar substitute.
Similarly to Stevia, monk fruit extract is a GRAS sweetener, contains no sugar or calories, and products containing have permission to describe themselves as "naturally sweetened." Monk fruit is also available as a tabletop sweetener.
Monk fruit sweeteners are available to purchase online.
Reading a nutrition label
In the U.S., all packaged food and drink products display a Nutrition Facts label.
Knowing how to read this label can help people determine the potential impact food or drink may have on their blood glucose levels.
There is often a multitude of information on a Nutrition Facts label, but the three most important numbers are:
- serving size
- total carbohydrates
We discuss each of these below.
If a food product contains any artificial sweeteners or other sugar substitutes, the manufacturer will include them an ingredients list directly below the Nutrition Facts box.
The first figure to look at on a Nutrition Facts label is the serving size. Manufacturers base all other information on one serving of the food.
For example, a box of crackers may list 10 crackers as one serving. So, if someone eats 20 crackers, they will be consuming twice the calories and carbohydrates stated on the box.
Manufacturers base the serving size on common household measures that are appropriate to the food, such as:
The label will also always include the serving size in grams (g) and the number of servings per container.
A Nutrition Facts label will also inform the customer about the total number of calories in one serving. These calories come from all sources, including fat, carbohydrate, protein, and alcohol.
Knowing daily calorie intake can be important for people wanting to lose weight or maintain a healthy weight. To lose weight, people need to eat fewer calories than they burn. They can achieve this by engaging in physical activity and exercise to activate metabolic processes.
Anyone who wishes to lose weight should speak to a doctor or dietician for advice on a diet plan.
The figure for total carbohydrates states the amount of carbohydrate in grams that one serving contains. This number includes sugar, complex carbohydrate, and fiber.
For people with diabetes, it is critical to consider the total amount of carbohydrate and not just sugar. All types of carbohydrate can affect blood glucose levels.
A diabetes educator, dietitian, or diabetologist will create an individualized diet plan as part of managing glucose. The plan restricts carbohydrate intake to keep blood sugar within a normal range.
The ADA do not suggest a specific number of carbohydrates for people with diabetes. Instead, people should closely follow their doctor's diet plan.
Some foods may contain little or no sugar but a lot of carbohydrate. By only looking at the amount of sugar on a label, a person may end up underestimating the food's potential impact on their blood glucose.
Food manufacturers will sometimes also use terms such as "net carbs," "impact carbohydrate," or "digestible carbohydrate" on their packaging.
The FDA and the American Diabetes Association do not recognize these terms. They can be misleading about the total carbohydrates in a product.
Manufacturers often calculate these figures by subtracting the quantity of sugar alcohol and fiber from the total carbohydrate. However, this method can give the impression that the product has less carbohydrate than it does.
People with diabetes should always look at the number of total carbohydrates when deciding whether or not to eat a particular food.
People with diabetes can have sweets and other sugary foods as part of a healthful meal plan or when combined with exercise. However, it is best to enjoy sweets in small portions as an occasional treat.
When choosing any food, it is important to read the nutrition label and be mindful of how the number of total carbohydrates can affect a person's blood sugar levels.