General Question

mikey7183's avatar

Do Diabetics not eat sugar AT ALL or just reduced amounts of sugar in the foods they eat?

Asked by mikey7183 (338points) June 9th, 2008

have someone in the family with it and I was curious

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19 Answers

playthebanjo's avatar

That all depends on the diabetic. It’s not just sugar…it’a ll things that go into the total carbohydrate column on the nutritional information list that effects blood sugars. The real question is not whether they eat it…it is how do they manage the effect when they do eat it. Type1 diabetics require insulin. Type 2 can be controlled through diet, exercise or medication.

mikey7183's avatar

So Type 1 AND Type 2 diabetics CAN eat sugar, it is just a matter of how much and how they handle it when they eat it with things like low-sugar diet, exercise, and medication?

shilolo's avatar

Mikey, Yes, they can (and must) eat sugar. Playthebanjo is right. I would add however that thy distinction between type 1 and type 2 diabetics is not as clear cut. Many people with so-called type 2 diabetes (which is caused by peripheral resistance to insulin rather than a complete absence of insulin) eventually require insulin for management of high blood sugars. That said, a recent study from the Lancet suggested that starting intensive insulin earlier in the course of type 2 diabetes was preferable to treatment with pills alone (note: I cited a review since most people cannot access the Lancet for free).

In particular, if insulin requiring diabetics take too much insulin, or even their normal amount but don’t eat, they can develop life-threatening hypoglycemia (or low blood sugar). That can lead to death, very quickly.

Babo's avatar

It depends on the diabetic.

playthebanjo's avatar

That’s a great study- but think about this: a main facet of intensive insulin therapy is a good regimen of glucose testing. If a type 2 diabetic tested their blood sugar as much as they should, and gave those results to their endocrinologist, perhaps their results would be less dramatic than the ones in the study.

shilolo's avatar

@Play. Type II diabetics don’t really have to test their sugars regularly if they are only taking oral medications (since there isn’t much to be done about a high reading here and there). Its a real pain in the ass (I mean finger) to test yourself regularly. Only type II diabetics on insulin need to check regularly. That said, if they did keep track and saw their doc very frequently, then perhaps she could adjust the oral meds to maintain tighter control of hyperglycemia.

playthebanjo's avatar

Exactly——they don’t have to. But if they did they would be more informed about their own situation. Tighter control is tighter control and many aspects are related to it whether you are type 1 or 2.

And you get used to the finger sticks.

jlm11f's avatar

you can’t just not eat sugar at all. not possible (or rather, probable).

shilolo's avatar

PnL. You could technically survive on protein and fat alone, since the body can synthesize glucose from amino acids and fat.

jlm11f's avatar

yeah but why would you want to? okay j/k. i know you CAN survive. but i also know that no diabetic is given a “no sugar at all” diet. its always reduced amounts like the asker said. so yes, my answer was framed badly (i was rushing…what a surprise). thanks !

skfinkel's avatar

Just read an article on diabetics and sugars, and the amount in blood doesn’t seem to connect to heart problems. Maybe other things, but not heart. This was a surprise to the researchers.

shilolo's avatar

@skfinkel. Can you link to the article? That would overturn years of epidemiologic research.

theabk's avatar

The study skfinkel is talking about is the ACCORD study which is going to be published in the NEJM in a few days. There’s a press release about it at The participants were Type II diabetics, 40 to 79 years old, with “pre-existing heart disease or at least two cardiovascular disease risk factors”, and tight control was not found to decrease the risk of heart attack or stroke. There is a lot of hullabaloo about this finding in the press because it is very unexpected (although the evidence for a connection between macrovascular disease [e.g. heart attacks] and prolonged high blood sugar in Type II diabetics has never been as strong as it is for microvascular disease [kidney, retina, etc.]).

However, I think there is a major problem with the conclusion, namely the pre-existing risk factors. By the time most Type II diabetics are diagnosed, they have often had elevated blood sugar for years; if they also have other cardiovascular risk factors or frank heart disease, it may be too late for tight blood sugar control to have much effect on the subsequent risk of a heart attack or stroke, especially if they are not doing anything to modify other risk factors (cholesterol, obesity, etc.).

In other words, we don’t know what the results would be if tight control were introduced as soon as blood sugar levels began to rise in these patients, or at least before the development of other cardiovascular risk factors. In Type I diabetes, tight control HAS been shown to significantly reduce heart attacks, strokes, and deaths from cardiovascular disease (article is free at The patients in this study were 13 to 40 when the study began and did not start out with heart disease or years of totally untreated elevated blood sugar. So, I think this suggests what might happen if an early intervention of Type IIs were attempted.

And very importantly (this, I think is not being emphasized nearly enough in the news), tight control DOES lower the risk of all the terrible microvascular complications of diabetes: retinopathy (leading to blindness), nephropathy (leading to kidney failure), peripheral vascular disease (leading to pain, terrible wounds, amputation), etc.

Just my two cents – and I realize this wasn’t what the original questions was – as to that, Type I diabetics, who don’t have any insulin insensitivity, can eat as much sugar as they want as long as they take enough insulin, although it requires a lot of blood sugar checking.

jlm11f's avatar

@ theabk – if you weren’t a girl, i would ask you to marry me.

theabk's avatar

Well, I am in California…

shilolo's avatar

I guess I’ll just wait until the NEJM arrives on my doorstep…

Judi's avatar

Did anyone take up the challenge and is still doing it?

TheOnlyException's avatar

My dad is diabetic, he has type 2 diabetes.
We all need sugar to function, it is just that diabetics are unable to cope with high sugar levels, they can’t produce the right hormone to bring them down.

Some diabetics can eat a normal amount of sugar and then take insulin injections to provide them with the right hormones to help bring their sugar levels down again.
But others do not like to take these insulin injections, so eat VERY little sugar, like my dad.
I wouldn’t say he eats NONE, because things like bread and rice break down to sugar, but he doesn’t stuff his face with candy if that’s what you mean haha!
They also tend to stick to brown bread, brown rice, wholemeal products, because the sugar is absorbed into their system more gradually, so it doesn’t spike their sugar level all at once.
Hope I helped :)

edit:// also those with type 2 diabetes (where they develop it due to overeating) can control their sugar and manage that way.

but type 1 often have to have injections of insulin regardless of how well they control their diet.

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