There still seems to be confusion about whether or not people with diabetes can have sugar. Many of you may have been diagnosed some time ago and it seems that a lot of people are still keeping to outdated advice - either because their GP is unaware of research on sugar and it’s effect on blood glucose levels, or because they have been given a diet sheet years ago and have not seen a dietitian recently.
If you have diabetes, you are entitled to a referral to a state registered dietitian If you have not been given one, make sure you ask for one through your doctor or diabetes clinic.
The advice for people with diabetes with regards to lifestyle is to follow a healthy balanced diet and take regular exercise. A healthy balanced diet is in line with national recommendations for people with or without diabetes. In essence, it is low in sugar (not sugar-free), fat (esp. saturated fat) and salt, and high in fibre. Just because you have diabetes does not mean you have to have a ’sugar free’ diet, or that you have to eat specialist diabetic products. Sugar in moderate amounts can be eaten as part of a balanced, healthy eating plan without having a harmful effect on blood glucose control, especially if you eat low sugar foods with meals.
The other components of the meal, especially low GI (see below) ingredients like vegetables, salad, beans, lentils and pasta will help to slow down the rise in blood glucose after the meal. However, it is obviously sensible to cut down on sugary foods and drinks since eating them has implications for tooth decay, weight control and the overall balance of your diet.
People with diabetes used to be advised to severely restrict the use of sugar and sugary foods. However, research on glycaemic response (blood glucose rise after a meal) suggests that sugar does not raise the blood sugar level any higher than even some starchy foods. Sugary foods unfortunately are generally lacking in important nutrients, so although the blood glucose rise may in some cases not be significantly different to a starchy food, this doesn’t mean you should eat sugary foods in preference, especially if you are watching your weight. Sugar can be used by people with diabetes, provided that it is used in the context of a healthy diet and does not account for more than 10 per cent of your daily calorie intake.
Blood glucose control depends on diabetes medication and lifestyle factors, such as how much activity you do as well as what you eat. If you are in any doubt as to what you should be doing, or your treatment, see your doctor or diabetes clinic. As we are all different in terms of our nutritional needs, the limits are different too. Lots of foods contain sugar - natural or added - and it is the overall food choices you make, rather than just one food, that will determine whether you are eating a healthy diet.
The key is to get the balance right. Having a dessert on occasions after a meal should not cause blood sugar to rise too quickly. If you are overweight, you need to look at the calorie content of the recipes and choose those that are lower in calories.The Glycaemic Index (GI) is a listing of foods ranked according to the rate at which they raise blood glucose in your body. Using the GI in the right context can help make blood sugar levels more stable and help you lose weight. Simply looking at the GI of a food is not the answer. Foods are made up of a range of nutrients and it is the overall balance that is important.
For more information on Gi, visit www.giplan.com, or call DRWF on 02392 637808 for information on our GI and other publications.