THE sweet stuff
Sugar has been much maligned by authors, celebrities and health authorities but should you cut it out altogether? DL dietitian Lisa Urquhart answers your questions about this tasty sweetener
Q What should we know about sugar?
A When we think of sugar, we might visualise ice-white cubes dropped into cups of tea or tiny crystals used in baking. But that’s just one part of the story. Sugar is a small, dissolvable carbohydrate that takes three forms: monosaccharides
(single sugars), disaccharides (double sugars) and polysaccharides (multiple sugars). It can be helpful for those with diabetes to know what happens when these types of carbs are digested.
Monosaccharides are the simplest form and contain a single molecule of either glucose, fructose or galactose. Two monosaccharides joined together make a disaccharide. Sucrose – common table sugar – is a disaccharide, made up of fructose and glucose. Lactose
(in milk) is galactose and glucose and, finally, maltose (malt sugar) contains two glucose molecules. As the sugar chains become longer they can be grouped into other forms of carbohydrates, like starches or polysaccharides.
This information might sound like a science lesson, but it’s important to learn as even starches, such as potatoes, pasta and rice, are simply long chains of sugars.
Once eaten, your body digests most carbohydrates, both starches and sugars, and breaks them down into their simplest form: glucose. This form of sugar is then transported around the body via the bloodstream as blood glucose ready to be used by the cells, particularly by the brain.
Q
Why is that important?
A In people with diabetes blood glucose levels (BGLs) aren’t as well-regulated, due to insufficient insulin production, so they must be managed with diet, medication and/or injected insulin.
People with diabetes need to be aware of their carb intake and may assess food via carb exchanges (see next page). Because carbs are important for diabetes management, DL doesn’t separately list sugar in the nutrition panels.
Q How do carb exchanges work?
A Carb exchanges make counting carbs simpler. One carb exchange, made up of sugar + starches = 15g carbs (fibre is excluded as we can’t digest it). Most people need to aim for one to two carb exchanges in snacks, and one to four in a main meal. Your diabetes team will be able to suggest the appropriate number of carb exchanges for you and help you match the insulin dose (if you take it) you require to maintain good BGLs.
Q Is ‘natural sugar’ a healthier option?
A Often products are promoted as containing ‘natural’ or ‘unrefined’ sugar, and while this may seem better, your body is unlikely to know the difference. Whether it comes from cane, honey or another source, added sugar increases the total carbs of a food. So one type isn’t notably healthier.
Q How do I know what’s OK and what’s not?
A Processed foods can be high in added sugars (think soft drinks and sweet snacks), but sugar also exists naturally in fruit and milk. It’s important to enjoy these foods as part of a healthy diet, as they contain essential nutrients. So, rather than cutting them out, aim to reduce your processed sugar intake.
Q
So I can have sugar?
A Yes! It’s important to consume a balanced diet that includes fruit and milk. Small amounts of processed food – a slice of cake or a biscuit – can be eaten occasionally, but it’s wise to discuss treats with your dietitian.
If you take insulin or certain medications to manage diabetes, sugar can be a lifesaver. It’s absorbed rapidly which is ideal for raising BGLs if you have a hypoglycaemic event (BGLs under 4mmol/L). It’s a good idea to keep a ‘hypo pack’ containing around 30g of carbs, such as five jelly beans, plus a juice popper.