Can eating too much sugar cause diabetes?

Myth or truth: does eating too much sugar cause diabetes?

We tell kids that candy and sweets, desserts are not good for them. Often, we tell them that eating too much sugar can make your teeth go bad and cause serious cavities and other conditions. Also, we hear people talk about the possibility of getting diabetes due to sugar intake.

People who get diabetes can get those questions in their heads or from other people because some think that too much sugar causes diabetes to occur. Of course, that is not the case when you get diabetes in your early childhood. However, even gestational diabetes that pregnant women get is often linked with sugary cravings during pregnancy.

Do we really know that all these claims are true? Eating large amounts of added sugar can lead to diabetes development, but sugar intake is just one piece of the puzzle. Eating sugary things often and in large amounts can lead to the diagnosis, but many other factors are bigger.

Things like diet, lifestyle, and genetics affect your chance of developing diabetes. These are more serious than overall sugar intake. Diabetes is a serious life-long condition that affects a person's life, but it can be maintained with lifestyle and diet changes that people need to implement^[1].

Diabetes is mainly related to organ functions, pancreas, and insulin production, not sugar intake

Diabetes is a condition where the body struggles to manage blood sugar levels effectively. This issue arises either because the pancreas does not produce enough insulin because the body's cells start to resist insulin, or sometimes both.

Insulin is a crucial hormone that helps transport sugar from the bloodstream into the cells. If your body either makes insufficient insulin or becomes resistant to it, your blood sugar levels may remain consistently high. Over time, this can lead to serious health problems such as heart disease, nerve damage, and kidney issues. Therefore, it's vital to manage blood sugar levels carefully^[2].

Type 1 Diabetes is an autoimmune condition where the immune system attacks the pancreas, reducing its ability to produce insulin. It's less common, making up about 5-10% of all diabetes cases.

Type 2 Diabetes is the type is more prevalent, accounting for over 90% of diabetes cases, and often results from factors related to diet and lifestyle. Here, the pancreas does not produce adequate insulin, or the body's cells start to ignore the insulin.

Research: consumption of sugary drinks can heighten the risk of developing type 2 diabetes

Studies from 175 countries indicate a strong link between high sugar consumption and an increased risk of diabetes; conversely, lower sugar intake seems to reduce the risk. While these findings don't conclusively prove that sugar directly causes diabetes, the evidence strongly suggests a significant connection.

Sugar may raise diabetes risk in two ways:

1. Directly through the effects of fructose on the liver.
2. Indirectly, by promoting weight gain and increased body fat, both of which are risk factors for diabetes.

To mitigate these risks, the 2020-2025 Dietary Guidelines for Americans recommend keeping added sugars to no more than 10% of total daily calories. This strategy helps manage and potentially reduce the risk of diabetes and its associated health complications.

However, natural sugars do not affect the body the same as these additives and sugary drinks and sweets. Eating a lot of added sugars is linked to diabetes, but this is not the case with natural sugars.

Natural sugars are found in fruits and vegetables. They are part of these foods and are not added during any manufacturing process. Because they are mixed with fiber, water, and other nutrients, they do not quickly raise blood sugar levels. Fruits and vegetables generally have much less sugar compared to processed foods, making it easier to manage how much sugar you eat^[3].

For example, the impact of drinking 100% fruit juice on diabetes risk is unclear. Natural fruit juices can be high in sugar and low in fiber, which might increase blood sugar levels quickly. However, if you drink them with meals that include fat, fiber, and protein, it might help prevent these spikes.

The American Diabetes Association suggests drinking water or calorie-free drinks instead of fruit juice. These are the sources of natural vitamins and natural sugar that is needed, but consumption should be moderate regardless if you have diabetes or not.

Are sweeteners better than sugar when you manage diabetes?

Natural sweeteners like honey and maple syrup are less processed than regular table sugar, but they still mainly consist of sugar and have very little fiber. Other sweeteners that are often labeled as "natural," such as agave syrup, coconut sugar, and cane sugar, should also be considered added sugars^[4].

Artificial sweeteners are manufactured. These substances cannot be metabolized for energy, but they provide sweetness without any calories. However, sweeteners do not spike blood sugar levels while they still are linked to insulin resistance and type 2 diabetes. Experts do not have an explanation for this to this day.

One idea is that products with artificial sweeteners make you crave more sweet foods, which might lead you to eat more sugary things. Another thought is that these sweeteners confuse your body because your brain thinks you're eating something sweet without any calories, making it harder for your body to handle real sugar calories properly.

But it's important to remember that for people with diabetes, drinking diet soda is still better than drinking regular soda with sugar. When we talk about sugar, we usually mean sucrose, which is common table sugar. Sucrose is made of one glucose molecule and one fructose molecule stuck together.

When you eat sucrose, enzymes in your small intestine break it down into glucose and fructose before they go into your blood. This raises your blood sugar levels, making your pancreas release insulin. Insulin helps move glucose into your cells for energy. While cells can use a little fructose for energy, most goes to the liver. There, it's turned into glucose for energy or stored as fat.

Since fructose can turn into fat, eating too much can raise your triglyceride levels. This could increase your risk of heart disease and fatty liver disease. Eating a lot of fructose is also linked to higher levels of uric acid in your blood. If uric acid builds up in your joints, it can cause gout, a painful condition that leads to sore and swollen joints.

It is crucial to note that sugar consumption is the biggest risk for diabetes. Body weight, exercise routine or lack of, smoking, sleep apnea, and genetics can all contribute to this. Following a whole-food diet, avoiding those dangerous sugars, and eating more green leafy vegetables can be the best natural solution for managing this disease.