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The sugar-diabetes link

sugar

November is Diabetes Awareness Month. The shocking reality is that one Canadian is diagnosed with diabetes every three minutes, and the disease is the 7th leading cause of death among Americans. Can eating too much Halloween candy be the cause? Diana Chard, resident dietitian at Rustik, dispels some of the myths.

Q. Is it true that sugar causes diabetes?

A. No, and yes… sort of… maybe. Before I explain, let’s go back and refresh ourselves on what diabetes is.

There are two main types of diabetes: Type 1 and Type 2. Type 1 diabetes used to be known as juvenile diabetes because it was more often seen in children. This form of diabetes is usually characterized by a decreased release of insulin from the pancreas. Type 1 diabetes is usually triggered by an autoimmune system disorder which destroys the insulin-producing beta cells in the pancreas. It also has a moderate hereditary component. People with Type 1 diabetes rely on insulin injections, or an insulin pump, to regulate their blood sugar levels.

In contrast, Type 2 diabetes was initially more commonly seen in adults over 40. However, in recent years, it’s become increasingly prevalent in younger adults and even children as young as two. This form of diabetes is characterized by an inability of insulin receptors on cell surfaces to pick up glucose from the bloodstream. Rather than a lack of insulin, as seen in Type 1, there’s an excess of insulin as the pancreas pumps out more and more in a futile effort to regulate blood sugar. This form of diabetes is by far the most common.

(There is also gestational diabetes, and possibly Type 3 and Type 4 diabetes, but that’s a whole other column!)

Focusing on Type 2 diabetes: we know that the risk factors include a strong genetic predisposition, a sedentary lifestyle, and most importantly, obesity. Because it may appear that the ’cause’ of diabetes is excessive sugar in the bloodstream, it’s easy to see why many people believe in the simplified equation that sugar causes diabetes. However, as stated above, it’s a failure of the cells to remove the sugar from the bloodstream that causes this build-up of sugar, not excessive consumption.

So, sugar doesn’t cause diabetes.

Then why did I say “sort of maybe”?

Too much sugar consumption, including sweetened beverages, can contribute to obesity. (Photo Credit: Marlith)

Too much sugar consumption, including sweetened beverages, could contribute to obesity. (Photo Credit: Marlith)

Well, obesity is one of the major risk factors for Type 2 diabetes. And yes, it is possible that excessive consumption of sugar (especially in the form of sugar-sweetened beverages) can result in obesity. Obviously there are many factors contributing to the development of obesity, and every individual with obesity is going to have differing contributing factors to differing degrees. It is very possible that sugar could be one of those contributing factors.

To flesh it out further, my point is that sugar doesn’t directly cause diabetes, but it may be a factor in the development of obesity, which is a risk factor for Type 2 diabetes (there’s your yes, sort of, maybe). As a dietitian, I’d be remiss if I left you with that answer without providing some advice on how to lower your risk of developing Type 2 diabetes.

Clearly you can’t control genetic risk factors (yet), so let’s look at two important factors you can control: physical activity and weight. Despite what many gyms and personal trainers would have you believe, physical activity has minimal impact on weight loss. Physical activity and exercise are still extremely important in achieving and maintaining good health but you don’t have to go crazy. If you’re currently inactive, start small by taking the stairs whenever possible, parking far from the entrance of your local shopping mall, or just going for a walk.

walking

If you want to go bigger, check with your primary health care provider and consider signing up for fitness classes, swimming, running, weight training (this is where a personal trainer can be of great benefit), or whatever else you think you might enjoy. You want an activity you derive some degree of pleasure from because, if you’re hating every step of a run, it’s unlikely you’re going to stick with it.

As for weight management, if you’re not overweight nor obese, awesome! Maintain your weight. Of course, it is absolutely possible for people to be healthy and overweight. However, as obesity is a risk factor for many chronic diseases, including diabetes, you may wish to lose some of that weight. This is easier said than done. Remember, it took time to gain the weight, and it will likely take even more time to lose it. Unfortunately, there’s no one-size-fits-all, tried-and-true method for weight loss.

Most importantly, you should get in the kitchen. Preparing the majority of your own meals from minimally processed ingredients is key to good health and to weight loss (e.g. TV dinners and Hamburger Helper don’t count; pasta and frozen vegetables do). Don’t be ashamed to ask for help. Support from health care professionals and/or others attempting to lose weight can be invaluable to many people striving to take off pounds. Look for interdisciplinary weight management teams in your area, weight-loss support groups, and of course, registered dietitians. Even losing just a small percentage of your body weight can help lower your risk of developing Type 2 diabetes or help manage your blood sugar if you already have Type 2 diabetes.

For more information on diabetes and strategies to avoid and/or manage it, check out diabetes.ca (Canada) or diabetes.org (US).

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