Q: My brother-in-law has type 1 diabetes and says he cannot have any sugar at all. He doesn't understand how Diabetic Living recipes can use sugar as an ingredient. Can you settle the confusion?
A: The American Diabetes Association (ADA) recommends that sugar (sucrose) can be consumed by people with diabetes as part of their total carbohydrate count. This recommendation, first published in 1994, was a dramatic change from the old-school recommendation that guided people to avoid sugar. The recommendation changed due to research suggesting that sucrose and other sugars in foods do not have a greater impact on blood glucose levels than other sources of carbohydrates when eaten separately or as part of a meal or snack.
The current ADA guidelines suggest that your brother-in-law should be more concerned about the total amount of carbohydrates he consumes instead of the source. He also needs to be concerned about eating similar amounts of carbohydrates from meal to meal, unless he takes insulin several times a day and adjusts his doses based on the amount of carbohydrates he eats.
For people who need to lose weight and for those interested in eating healthfully, we recommend eating only small amounts of foods containing sugar because they may also be high in calories and fat. If your brother-in-law prefers to eliminate sugar for either health or blood glucose control reasons, that should be his decision.
Jeannette Jordan, M.S., R.D., CDE, is the American Dietetic Association's national spokesperson for African-American nutrition issues and oversees nutrition education at the Medical University of South Carolina.