In 1980, the World Health Organization estimated that there were 108 million people with diabetes. By 2021, the International Diabetes Federation database reported 537 million people with diabetes between the ages of 20 and 70, with projections of 643 million by 2030 and 783 million by 2045 (IDF Diabetes Atlas).
Myth: Eating sugar causes diabetes.
Diabetes is a disease in which the level of sugar in the blood, known as glucose, is too high. This glucose comes from the food we eat and is the body’s primary fuel. Normally, the body produces a hormone called insulin in the pancreas, which helps transport glucose into cells so it can be used for energy. In people with diabetes, however, either not enough insulin is produced (type 1 diabetes, insulin-dependent or juvenile diabetes), or the body does not use insulin properly (type 2 diabetes). As a result, sugar remains in the bloodstream, which can cause serious long-term health problems, affecting organs such as the eyes, heart, kidneys, and nerves.
The importance of carbohydrates in the body
Sugars, also known as carbohydrates, are essential for the body’s functioning. They provide the energy we need for our daily activities. Beyond this, some carbohydrates have structural roles: they are “building blocks” that contribute to the formation of certain tissues and protect cells as an integral part of cell membranes. They also play an essential role in certain cellular reactions and in the process of cellular “respiration,” that is, the way cells use oxygen. When we eat foods containing carbohydrates, they are ultimately broken down into glucose, the sugar our bodies use most efficiently as a source of energy. Insulin, a hormone produced by the pancreas, helps transport glucose into cells to be used for energy, while excess glucose is stored in the liver as glycogen, ready to be used when we need an additional source of energy.
Types of carbohydrates in the diet
Sugar is present in foods in the form of simple and complex carbohydrates. Simple carbohydrates are digested quickly, providing an immediate source of energy in the form of glucose. They can be divided into added sugars and naturally occurring carbohydrates. Added sugar provides calories without supplying vitamins, minerals, or fibre. By contrast, naturally occurring carbohydrates found in fruits, vegetables, seeds, and grains are accompanied by vitamins, minerals, and fibre. Excessive consumption of added sugar (free sugar), in particular, causes significant metabolic imbalances and is the most harmful to health. Processed foods such as candy, soft drinks, syrups, and breakfast cereals are often major sources of added sugar.
Complex carbohydrates are an excellent source of energy. In contrast to simple carbohydrates, they are digested more slowly, resulting in a gradual release of glucose into the bloodstream. These carbohydrates are found in foods such as starchy vegetables (potatoes, peas, squash, and corn), whole grains, and brown rice.
According to Diabetes UK, the maximum recommended daily intake of sugar for an adult is 30 g, equivalent to approximately seven teaspoons. One teaspoon of ketchup contains one teaspoon of sugar, a chocolate biscuit contains two teaspoons of sugar, and a small serving of baked beans is equivalent to almost three teaspoons of sugar (Diabetes UK). This shows how easily we can reach the equivalent of no fewer than six teaspoons of sugar.
The relationship between sugar and diabetes
When we consume foods high in sugar, including those containing complex carbohydrates, the pancreas responds by releasing insulin, which helps transport and process sugar to produce energy. Excessive carbohydrate consumption can lead to a higher calorie intake, and surplus calories are converted into and stored as fat, contributing to weight gain and, potentially, obesity.
If this becomes a habit, the pancreas is placed under strain, as it is required to produce insulin continuously. Over time, this excessive insulin secretion can cause the body to become insulin resistant, meaning that cells can no longer use glucose from the bloodstream efficiently. This is a step toward elevated blood sugar levels, or hyperglycaemia. Chronic hyperglycaemia and the resulting metabolic disturbances disrupt the body’s internal balance. Once this imbalance becomes chronic, it creates favourable conditions for insulin resistance syndrome (metabolic syndrome)—a condition characterised by the presence of at least three of the following: elevated blood glucose, high triglyceride levels, low HDL cholesterol, abdominal obesity, and high blood pressure. This syndrome increases the risk of developing diabetes, heart disease, and stroke. In the United States, 1 in 3 adults has at least three of the symptoms of metabolic syndrome. How many do you have?
References
- “Carbohydrates”, in American Heart Association (online), available at https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/carbohydrates [accessed on 29 October 2023].
- “Diabetes”, in World Health Organization (online), 5 April 2023, available at https://www.who.int/news-room/fact-sheets/detail/diabetes [accessed on 29 October 2023].
- Diabetes UK – “Sugar and diabetes”, in Diabetes UK (online), available at https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/food-groups/sugar-and-diabetes [accessed on 29 October 2023].
- IDF Diabetes Atlas – “Diabetes around the world in 2021”, in IDF Diabetes Atlas (online), available at https://diabetesatlas.org [accessed on 29 October 2023].
- Scientific Advisory Committee on Nutrition (2015), Carbohydrates and Health, TSO, London, available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/445503/SACN_Carbohydrates_and_Health.pdf [accessed on 29 October 2023].
- “What is metabolic syndrome?”, in National Heart, Lung, and Blood Institute (online), available at https://www.nhlbi.nih.gov/health/metabolic-syndrome [accessed on 29 October 2023].