Diabetes Misconceptions

Let’s Debunk A Few!

Let’s talk about some common misconceptions about nutrition and people living with diabetes.
Here are a few that we often come across:

People living with diabetes should avoid all sugar
While it’s true that eating sugar results in increased blood sugar levels, that doesn’t mean that sugar has to (or should) be avoided! Glucose, one of the most abundant simple sugars, is our body’s preferred energy source. It’s found not only in countless foods, but our bodies also can create glucose through a process called gluconeogenesis. Our blood sugars change throughout the day as a normal bodily process – our blood sugar is expected to rise and fall as we eat, exercise, and release various hormones like insulin. Those living with diabetes don’t need to avoid sugar, and it’s not anyone’s job to police them. People living with diabetes learn how sugar-containing foods and different food combinations impact their blood sugar. This is an individual process and the central tenet of patient self-management.

Diabetes-friendly foods are always better for you options :
There are loads of food products labeled “sugar-free” or “diabetic-friendly.” Becoming an informed consumer who can read the front of package labeling and the nutrition facts panel on the back will place you in a position to make choices that support your individual needs and desired outcomes. In short, make the choice that works for you, and don’t rely solely on front-of-packaging health claims.

Carbohydrate literacy is key: understanding the types of carbohydrates
Carbohydrates come in many forms, and all have different effects on blood sugar! Some people experience less of an increase in their blood sugars when they eat lower glycemic index foods. For many, eating refined carbohydrates, like white bread and rice alone, tends to have a higher glycemic index and cause a larger increase in your blood sugar. When combined with fiber-rich foods like beans or collards, there tends to be less of a rapid increase in blood sugars. More complex carbs like those found in non-starchy vegetables and legumes often result in less of a rapid elevation in blood sugars. Learning the combinations that work for you is key.

Carbohydrates are the only thing that affects blood sugar:
Because glucose is our number one energy source, our bodies have the awesome ability to create glucose from other food building blocks in a process called gluconeogenesis. One important building block of gluconeogenesis is protein! So as odd as it sounds, eating tons of protein may encourage excess gluconeogenesis and elevate your blood sugar. And, because you’re not consuming many carbs, you may not even think to take your blood sugar levels! This would be an example of a situation where consuming a meat-centric pattern of eating may not serve you.

Artificial sweeteners are always a better choice:
Artificial sweeteners, also known as sugar substitutes (Saccharin, Sucralose, Neotame), are found in many products for those with diabetes. While these sugar substitutes don’t raise blood sugar, some research has found that they may alter normal metabolic processes, change the gut microbial makeup, and may lead to food cravings. Making an informed choice where and when possible is always supportive. Non-nutritive sweeteners can add a depth of flavor and texture to a dish while not significantly impacting blood sugar levels.

Here are some of our guiding principles:

• Create a plate that works for you: Rather than centering your meal on specific nutrients, emphasize creating and consuming a variety of flavorful nutrient-rich foods. This can help not only support our blood sugar levels but also our relationship with food and eating. After all, we eat food, not nutrients.
• Mindful eating (when possible): This will resonate with some and not others. Take all, a portion, or nothing at all. When possible, carving out the space and time to enjoy the process of eating, and savoring the food can determine the satisfaction and experience of eating. It helps us bring awareness to the physical and emotional sensation of eating, allowing us to eat and feel comfortably full.
• Individualization is #1: Following a generic meal plan is a recipe for, well, disaster. Everybody eats differently and eating means something different to everybody! Working with food and nutrition professionals (like us) can support you in developing a pattern of eating that is centered on your values and preferences.
• Reframing monitoring: Monitoring blood sugars for many is something that happens daily. We understand that people have different experiences with the process. One way of thinking that may resonate is to think of self-monitoring as an exploration to understand how different foods and food combinations affect your blood glucose.
• Emphasize Nourishment: Eating enough and regularly is at the core of level blood sugar. Becoming a savvy shopper who can utilize the entire grocery store from the center to the perimeter allows you to build a fridge and pantry filled with variety and flavor.

People living with diabetes can and should enjoy a wide variety of foods. Adopting a flexible and inclusive approach to nutrition, nutrient-dense foods, affordable, accessible, culturally relevant options, and making meaningful modifications based on individual needs and preferences is supportive of creating an eating pattern for the long term. Working with a registered dietitian who considers the whole person and their needs when creating nutrition plans can be invaluable in developing a personalized and sustainable nutrition plan for diabetes self-management.

Sources

1. Yang, Q. (2010). Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010. Yale Journal of Biology and Medicine, 83(2), 101.
2. Christofides EA. POINT: Artificial Sweeteners and Obesity-Not the Solution and Potentially a Problem. Endocr Pract. 2021;27(10):1052-1055. doi:10.1016/j.eprac.2021.08.001
3. Yunker AG, Alves JM, Luo S, et al. Obesity and Sex-Related Associations With Differential Effects of Sucralose vs Sucrose on Appetite and Reward Processing: A Randomized Crossover Trial. JAMA Netw Open. 2021;4(9):e2126313. doi:10.1001/jamanetworkopen.2021.26313