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Sugar-Free With Diabetes

Sugar-Free With Diabetes
By Dr. Janet Starr Hull

Diabetes may be a common disease these days, but it is still misunderstood.  Most people think diabetes is simply a disease that means you just can’t eat sugar. The artificial sugar industry markets fake sugars as totally harmless to the diabetic, and tempts them into believing they can eat and drink all they want by “tricking” their bodies. But what works for one person may not work for another. What makes this matter even more difficult to understand: diabetes is just a little bit different for every diabetic.  This is why no one artificial sweetener company can truly make a blanket statement that their product is “safe for diabetics.” 

If you have diabetes, to determine your correct amount and type of medication and/or insulin you need, your doctor must individualize your case of diabetes. Whether Type I or II, every diabetic is different. Treating diabetes is not like setting a broken leg where the procedure to cast the bone is the same for everyone - every case of diabetes should be treated uniquely.  There is no standard unit of insulin for every Type I diabetic, no standard dose of medication for every Type II diabetic, and some diabetes can be controlled with diet alone. Even for those on insulin, there is not just one type of insulin nor just one regimen for taking it.  Many insulin-dependent diabetics take more than one kind of insulin during a single day. In the same way they require and respond to medication and insulin differently, diabetics respond to foods differently. And diabetics react to chemical sweeteners differently!

As delicate as diabetes is, how, then, can diet chemical sweeteners be safe when a person with diabetes requires such precise chemical management? 

Diabetes is a disease that interferes with the way the body uses food. For those of us who do not have diabetes, we take for granted that our bodies properly digest carbohydrates (sugars and starches) and easily changes them into glucose (blood sugar), one of the body's major sources of energy.  After twenty years of aspartame use, it seems apparent that artificial sweeteners are not the answer for diabetics with a sweet tooth. Why, you ask? Read on…

Basically, diabetics need tools for self-help – the proper tools, that is!  Today, “sugar-free” marketers attempt to convince diabetics that life cannot go on without “sweets”, and artificial sweeteners are the answer. But diabetes survived long before the sugar-free frenzy, and the number of diabetics merely twenty years ago was much fewer than today. So, take control of your diabetes and get control of your life by making a few lifestyle changes such as eating healthier foods (minus the sugar free), drinking plenty of pure water, and maintaining regular exercise.  These changes may make living with diabetes much easier and put YOU back in control of your life rather than diabetes controlling you.

Don’t lose heart. Having diabetes doesn't mean that you have to give up the things that are important to you such as enjoying a good meal, working, sport activities, or having children. With planning, even travel can be easy and relatively carefree. Those with diabetes do have to be more conscientious about eating and taking medication at regularly scheduled times, and many times may need to educate their friends and family on the nature of diabetes and the treatments necessary to maintain a stable blood sugar level.        

Can Chemical Sweeteners Interact With Insulin? The manufacturers for the various sugar-free products market their diet sweeteners as completely safe for diabetics. But, their clinical studies represent merely a fragment of the diverse effects chemical sweeteners can have on diabetic individuals, particularly Type I diabetics. An important point that is overlooked: it is vital to monitor chemical sweetener interactions with the various types of diabetic medications.

There are many different types of medications and insulin for the many different types of diabetes. For example:

• One medication helps control insulin production, while another regulates insulin resistance, and yet another helps the body use its insulin more efficiently.
• When using Glucophage®, a popular medication for non-insulin diabetics, it is recommended to have your liver checked every three months.
• There is short-acting insulin (used primarily after meals to help process the food) and long-term insulin (regulates blood sugar throughout the day without the need for short term insulin). 
• Some diabetics need both short–acting insulin after meals and long term insulin morning and night, and there is more than one kind of long-acting, and more than one kind of short-acting insulin.  Question: if all diabetics are the same, why are there so many different kinds of medication to treat it?
• The insulin pump constantly delivers throughout the day short-acting micro-doses of approximately one-tenth a unit of insulin, and all pumps don’t use the same type of insulin.

So let me stress again: it is vital to monitor chemical sweetener interactions with the various types of medications, and no one can assume artificial, chemical sweeteners will react the same in individuals with diabetes.

Net Carb Alert For Diabetics!

“Net carb” is a new catchword these days for people watching their carbs.  It means that the carbs from fiber don’t count in your total carb intake, which is a good thing for the weight conscious consumer, but it doesn’t work the same for a diabetic. “Net carb” means something different, and so do the carbs from fiber. (To determine the net carbs, take the total carbs and subtract the amount of fiber.) Diabetics must monitor the “total carbs” in packaged products.

A carb is a carb is a carb to a diabetic. It doesn’t matter if it’s a fiber carb or a sugar carb. And, there is a difference between longer acting carbs (complex sugars and starches) and short response carbs (simple sugars and refined grains), and the impact they have on diabetes. Let’s say you have a choice to eat a piece of cake (a simple carb) versus a sandwich on soy-based, whole grain bread (long-acting carb). Choose the sandwich, of course, because the “total complex carbs” will have less harmful glucose effects on your body.

As a diabetic, “net carbs” may affect blood sugar much like a carb load. Many diabetics use “net carb” products as high protein and in-between-meal snacks, thinking they are eating less “total carbs.” The result, these products may require you to take more insulin because your blood sugar can spike. So, keep in mind that “net carb” products actually contain more carbs than most diabetics have in one meal. Read your labels carefully and plan your meals in a good way, but remember to watch out for the supplemental products full of “net carbs.”

The goal of diabetic management is to keep blood glucose levels as close to normal as safely possible, reducing the risk of developing major complications. With this in mind, why take the risk of jumbling your immune system with toxic chemicals  - methanol in aspartame – chlorine in sucralose – methylene chloride in acesulfame K?  Ideally, researchers search for less harmful drugs to aid the diabetic.  Why, then, do we promote more toxic food chemicals for the diabetic’s diet?

What Do The Sweetener Corporations Say About Diabetes? The corporations typically default safety issues to research studies, and as you are discovering, those studies are corporate-funded and are generally re-run, re-adjusted, and re-calibrated until they “pass” FDA approval standards. Here’s a good example: a small independent study of diabetic patients using sucralose resulted in a significant increase in glycosylated hemoglobin (Hba1C), which is a marker of long-term blood glucose levels used to assess glycemic control in diabetic patients.  (Translation: blood sugar increases were observed from sucralose use in diabetics.)

The FDA reviewed the study, and responded with: “…increases in glycosolation in hemoglobin imply lessening control of diabetes.”  (Translation: from this study, they agreed with the apparent results that sucralose raised blood sugar levels in the diabetic control group.)

Because of the small patient group size of this study, however, McNeil Nutritionals defended that the clinical significance was not determined, so the FDA suggested more research, which McNeil did.  The studies were modified from the original tests performed, and it was eventually determined that sucralose at lower doses were safe for diabetics.  But, the tests were not the same. As stated in the FDA Final Rule report relating to the final studies performed: “Serum insulin levels were not measured in this (subsequent) study.” ¹

So, do the original tests showing increases in serum glucose levels be thrown out completely? Does this mean all negative results be discarded and retested until a positive corporate result is achieved? So what does safety testing really mean?  So, can all people with diabetes safely use SPLENDA® No Calorie Sweetener? “Yes” the corporations say. “Numerous studies have shown that SPLENDA® Brand Sweetener, or sucralose, is suitable for people with diabetes,” they state.  Why is it safe?  Well, they claim: “Sucralose is not recognized by the body as sugar or as a carbohydrate, so it is not metabolized by the body and does not affect blood glucose levels. Sucralose has no affect on carbohydrate metabolism or insulin secretion. Foods and beverages sweetened with SPLENDA® Brand Sweetener can provide good-tasting, lower-calorie alternatives for people with diabetes who are interested in reducing their calorie or sugar intake.”

Most people with diabetes will tell you it’s really not that simple.  Diabetics work hard to maintain control of their blood sugar levels.  If you’re diabetic, your doctor more than likely recommends you test your blood sugar at least four times every day. If you are insulin dependent, you take, on average, from one to three shots of insulin every day.  Your doctor probably recommends that you eat three carefully regulated meals plus three snacks daily.  If you are ill, you test your blood sugar more frequently. If you exercise, you must eat extra food so you won’t have a low blood sugar reaction. If your blood sugar strays from your target goal, you must adjust your medication. Even with discipline, maintaining control of diabetes can be difficult. Without discipline, it is impossible.

Sugar-free chemical products can be dangerous for diabetics for many obvious reasons, and popping open a can of diet cola throughout your day isn’t what I recommend as a wholesome diet for the average diabetic.

Most nutritionists agree that artificial sweeteners trigger cravings for sweet treats, making it difficult to diet or control blood sugar. But don’t forget that artificial sweeteners substitute a non-nutritive food, for foods that have vitamins and other nutrients - for example, a muffin made with Splenda may have the same number of carbs as a carrot, but the carrot is better for you.

Are Diet Sweeteners An Overload For The Diabetic? The American Diabetes Association Joslin Diabetes Center says no. They recommend artificial sweeteners and the sweetener blends as safe for diabetics, stating:

“Artificial sweeteners make food taste sweet but they have no calories and do not raise blood glucose levels. They do not count as a carbohydrate, a fat, or any other exchange.

Artificial sweeteners can easily be added to your diet, and are very useful for people with diabetes. However, you should not depend entirely on foods made with artificial sweeteners.

The American Diabetes Association approves the use of these four artificial sweeteners in moderate amounts:

• Aspartame (NutraSweet, Equal)
• Acesulfame Potassium (Sweet One)
• Saccharin
• Sucralose (Splenda)”

As the market for sweeteners expands, the sugar industry is not suffering, according to Pierre Wursch from the Nestle Research Centre in Lausanne, Switzerland. The market will widen much further with the advent of new sweeteners. The “new generation” will enable the food industry to produce more and more artificially sweetened baked goods - cakes, biscuits and breakfast cereals, for example.

If these sweeteners are really safe for diabetics, then why has diabetes reached all-time epidemic highs, and at younger and younger ages? Apparently, artificial sweeteners are not the solution.

References

1. Federal Register. Vol. 63. No. 64. Rules and Regulations 16417-16433. Friday. April 3, 1998, age 16426, paragraph two.

Posted on February 7, 2005 in Diabetes | Link To This Entry | Comments (10)

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