Does Sugar Cause Diabetes?

November 14 is World Diabetes Day and November is Diabetes Month in both the United States and Canada. 

Diabetes is a condition that affects approximately 1 out of every 11 people worldwide and up to 50% of those living with diabetes don’t know that they have it. 

Diabetes reduces immune response and increases risk of heart attack and stroke. It can result in eye damage, kidney failure, nerve and blood vessel damage, gum disease, wounds, and amputations. BUT, these complications can be PREVENTED with appropriate management.

This month I will be doing a series of posts that will cover:

- What diabetes is
- Risk factors

- How diabetes affects women specifically
- Key factors in management
- Diabetic foot and wound care to prevent amputation

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WHAT IS DIABETES?

When we eat food, our body breaks down the carbohydrates ("carbs") into a sugar called GLUCOSE. Carbohydrates are just the sugars, starches, and fibers present in most foods that we eat. Carbohydrates are not "bad" in and of themselves. Complex carbohydrates (such as whole wheat, oats, high-fiber fruits and vegetables) take longer to break down than simple carbohydrates (table sugar, milk, white flour), helping the body to avoid sugar spikes.

Glucose is used by our cells for fuel (like gas for your car). Normally our body produces a hormone called INSULIN that helps the glucose get into the cells where it can be used for energy. Think of it like the key to unlock the cell door. Without the key, you can’t get in.

Diabetes is a condition where the body is unable to bring the glucose into the cells, which results in increase glucose circulating in your blood. This is called “high blood sugar”. 

So the answer to the title question is NO, sugar does not CAUSE diabetes. But a diet that is generally high in sugar, combined with genetic predisposition, and not enough physical activity are all contributory factors to the development and progression of the condition, particularly type 2 diabetes. 

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THERE ARE 3 MAIN TYPES OF DIABETES:

Type 1 diabetes is an autoimmune condition where the body attacks the cells that make insulin. Since there is no insulin available to bring glucose into the cells, people with this condition need to take insulin everyday. This condition is typically diagnosed children or young adults and for this reason it used to be called “juvenile diabetes”. 

Type 2 diabetes is the most common type. In this condition, the body either does not produce enough insulin or the body does not respond to the insulin that is present. It is typically diagnosed in older adults, although in recent years lifestyle factors have resulted in a sharp increase in children and young adults with this condition. Diet, genetics, and physical activity all play a big role.

Gestational diabetes is something that occurs in some women during pregnancy. While usually temporary, it can increase the risk of type 2 diabetes later on for both mother and baby. If you have ever been pregnant and had to drink the super sweet orange liquid, this is the condition they are testing for. This test can help to show how your body tolerates a large dose of sugar. In fact, it is normal during pregnancy to have slightly increased blood sugar because it helps ensure that the developing fetus gets enough. In some women, something goes wrong with this process, resulting in gestational diabetes. 

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SO WHY DOES THIS MATTER?

High levels of sugar in the blood causes damage to blood vessels and nerves. Imagine the blood being like a thick, sticky maple syrup vs a thinner, free-flowing liquid. 

This damage occurs slowly over time, which is why it can be dangerous and difficult to control. By the time a person with diabetes has started to lose their sight or feeling in their feet, they have likely had many years of high blood sugar levels, causing damage throughout their body. This is why REGULAR BLOOD SUGAR MONITORING is so important. Most people do not experience any symptoms when their blood sugar is too high. 

While diabetes in WOMEN is slightly less common than in men, women (and those with female sex hormones) have SPECIAL considerations related to hormonal differences that can impact diabetes. This is covered here in a separate post about Women & Diabetes.

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RISK FACTORS FOR TYPE 2 DIABETES:

1) Diagnosis of prediabetes, insulin resistance, or polycystic ovary syndrome (PCOS)

2) 45 years or older

3) Overweight, especially in the stomach area

4) Limited physical activity (typically less than 3 days per week)

5) Have a parent, brother, or sister with type 2 diabetes

6) History of gestational diabetes OR gave birth to a baby larger than 9 lbs

7) Are Black, Hispanic, Latino, Native/Indigenous, or Pacific Islander

8) High or chronic psychological stress (especially for women)

Do you think you may be at risk for type 2 diabetes? TAKE THIS QUIZ

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SIGNS & SYMPTOMS OF DIABETES:

1) More thirsty than usual or expected based on activity
2) Peeing more often than usual 

3) More hungry than usual
4) Constant feelings of tiredness or low energy
5) Blurred vision
6) Unexplained weight loss
7) Burning, tingling, or numbness in toes or feet
8) New or worsening gum disease or other oral health issues
9) Frequent or recurring infections
10) Wounds or cuts that heal slowly or not at all
11) Dark skin patches, especially in armpits or groin

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PREVENTION

1) Limit sugary foods and refined carbohydrates (such as white bread, white pasta, white rice). Identifying the best carbohydrates can be tricky so be sure to work with a dietitian, nutritionist, or knowledgable healthcare provider when altering your diet.

2) Get regular physical activity. At least 20 minutes most days of the week. Depending on your situation, you will likely benefit from more. Discuss this with your healthcare provider.

3) Water should be your beverage of choice. Sugary drinks should be avoided.

4) Optimize vitamin D levels through natural sunlight and dietary sources. Supplements, while sometimes necessary, are not the best source of vitamin D. Discuss your vitamin D levels and options with your healthcare provider.

5) Maintain a healthy weight. If you are overweight, make a plan with your healthcare provider to lose weight in a healthy manner. Don't jump on a fad diet that promises quick results at the expense of health.

Here are some resources to help prevent diabetes and its complications:

If you are in the United States, this website allows you to enter your zip code and will locate a Diabetes Prevention Program in a community near you: https://nccd.cdc.gov/DDT_DPRP/Programs.aspx.

If you are in Canada, you can find local Diabetes Prevention resources here: https://www.diabetes.ca/diabetes-prevention-program.

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FOR MORE INFORATION:

World Diabetes Day: https://worlddiabetesday.org

International Diabetes Federation: https://idf.org

American Diabetes Association: https://www.diabetes.org

Canadian Diabetes Association: https://www.diabetes.ca 

NEXT POST: Women & Diabetes