Here’s what you need to know about diabetes

Diabetes is a metabolic disorder that causes the body to either lack insulin production or not react to insulin. These reactions are caused by one of two things; production of insulin (Type 1 Diabetes) or resistance of insulin (Type 2 Diabetes). As you may know, Insulin is the key to allowing glucose to get into the cells and metabolize into energy. However, when the key doesn’t exist or doesn’t work, then glucose remains elevated in the blood, and leads to a crisis called diabetes.

It’s well-known, reducing intake of foods that contain glucose (carbs/sugar) causes blood glucose levels to remain low. However, we should address why insulin stopped working in the first place. The blame can be justifiably placed on two major culprits; inflammation (due to oxidative stress) and over-consumption of fructose.

Fructose is a sugar commonly found in fruit (which, is why the words sound alike!) and honey (source 1). A processed form of fructose is high fructose corn syrup. This is found in soda and many packaged foods. Yes, both soda and fruit have fructose! However, the major benefit of fruit is that it comes with fiber, antioxidants, phytonutrients, enzymes and much more! Don’t put these foods / beverages on equal playing fields. Importantly, fruit still wins!

A sugar lesson

To start, let’s do a little sugar lesson. Fructose and glucose differ in how they act in the body and what foods they are found in. See the chart below for a summary.

Monosaccharides (simple sugars):
Fructose: A form of sugar that goes directly to the liver and has a lower glycemic index—meaning it does not spike blood glucose. Sources: Fruits, honey, high fructose corn syrup
Glucose: Form of sugar used by the body for energy production. All carb sources are converted to glucose in the body.
Galactose: Found in mammalian milk.
Disaccharides
Lactose: Glucose + Galactose. Sources: dairy products, breast milk of mammals.
Sucrose: Glucose + Fructose. Sources: table sugar, beet sugar, some fruits.
Maltase: Glucose + Glucose. Sources: “malt sugar” and many processed foods.

 

While too much of any sugar is not a good thing, too much fructose is extra harmful for those with diabetes. Why?

Fructose

Fructose is the only sugar that goes directly to the liver and increases lipogenesis, also know as fat production (source 7). This, in turn, increases triglycerides and inflammation.  Both of these increase the risk for insulin resistance (source 6). Inflammation is the body’s way of healing. We experience healthy inflammation when we get a cut or when we exercise. However, chronic inflammation is a different issue. Chronic inflammation occurs when our body is exposed to inflammation for long periods of time. When this occurs, your body sounds a signal to the presence of disease (ie. Diabetes, cancer, autoimmune disease, heart disease, etc). Unfortunately, most of us do not observe the alarms and triggers our bodies send out, and sadly, disease is often diagnosed too late.

Inflammation in diabetes

What contributes to inflammation in diabetes? A few things:

  1. Elevated blood sugars / glucose on a regular basis.
  2. High triglycerides can impair pancreas secretion and increase insulin resistance (source 6)
  3. High oxidative stress / inflammation which affects the beta cells of the pancreas (source 3 and 4).
  4. Damage to the endoplasmic reticulum in the beta cells (source 5). This is worsened with too much insulin production.

 

An underlying factor to all of these contributions is nutrition – both quality and quantity. However, putting all the focus on lowering one’s A1c and blood sugar will only do so much. Equally, you MUST address inflammation!

How can you lower fructose consumption?

  • Reduce/remove any processed foods
  • Read labels and stick to foods that have 5 ingredients or less
    • Note that 4 grams of sugar = 1 tsp
  • Avoid foods with High fructose corn syrup in the ingredient list
  • Eat fruit instead of drinking it
  • Add cinnamon or liquid stevia to coffee/tea instead of sugar, honey, agave, etc.
  • Make dessert an occasional treat
  • Learn how to make healthier sweet treats with lower sugar content
  • Include plenty of ANTI-inflammatory foods

 

Resources:

  1. http://www.sciencedirect.com/science/article/pii/S0899900714001920
  2. http://diabetes.diabetesjournals.org/content/62/10/3307
  3. https://www.ncbi.nlm.nih.gov/pubmed/19805130
  4. http://ajpregu.physiology.org/content/298/5/R1343
  5. https://www.ncbi.nlm.nih.gov/pubmed/20924496
  6. https://www.ncbi.nlm.nih.gov/pubmed/15925013
  7. https://www.ncbi.nlm.nih.gov/pubmed/19381015/