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The sugar thieves

BY KAREN FLANAGAN, MA, RD, CDE

Do you know any sugar thieves? Those well-meaning people who steal your real sugar and replace it with stevia, saccharin or other substitutes?

I think about one Thanksgiving a few years ago. There was a huge table filled with pies, cakes, candy and cookies—straight out of Willy Wonka's dream. The smell alone made my mouth water.

Next to that table was a smaller one with sugar-free apple pie, cookies and gummy bears, just for me. While it was extremely thoughtful and considerate of my diabetes, well, YUCK! I choked down a dry cookie and watched the others enjoy their desserts. Out of politeness, I ate some gummy bears, hoping the sugar alcohol-induced diarrhea wouldn't hit till after I got home. 

It's been over a decade since the experts announced that sugar is not our enemy. So why won't people believe it?

Most people don't understand that there are carbohydrates in sugar-free foods, too. It doesn't matter where the carbohydrate comes from. If you're on an insulin pump, you adjust your insulin to the amount of carbohydrate you eat. Instead of adapting our lives to food, we can adapt insulin to fit the situation.

For example a regular chocolate chip cookie has approximately 26 grams of carbohydrate in it. A similar sugar-free cookie has about 20 grams. Real apple pie has about 40 grams of carbohydrate per serving, and the sugar-free variety has about 37. A slice of yellow cake with frosting has about 40 grams of carbohydrate while the sugar-free version still delivers about 28 grams. The sugar-free ones are not free foods.

Why? Carbohydrates come from many sources, not just sugar. Sugar alcohols (usually ending in -tol, such as malitol, xylitol and sorbitol) have fewer calories than sugar, but often aren't as sweet. It takes more to get the same sweetness, making the carb count rival table sugar. And many carb-free sugar substitutes can't be used in cooking. Higher-carb options are used instead.

Whatever you choose to eat, remember that it's not the amount of sugar or where carbs come from that affect the overall rise in blood sugar. It's simply is the amount of carbohydrate. (Although the source of the carb may impact how quickly blood sugar rises.)

Show your friends that one healthy, sugar-free baked potato has approximately 29 grams of carbohydrate, while a sandwich cookie provides about 8 grams. Amazing!

And remember that even if the source of carbohydrate doesn't matter to your blood sugar, it will to the rest of your body. Carbohydrates, like everything you eat, should come from a variety of foods. One cannot live on cookies alone. Carbohydrates from whole grains, beans, fruits and dairy offer more essential nutrients, vitamins and minerals. Everyone, diabetes or not, should follow that rule.

Carbohydrate counting is a great tool to help control your diabetes. Combined with pumping, it can make your life and meals much more flexible and enjoyable. We need to educate the sugar thieves. Next year, I will be bringing desserts to Thanksgiving dinner. I already have a few new recipes in mind—and nothing will be sugar-free!

Karen Flanagan is a registered dietitian and certified diabetes educator who previously worked with pump users through Roche Diabetes Care. She has been wearing an insulin pump since 1992.

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