By Suchitra Bajpai Chaudhary, Senior Reporter
Dubai: People diagnosed with diabetes continue to consume sugar according to a report released by Nielsen, seriously jeopardising their health as having sugar when blood glucose is already high can only aggravate the health of a diabetic.
The study that surveyed 400 diabetics in UAE, Saudi Arabia and Egypt — countries that feature among the top ten most prevalent countries for the disease — indicated that most of them preferred to have refined sugar in their daily diet despite the availability of a wide variety of sugar substitutes.
Dr Prakash Pania, specialist endocrinologist at the Aster Jubilee Medical Complex, Dubai, who treats a lot of diabetics, felt that was happening because of a common misconception.
“Many patients believe in a lot of myths that sugar substitutes cause brain tumours and other diseases, which has not been proven. The America Diabetes Association (ADA) recommends that it is safe for diabetics to have up to two to three satchets of sugar substitutes on a daily basis with no side effects.”
Dr Pania said that many patients continued to use not just sugar but jaggery or honey, all of which cause a sudden spike in blood sugar levels. A teaspoon of sugar may have approximately 16-20 calories, but for diabetics it is not just a matter of calorie counting as it is an issue of having food groups with a low Glycaemic Index (GI). A GI is a unit used to measure the speed at which the glucose from food is absorbed in the body.
“Simple sugars and refined carbohydrates have a high GI and get absorbed so fast that they cause a spike in blood sugar levels causing insulin to be produced rapidly. The higher the spike, the lower is the dip after it and this creates an erratic high and low cycle of insulin release in the body, causing complications in sugar metabolism,” he said
Dr Pania explained: “You can compare this to having Dh1,000 in your pocket as opposed to having the same amount in a fixed deposit. The amount in your pocket gets spent easily whereas you have to break a fixed deposit. Similarly, complex carbohydrates take efforts to be broken down and are absorbed slowly in the blood. In diabetics the insulin production gets lower over a period of time and, besides that, whatever level of insulin is present does not get absorbed easily by the cells as there is insulin resistance usually due to obesity. If diabetics continue to use sugar, their blood sugar levels continue to rise and the excess glucose binds itself to different molecules such as haemoglobin and nerves and blood vessels, damaging them. Accumulation of sugar damages the nerve endings in the eyes, the kidneys, and the heart, causing degeneration of the healthy tissue.”
Endocrinologists have warned that long-term damage from high blood glucose can include retinopathy, nephropathy, neuropathy, arteriosclerosis, stroke and coma, among other conditions.
Dr Pania also cautions that ignorance about the disease leaves it undiagnosed for a long time.
“Many times, patients come to us with damage to the optic nerve and then get diagnosed with high sugar. In such cases the degeneration has already set in. It is important for all diabetics to avoid direct sugar completely and opt for sugar substitutes. In any case all food eventually gets converted into glucose. So, diabetics must avoid direct sugar that will cause an unhealthy spike in sugar levels.
Opting for the healthier alternative
Juliot Vinolia, Clinical dietician and Consultant Nutritionist at iCare Clinics, Dubai, says patients usually avoid using sugar substitutes because of the metallic aftertaste and the fear of side effects. “But there are different kinds of sugar substitutes available in the market. These are chemical derivatives, those that are processed from sugar after isolating the sugar alcohols and the natural plant-based derivatives. Using these in moderation is fine (about two to three satchets) a day. However, she recommends the use of plant-based substitutes that, according to studies, not only improve the insulin receptors but act on the sugar digestion enzymes. “Besides, they are organic and whatever end product they produce is eaten up by the bacteria in our guts leaving no residue. The natural fibres in them makes their absorption slow.”She recommends that diabetics use sugar substitutes. “Even healthy people have sugar spikes immediately after a big meal. Using moderate sugar may not be such a bad thing, but most diabetics tend to have a cup of tea directly after a big meal. This means that when their bodies are already dealing with a spike in blood sugar why overload the system with direct and simple sugar. It is best to avoid direct sugar as cutting down on sugar completely will lead to better glycaemic control. If diabetics continue to have sugar despite high blood sugar levels, they will end up stressing their bodies