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Sugar is often portrayed as a villain or main culprit when the topic of diabetes comes up.

While sugar does play an important role in the context of this condition, several misconceptions exist about people with diabetes being able to consume sugar.

People with diabetes can eat food and drink beverages that contain sugar. But just like everything, moderation is key.

This article will give you more information about the role that sugar plays in diabetes and glucose management, and how to approach it in appropriate and balanced ways.

Clinical guidelines or recommendations about anything, including sugar consumption by people with diabetes, are just that: guidelines. They are meant to guide many people to stay as healthy as possible.

Expert opinions differ on how much sugar is recommended each day.

  • The World Health Organization (WHO) recommends that only 5 to 10% of your calories be from added sugars, or “free sugars.”
  • In the United States, that recommendation is the same, according to the Dietary Guidelines for Americans. That translates to 12 teaspoons per day when following a 2,000-calorie diet.
  • However, the American Heart Association advises limiting sugar to 6% of total calories per day. That means a limit of 7.5 teaspoons per day for a 2,000-calorie diet.

The Centers for Disease Control and Prevention (CDC) mentions that the average intake of added sugars was 17 teaspoons per day — or 19 teaspoons for men and 15 teaspoons for women — for Americans ages 20 and over in 2018.

If you’re used to eating a lot of sugar, you may want to reduce your intake to help manage blood glucose levels and keep them in target range.

Carbohydrates count, too

Calories and sugar are not the only things that matter when looking at a nutrition label. Carbohydrates are just as important for people with diabetes.

It’s important to keep in mind that carbs break down into sugars. So just because you see “no sugar” on a nutrition label, that doesn’t mean it’s free of any blood sugar effect. Carbs impact glucose levels just like forms of sugar do.

The American Diabetes Association does not recommend a specific daily carb limit for people with diabetes because it’s so individualized. However, the average American diet contains about 250 grams of carbs per day, and that’s too high for most people with diabetes.

If you decide to try carb counting, you’ll need to know the total grams of carbs in the foods or drinks you’re planning to consume and have a reasonably accurate estimation of the serving size.

One carb serving contains about 15 grams. However, a carb serving might not match what you’d normally consider a serving of food, so you’ll need to carefully balance carb servings and serving sizes.

You can learn more about carb counting here.

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Of course, everyone is different. Your weight, activity level, nutritional needs, and your body’s reaction to factors that affect your blood sugar levels will differ from those of another person with diabetes.

You and your diabetes care team should discuss your situation, including your history of managing your blood sugar levels, to determine how much sugar you can eat in a typical day. This can vary, too, depending on what type of diabetes you have and any medications you take.

Some people may worry that eating sugar will lead to diabetes, but diabetes is much more complex. Plus, your body does need some sugar to function. According to the National Institutes of Health, one type of sugar called glucose is an important source of fuel for your body and your brain.

The sugar in your body comes, in part, from carbohydrates. After you eat, your body breaks down the food you eat as you’re digesting, which sends glucose into your bloodstream.

Simple carbohydrates like candy or fruit break down quickly, sending a quick burst of sugar into your bloodstream. More complex carbohydrates like pasta break down more slowly and deliver a steadier dose of sugar over time.

If you don’t have diabetes, your pancreas will respond to the influx of sugar by releasing a hormone called insulin, which works to move that sugar out of your blood and into your cells to use as fuel.

However, if you have diabetes, your pancreas may not respond by producing enough (or any, in some cases) insulin to do the job. The sugar can build up in your bloodstream, which can eventually damage your blood vessels and cause other complications.

Different types of diabetes

Here’s what to know about each of the main types of diabetes:

  • Type 1 diabetes (T1D): This autoimmune condition is when your pancreas is no longer able to produce any or enough insulin to help you naturally regulate your blood sugar (glucose) levels. You must take insulin (injection, insulin pump, inhaled) so your body can move the glucose into your cells from the bloodstream for energy. Roughly 5% to 10% of people with diabetes have this type.
  • Latent autoimmune diabetes in adults (LADA): Sometimes known as type 1.5 diabetes, this is another name for type 1 diabetes diagnosed in adults.
  • Type 2 diabetes (T2D): Those with T2D have developed a resistance to insulin, so it doesn’t work efficiently to move sugar from the bloodstream into your cells. Over time, your pancreas may also stop producing insulin. While many people use lifestyle measures (diet, exercise) to manage their T2D and keep blood sugars steady, many also take medications (like insulin or metformin) to manage their condition. T2D is the most common form, with roughly 90% of people with diabetes living with this type.
  • Gestational diabetes: Some people develop diabetes during pregnancy, which often requires them to take insulin until delivery.
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It’s a common misconception that people with diabetes need to give up sugar and go sugar-free for the rest of their lives.

In other words, yes, people with diabetes actually can still eat sugar. They can eat foods with added sugars and also other foods containing carbohydrates that get broken down into sugar inside the body.

People with diabetes need to be careful about how much sugar they consume. The key word is “moderation,” according to the Association of Diabetes Care and Education Specialists.

Addressing diabetes stigma

No one chooses to have diabetes — regardless of the type. Food choices and lifestyle habits can play a part in developing type 2 diabetes, but science is also clear that genetics play a part in the development of this condition.

The most common diabetes stigma is the perception that people with diabetes are responsible for developing diabetes. Eating too much sugar does not directly cause diabetes.

Stigmatizing people by mentioning they are “eating too much sugar” or taking other actions to cause their diabetes can be damaging to that person’s mental health. A 2020 study shows a link between stigma to symptoms of depression, anxiety, and distress.

You can consider joining the American Diabetes Association’s online support community or visit diaTribe’s dStigmatize page for more information and resources.

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Limiting sugar content overall is a smart choice. A few commonly recommended strategies include:

  • Try eating smaller portions to reduce your daily calorie count.
  • Eat a variety of foods, including vegetables, fruits, grains, and low fat dairy, to get the most nutritional bang for your buck.
  • Choose foods with lower amounts of fat.
  • Watch out for highly processed foods, which may contain a lot of added sugars.
  • Limit sugar-sweetened beverages. Instead, try substituting with a lower sugar option or choosing water more often.

You can also learn how to count carbohydrates. Many people with diabetes count carbs to help them keep track of what they’re eating so they can manage their blood sugar levels better.

According to the CDC, if you are overweight, you may help reverse prediabetes and delay or prevent type 2 diabetes by shedding 5% to 7% of your body weight. As this is not the only way to prevent type 2 diabetes and it may not be necessary for everyone, it’s best to speak with your doctor first.

If you have diabetes, you don’t have to resign yourself to a life without sugar. But you do need to be mindful of how much sugar you consume and how it affects your ability to control your glucose levels.

This includes not only sugary sweets but beverages and anything with carbohydrates, as those convert into sugar in your body. Your diabetes care team can help you design a plan that helps you achieve a healthy balance.