06/05/2023
TYPE 2 DIABETES
NUTRITION
Evidence Based
Does Sugar Cause Diabetes? Fact vs Fiction
By Erica Julson, MS, RDN, CLT on September 18, 2018
Diabetes
Metabolism
Sugar's Role
Natural Sugars
Artificial Sweeteners
Since diabetes is a disease characterized by high blood sugar levels, many people wonder whether eating sugar can cause it.
While it’s true that eating large amounts of added sugar may increase your risk of diabetes, sugar intake is just one piece of the puzzle.
Many other factors — including overall diet, lifestyle and genetics — also impact your risk.
This article reviews sugar’s role in developing diabetes and provides tips for preventing the disease.
What Is Diabetes?
Diabetes occurs when your body is no longer able to effectively regulate blood sugar levels.
This can happen when your pancreas stops producing enough insulin, when your cells become resistant to the insulin that is produced or both.
Insulin is the hormone required to move sugar out of your bloodstream and into your cells — so both scenarios result in chronically elevated blood sugar levels.
High blood sugar levels over a long period can lead to complications like an increased risk of heart disease, as well as nerve and kidney damage, so it is important to keep them in check.
There are two main types of diabetes, each with different causes:
Type 1: Occurs when your immune system attacks your pancreas, destroying its ability to produce insulin.
Type 2: Occurs when your pancreas stops producing enough insulin, when your body’s cells no longer respond to the insulin it produces or both.
Type 1 diabetes is relatively rare, largely genetic, and only accounts for 5–10% of all diabetes cases.
Type 2 diabetes — which will be the focus of this article — accounts for more than 90% of diabetes cases and is mainly triggered by diet and lifestyle factors.
SUMMARY
Type 2 diabetes is the most common form of diabetes. It occurs when your body stops producing enough insulin or when cells become resistant to the insulin produced, leading to chronically elevated blood sugar levels.
How Sugar Is Metabolized
When most people talk about sugar, they’re referring to sucrose, or table sugar, which is made from sugar beets or sugarcane.
Sucrose is made up of one molecule of glucose and one molecule of fructose bonded together.
When you eat sucrose, the glucose and fructose molecules are separated by enzymes in your small intestine before being absorbed into your bloodstream .
This raises blood sugar levels and signals your pancreas to release insulin. Insulin shuttles glucose out of the bloodstream and into your cells where it can be metabolized for energy.
While a small amount of fructose can also be taken up by cells and used for energy, the majority is carried to your liver where it is converted to either glucose for energy or fat for storage.
If you eat more sugar than your body can use for energy, the excess will be converted into fatty acids and stored as body fat.
Since fructose can be converted to fat, high intakes tend to increase triglyceride levels, which may increase your risk of heart disease and fatty liver.
High intake of fructose is also associated with higher uric acid levels in blood. If these uric acid crystals settle in your joints, a painful condition known as gout can develop.
Glucose from sugar is mostly used by your body for energy, while fructose is taken to your liver for conversion into glucose or fat. High fructose intake has been linked to elevated triglycerides, fatty liver and gout.
Does Sugar Increase Your Risk of Diabetes?
A large number of studies have found that people who regularly drink sugar-sweetened beverages have a roughly 25% greater risk of type 2 diabetes.
In fact, drinking just one sugar-sweetened beverage per day increases your risk by 13%, independent of any weight gain it may cause.
Additionally, countries where sugar consumption is highest also have the highest rates of type 2 diabetes, while those with the lowest consumption have the lowest rates (12Trusted Source).
The link between sugar intake and diabetes still holds even after controlling for total calorie intake, body weight, alcohol consumption and exercise.
While these studies do not prove that sugar causes diabetes, the association is strong.
Many researchers believe that sugar increases diabetes risk both directly and indirectly.
It may directly increase risk because of the impact fructose has on your liver, including promoting fatty liver, inflammation and localized insulin resistance.
These effects may trigger abnormal insulin production in your pancreas and increase your risk of type 2 diabetes (14Trusted Source).
Eating large amounts of sugar can also indirectly raise diabetes risk by contributing to weight gain and increased body fat — which are separate risk factors for developing diabetes (17Trusted Source).
What’s more, animal studies suggest that eating a lot of sugar may disrupt the signaling of leptin, a hormone that promotes feelings of fullness, leading to overeating and weight gain (19Trusted Source).
To reduce the negative effects of high sugar consumption, the WHO recommends getting no more than 10% of your daily calories from added sugars that are not naturally found in foods (20Trusted Source).
