Does Sugar Cause Diabetes? Know What Make Sugar The Villain

Diabetes is called ‘sugar’ illness or ‘sugar ki bimari’. Diabetics are told to steer clear of this 'white poison'. What makes sugar leave a bitter taste in your mouth when we talk about health?

Diabetes occurs when your blood glucose, also called blood sugar, is too high.

A person diagnosed with diabetes is often referred to (especially in India) as someone who has ‘sugar’, or ‘sugar ki bimari’. This likely stems from the connection between diabetes and elevated blood sugar levels. Often, out of fear that eating sweetmeats may give them diabetes, even healthy and non-diabetic people too prefer to give desserts the skip. Is that the right thing to do? Should a healthy, non-diabetic person eliminate sugar completely from the diet? Or is that taking things too much to the extremes? 

Let us first look at what is diabetes. 

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. According to the American National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the sugar in your blood is your body's primary source of energy. Your body can make glucose, but glucose also comes from the food you eat.  

The pancreatic gland in your body – the pancreas – manufactures insulin. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy.  

Type 1 diabetes is an autoimmune condition in which one’s immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas.

Type 2 diabetes — which is the most prevalent type of diabetes — is caused by several factors, including the foods we eat, the lifestyle we follow and the genes we inherited. Here, the pancreas makes insulin, but the cells don't respond to it as they should as they have now developed insulin resistance. When glucose can't get into cells, the blood sugar level rises. Then the pancreas works harder to make even more insulin.

Why fear diabetes, though? Because having too much glucose in the blood, over time, can invite serious health problems such as heart disease, nerve damage, eye problems, and kidney disease.

So, how does sugar become the primary villain here?

Sugar in our food comes in various forms: glucose, fructose (from fruits), sucrose (added or table sugar), and lactose (dairy sugar).

One consumes sugars in natural form (occurring naturally in items such as fruits, vegetables, food grains, and milk, etc.) and as an added ingredient as in soda, fruit drinks, cereals, cookies, cakes, candy, flavoured yoghurts, and many processed foods. 

A joint study by researchers from Stanford University and the University of California identified that sugar availability appears to be uniquely correlated to diabetes prevalence, independent of overweight and obesity prevalence rates, unlike other food types and total consumption.

Does Sugar Consumption Cause Diabetes? 

We need to look at the role sugar, especially added sugar, plays in our overall health. A holistic understanding of the ramifications of excessive sugar consumption can help us figure out its relation to diabetes.

"While sugar consumption alone may not lead to the development of diabetes, excessive consumption does lead to weight gain and can contribute to obesity which in turn is a major risk factor for diabetes,” Dr Aparna Govil Bhasker, Consultant Bariatric and Laparoscopic Surgeon, at Saifee, Namaha and Apollo Spectra Hospitals, tells ABP Live. 

Dr Sudha Desai, General Physician, Consultant Physician and Internal Medicine at Ruby Hall Clinic in Hinjewadi, Pune, echoes the thought. "Excessive sugar intake in daily diets is linked to health issues such as obesity, diabetes, tooth decay, and fatty liver. It can also contribute to inflammation of bones and joints, emphasizing the importance of moderating sugar consumption for overall well-being.” 

What relation sugar has to obesity, one may ask. How can sugar – that harmless-looking, sweet food item – take your health down?

Added Sugars Contribute Calories, But No Essential Nutrients!

"Sugar is an empty calorie food which means that it adds to the caloric intake but has no nutritional value. Over a period of time, continued sugar intake leads to excess caloric intake, which eventually gets stored as fat in the body,” says Dr Aparna Govil Bhasker.

In a non-diabetic person, excessive fat accumulation can in turn lead to insulin resistance, which is a harbinger of diabetes and obesity. In a person with diabetes, sugar intake can lead to insulin spikes that can cause symptoms of low sugars, paradoxically leading to further sugar intake and resultant weight gain. 

"High sugar consumption has been linked to leptin resistance which is a hormone that regulates hunger and satiety. Sugar can also be addictive and activates the reward pathways in the brain leading to further cravings and desire to consume more sweets,” says Dr Aparna.

Dr Sudha Desai wants to sound an alert on the addictive nature of sugar. "After consuming sugary food or drinks, the brain senses a surge in the 'feel-good' chemical called dopamine. Hence one feels more craving for sugar. Because of this, people end up eating too much sugar in the food,” she says.

Connection Of Excess Sugar Consumption To Liver Health

Sugar, especially fructose, impacts vital organs like the liver. When processed in large quantities, fructose can lead to liver damage. Our liver stores sugar in the form of glycogen. 

"When the body’s glycogen stores are full, the excess sugar gets converted into fat by a process called lipogenesis. This leads to increased insulin resistance which can lead to further weight gain and can also lead to conditions like PCOD or type 2 diabetes,” warns Dr Aparna.

How To Stay Wise And Safe On The Sugar Territory?

Dr Aparna Govil Bhasker has a short list of dos:

• Avoid diets rich in sugary foods, processed foods and refined carbohydrates
• Ensure that you get proper sleep
• Avoid chronic stress 
• Get regular physical activity so that your insulin resistance improves 

All the above steps can help to keep weight and blood sugar under control. While admitting that genes cannot be swapped or chosen, Dr Aparna says: “Genetics load the gun and it’s the environmental factors that pull the trigger. Lifestyle choices make a huge impact on whether the genetic predisposition will eventually manifest as the disease.”

Dr Sudha Desai feels fruit power in quelling hunger pangs is still an underrated factor. Always prioritise natural sugars like fruit — nature's candy — as they come with a plethora of nutritional benefits and fibre over foods with excessive amounts of added sugars. 

10 Steps To Control Your Sugar Tooth 

Dr Aniket Mule, Consultant - Internal Medicine, Wockhardt Hospitals, Mira Road (Mumbai), charts a step-by-step process for you to get rid of sweet tooth. Moderation is the key, and you need not give up sugar consumption totally, he says.  

Gradual reduction: Rather than going cold turkey, gradually reduce your sugar intake. This can prevent overwhelming cravings and withdrawal symptoms.

Read labels: Be mindful of the sugar content in packaged foods and drinks. Avoid products with high added sugar and opt for healthier alternatives.

Stay hydrated: Sometimes, thirst can be mistaken for hunger or sugar cravings. Stay hydrated by drinking plenty of water throughout the day.

Balanced meals: Consume balanced meals that include protein, healthy fats, and fibre. This can help stabilize blood sugar levels and reduce cravings.

Substitute wisely: Replace sugary treats with healthier alternatives, such as fresh fruits, nuts, or dark chocolate with higher cocoa content and less sugar. 

Manage stress: Stress can lead to emotional eating, including craving sugary foods. Find healthy ways to manage stress, such as exercise, meditation, or hobbies.

Get enough sleep: Lack of sleep can disrupt hormones related to hunger and satiety, leading to increased sugar cravings. Aim for 7-9 hours of quality sleep each night.

Support system: Share your goals with friends or family members who can provide encouragement and hold you accountable.

Identify triggers: Recognise situations or emotions that trigger your sugar cravings and develop strategies to cope with them in healthier ways.

Practise mindfulness: Be present and conscious of your eating habits. Avoid mindless snacking and focus on savouring your meals. 

After all, it is you who holds the reins to your health, and therefore you must make impactful lifestyle decisions for your well-being.

The author is an independent journalist.