Can too much sugar cause diabetes?

Monday, August 7, 2006
Diabetes is one of those diseases we all 'sort of' know about — something to do with sugar, right?

Well, if you 'sort of' know that much, here are some facts you should know for sure: diabetes can lead to blindness, heart attack, stroke and its incidence has tripled in the last ten years — there's a new case diagnosed every seven minutes.

So it affects millions of us.

But the good news is, for most people, it's largely preventable. But how?

Our reporter, Dr Andrew Rochford, is going to put a commonly held belief about diabetes to the test. Andrew is going to over indulge his sweet tooth — and it's all in the name of medical research.

Sugar is often associated with Australia's fastest growing chronic disease — diabetes. But what we want to know is can too much sugar in your diet actually cause diabetes?

>Essentially, diabetes is related to elevated blood sugar levels, so the logic goes, eat more sugar, get diabetes.

Associate Professor Maarten Kamp is a diabetes expert at the Gold Coast hospital: "Currently more than 1.2 million Aussies have diabetes and only half of those are diagnosed, so half the people with diabetes are unaware of it. There's a further two million or so people who are at risk of developing diabetes, having a condition we call pre-diabetes."

It's forecast that by 2010, 1.8 million Australians will have diabetes. That will put them at risk of heart disease, strokes, kidney failure, blindness, nerve damage and a whole host of other nasties.

Here's how diabetes happens:

To get the energy we need to survive, our body converts some of the food we eat into sugars, also known as glucose. At the same time, our pancreas is creating a hormone called insulin, which acts like a key, binding to cells and allowing them to absorb that glucose. But people with diabetes don't produce enough insulin, or that insulin doesn't work properly, so it's like they've lost the key — the cell door stays locked and the glucose stays in your blood.

"And that means that whilst there is plenty of glucose in the blood, too much glucose, and that's what's damaging, and isn't getting into the cells properly where it's needed to provide energy for the body," says Professor Kamp.

Andrew also needs to declare a personal interest: "My dad has diabetes and we've had some scary times with this illness. Diabetics have to keep a careful balance between insulin and glucose in his body. So my dad has to inject insulin four times a day. If he gets the balance wrong, then he can fall into a coma — called a hypo."

Unfortunately the diabetes has put a lot of strain on my wife and children particularly when I have hypos in the middle of the night and four and five-year-old kids see their father being carted down the stairs by ambulance men. Andrew unfortunately has seen that on a couple of occasions and I'm sure he's not too happy about it," says Michael Rochford.

Fortunately those attacks, which can be fatal, are rare.

There are two types of diabetes, Andrew's dad is a Type 1:

"Type 1 diabetes is predominantly caused by being at risk with having inherited genes that place people at risk and we think it's then set off by particular types of infections. It's not absolutely clear what causes Type 1 diabetes," says Professor Kamp.

But most people with diabetes, nearly 90 percent of sufferers are Type 2.

"Type 2 diabetes again people have a predisposition to it, genetic predisposition, but it largely develops as a result of overweight, inactivity, over-nutrition that we see in our society nowadays," says the Professor.

Type 2 diabetes usually starts around age 45, but a recent report showed children in Australia are now suffering from the disease.

Which brings us back to our test…

First Andrew has his normal insulin and glucose levels recorded through a blood test. Then comes the good part — a pig-out in a lolly shop.

Andrew: "It's a tough gig, but I'm up to the challenge … If a sugar overdose can cause diabetes, all this lot ought to do the trick … Finally a test I can enjoy — guilt-free."

It sounds logical — the more you eat, the higher the levels, so after Andrew has binged for 24 hours he heads off to have his blood sugar levels tested again. Remember, the body absorbs sugar, by producing insulin, which unlocks the cell doors. A non-diabetic person produces enough insulin to cope with as much glucose as we throw at it, and keep the blood sugar normal.

So what do Andrew's results say?

"Now on the day when I had the high sugar diet — the diet we should all avoid — my blood sugar stayed the same, which you'd expect from someone without diabetes. But my insulin level was through the roof, my pancreas was working overtime to try and maintain my blood sugar at that level," says Andrew.

But his system did cope — despite the binge, his blood sugar level stayed normal, and that means eating sugar is not a direct cause of diabetes.

But if Andrew kept that high-sugar diet up, he could develop insulin resistance and he'd certainly put on weight, which is a major problem.

"Obesity is a very important factor in contributing to diabetes it's certainly the main factor that's contributing to the epidemic of diabetes that we have," says Professor Kamp.

So how do you know if you have diabetes?

Some of the symptoms include:

  • Fatigue
  • Passing urine frequently
  • Constant thirst
  • Infections that are slow to heal

If you are diabetic or at risk of it, diet is one area you can really take control of to improve your situation.

>Chef Peter Howard has done just that. Food is Peter's passion, but as he himself admits, he loved it just a bit too much: "Always eating, always drinking, not really caring what I was eating and not really caring what I was drinking just as long it was a lot of both."

But all that's changed since he was diagnosed with Type 2 diabetes.

Diabetes can't be cured but Peter is controlling his condition with diet and exercise — so far he doesn't need insulin shots. He now walks every day and does weights and crunches and he's lost 15 kilos.

What did Peter have to cut out of his diet?

"Mostly fats, I loved deep fried things so the fats had to go. Sugars … I loved sweet things, absolutely loved sweet things, just adored them so they just had to go and I think actually the amount was the thing as well, and the constancy. So now I do eat very, very well and I eat a lot, but I eat a lot of really good food and what I'm always looking for is food that's high in fibre."

He's so passionate about living better, Peter's even brought out his own cookbook with recipes for good health.

The plain truth is we're sitting on an obesity time bomb that could explode into a massive diabetes epidemic. But we can change the future by changing how we eat right now.

So there are many causes of diabetes but we're happy to report that sugar isn't one of them. But does that mean you can stay in a lolly shop and gorge yourself? No, because if you eat too much sugar then you'll put on weight and obesity is a risk factor.

So all the fun aside, diabetes isn't a laughing matter — you can protect yourself with a healthy diet and regular exercise and if diabetes runs in the family or you have any concerns go and see your doctor.

  • Why do people normally inject insulin instead of taking a pill? Because if they swallowed it, digestive enzymes would destroy it before the body could use it.

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