This is quite loaded. I have went all my life thinking that excessive sugar is direct cause for diabetes but I discovered that it’s really more about excessive calories in general. So if this is the case, do diabetics monitor glycemic index instead?
In: Biology
I think the simple sugars get the most blame (soda, refined sugars, etc) but more often than not it’s just heavy carbohydrate meals. Carbs are cheap and they fill you up but they also have the larger glycemic effect. Biggest thing I tell patients is a) be mindful of your carb portions and b) don’t double dip in carb sources (burgers and fries) etc.
Edit: sorry breezed over the ELI5 piece, carbs are basically complex sugar molecules (so pack a heavier glycemic lunch) and carb heavy foods include rice, breads/baked goods, potatoes, flour tortillas…
It’s my understanding that it has to do with how quickly those calories can be turned into simple sugars by your body. For instance, white rice gets turned into sugar pretty quickly causing a quick flood of sugar into your bloodstream, but brown rice still has a protective layer on the grain which kinda stretches the process out over time. And, of course, more calories means more sugars.
The types of carbohydrate contained in the food are one feature that determines what “spikes” blood glucose. Food with a higher glucose content will cause a more rapid increase in blood glucose because glucose is actively absorbed from the digestive tract. Sugars like fructose, in comparison, are passively absorbed and must be converted to glucose so the rise is slower. With foods like starches, these have to be broken down prior to absorption, and that takes time. If they are starches “packaged” in dietary fiber (like whole grains or beans) the fiber is resistant to chemical breakdown and so absorption takes longer.
Foods have different mixtures of starch, dietary fiber, and simple sugars (monosaccharides). So some fruits may produce a more rapid increase in blood glucose than others because of these factors interacting with one another. Additionally, other factors such as protein, fat content, water content, and how the food is prepared or processed, the other foods it’s consumed with, etc. will affect the rate of absorption. This is why using the glycemic index to select foods is not preferred practice – it does not reflect the reality of how people eat, and **does not account for the total amount of carbohydrate produced, which is the major contributor to how high the glucose level can rise in someone with diabetes.**
Edit: Risk for T2DM is a completely different story, which is a close interplay of genetics with dietary and other controllable/uncontrollable factors. “Excessive calories” (i.e. obesity) is one possible contributor, but you don’t necessarily need to be very overweight to have T2DM. The level of processed sugar intake is believed to have a strong influence.
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