Diabetes Self-Management Blog

A couple of years ago, we examined the case being made by a prominent obesity researcher — Dr. Robert Lustig of the University of California, San Francisco — that sugar has toxic effects in the body that can lead to obesity, diabetes, and other ailments associated with the metabolic syndrome. We noted at the time, however, that no large-scale study had been conducted to examine the effects of sugar consumption, and that performing a randomized controlled trial with varying amounts of sugar in the diet would be very difficult.

As it turns out, Lustig was as hungry as anyone for new data on this subject. Last week, he was one of the authors of a study published in the journal PLOS ONE that examined the correlation between sugar availability and rates of Type 2 diabetes worldwide. According to an article in the Los Angeles Times, the researchers used data from the United Nations’ Food and Agricultural Organization on sugar availability worldwide, since this information is more closely tracked than direct sugar consumption. They also looked at rates of Type 2 diabetes over time in 175 different countries, as well as components of the diet in these countries other than sugar. By comparing these sets of data, they found that in countries where rates of diabetes had gone up, sugar consumption had gone up slightly earlier and in about the same proportion as the increase in diabetes.

Using statistical methods, the researchers calculated that a daily 150-calorie increase in the availability of sugar is associated with a 1.1% increase in the incidence of Type 2 diabetes. This association was seen after controlling for other factors such as overweight and obesity, total calories consumed, aging within populations, and levels of income and urbanization. Out of all the dietary components that were examined — including meat, fiber, fruit, oil, and grain consumption — only the availability of sugar was found to be associated with the rate of diabetes within countries.

Most of the medical and journalistic response to this study appeared to be positive, supporting its findings and the need to curb sugar intake. Dr. Walter Willett, a prominent nutritionist at the Harvard School of Public Health, noted in the Los Angeles Times article that the study probably underestimated the role of added sugars in the development of diabetes, since the data it used did not distinguish between naturally occurring sugar in fruits and more refined forms of sugar. And in his New York Times blog, Mark Bittman compared the study to ones that linked cigarettes to lung cancer in the 1960’s and asserted that the need for regulation is just as great in this case. The nutrition site GI News, however, takes issue with the study’s method of controlling for overweight and obesity, claiming that it fails to account for known differences in health risks among different racial groups. This means, the authors write, that any association between sugar and diabetes might be dwarfed by a more accurate assessment of the relationship between obesity and diabetes, independent of sugar intake.

What’s your reaction to this study — do you suspect that sugar is uniquely involved in the development of diabetes, or are you skeptical of such claims? Do you think your own sugar consumption played a role in developing diabetes? If sugar does lead to diabetes, do you think this mean it should be more strictly regulated? Leave a comment below!


  1. I am a Type 1 for 56 years and I use some sugar; enjoy a piece of dark chocolate, ONE bite of pie or cake or a cookie, and I do not have a weight issue. I prefer a small amount of sugar instead of purchasing sugar free items or food with high fructose corn syrup any day! My doctors suggested this several decades ago. If I can not spell or know the ingredients printed on a food label, I do not buy it!

    The amount of food and the type of carbohydrates consumed determines my weight and control method, along with activity level. If we eat too much of anything, it is usually harmful to anyone with or without diabetes.

    I think that the high fructose corn syrup and other 27 letters long ingredients can have a negative effect to our system. FDA why not do your job? The bottom line for me is: if our DNA has the markers for any disease - we may develop it.

    Posted by joan |
  2. I didn’t read any correlation between genetics and diabetes. I don’t believe that too much sugar causes diabetes but many other factors do.
    When diabetes has been rampant in my family going back as far as 5 generations that I know of, I’m not sure that not eating any sugar is going to prevent it. Also many of those with diabetes are not overweight. I am diligent about reminding my adult children and their children about the genetic factor.

    Posted by Ferne |
  3. I feel this is some misunderstanding about sugar. Although it is a high energy fuel and should not be consumed in high quantities, the GI of sugar is actually no worse and sometimes better than other foods. Sugar and other high GI carbohydrates are turned into glucose in the body fairly quickly. When checking the blood sugars of diabetics, it is the level of glucose which is being tested. Do you realise that within 30-60 minutes a piece of white bread has been broken down into glucose Your pancreas then has to produce insulin to metabolise this glucose leading to exhausting these levels of insulin and insulin resistance. Lets not look just at sugar but the overall amount of high GI foods that are consumed and which are placing undue stress on our bodies.

    Posted by Hanson |
  4. I think this is a dog day afternoon in blog land.

    Once again we are looking for excuses for diabetes. This is a statistical overkill not causitive science.

    As long as we keep blaiming genetics, environmental items and other handy excuses while we ignore the weakness of the efficient hunter gatherer digestion gene digestion system operating with few if any chnages for running in a age/land of 24/7 grains and refined food supplies coupled with reduced energy burn from all the couch potato work, entertainment, computers and cars; type 2 cases will continue to explode world wide.

    That is not to deny that there could be some cases and some medical conditions caused by gene aging and breaking and other factors but does not explain the world wide jump in these cases.

    The hunter gatherer system was optimized for preventing starvation at a time when food quality was poor and intermittent. Today one can overload the system.

    Thanks to modern science and agriculture we stopped starvation in the 70’s due to all the improvements in grains, corn, rice and their production efficiences and stopping pests. On top of that science was able to convert what was once a scarcity of sugar by converting straches to high fructose sugars on pennies on the ton.

    If only the hunter gathere system had a method to bypass excess glucoss from ingested food out of the system when the body was satiated with sufficient energy - presently that system dumps every bit of glucose into the blood system and expects the body to burn or store it. Once that is exceeded it backs up in the blood system. The present hunter gatherer body is not an infinite resorvoir for liquid glucose/energy.

    My read after 30 years fighting type 2 diabetes and in last 5 years getting mess under control does not support this type of study and wild excuse making.

    Posted by jim snell |

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