Diabetes Self-Management Blog

On WebMD’s Diabetes Community, a reader named damondj wrote, “I have been eating a lot of sugar free cakes… I’ve been feeling real tired lately… [and today my blood sugar] read 262.” Damondj is learning that “fat-free,” “sugar-free,” and “natural” labels don’t necessarily mean that a food is good for you.

Food manufacturers know what tastes good and what customers like. People will buy products containing fat and sugar and foods that taste like they have these ingredients. Therefore many packaged foods will have significant amounts of fat, sugar, and/or artificial flavors that mimic fat and sugar.

Manufacturers also know that customers want to be healthy. So some companies find ways to make foods seem healthier than they are. They may label their food as “healthy” because they know most of us won’t check out the detailed information. The main food label most people look at is the price.

Sugar-free foods can be flavored with all kinds of things, including isomalt, sorbitol, aspartame, and saccharin. The long-term health effects of many of these sweeteners are not well known at this point.

Sugar-free foods can also have large quantities of refined flour, dried fruits, and other carbohydrates that raise your blood glucose levels. “Sugar-free” usually means there is less than 0.5 grams of sucrose (table sugar) per serving of the product. But the food may have other kinds of sugars and sweeteners, including some that affect blood glucose more than sucrose. The best way to determine how a product will impact your blood glucose level is to read the Nutrition Facts label, which will tell you the carbohydrate content in a serving.

What do words like “natural” and “organic” mean? According to the science Web site wiseGEEK, the US Department of Agriculture (USDA) says food can only be labeled natural if it contains no artificial ingredients or added colors and is minimally processed. Animal products raised with the use of artificial hormones can be labeled natural, and so can genetically modified organisms.

Note that natural does not mean organic. According to North Carolina State University, “organic” on a label means that the foods are “produced without antibiotics, hormones, pesticides, irradiation, or bioengineering. Organic farmers are required to adhere to certain soil and water conservation methods and to rules about the humane treatment of animals.” The term “natural,” on the other hand, does not guarantee any of those things.

In my view, organic is better, and unprocessed foods are best. The more whole foods (vegetables, fruits, nuts, whole grains, tofu, meat if you like) you can eat, the better off you will likely be.

But perhaps I am being a purist. Packaged foods are usually easier to prepare, which can be important if you’re in a hurry. Do you eat packaged foods? Why? And how do you decide which ones to eat?


  1. Right on. I am a Type I on a pump. I am constantly reminding my Type II diabetic friends (I am the only Type I that they have ever met) that “sugar-free” does NOT mean “carb-free!”

    I am very surprised at how many diabetics are so ill-informed that they have no idea they should be looking at carb counts, not just “sugar.” I don’t get it. Where is the disconnect? Are doctors not informing their patients they have to carb-count? I guess I am very lucky that I was more or less forced to go to Diabetes Education classes once a week for a month after being diagnosed. It seems my type II friends were handed pills and told to watch how much sugar they eat. Just, wow.

    Posted by Kate Rosenfeld |
  2. I try to stick with mostly unprocessed foods. They are generally cheaper, more nutritious and generally place a lower glycemic load on your body. But I’m not working now and it’s easy to do this vs when I worked full time. When I do buy processed foods, I go for the higher quality ones with the least ingredients (Lightlife, Amy’s, Newman’s Own for examples). Yes, I would love to spend less money on food but my philosophy is “Pay now or pay later”. I can always make more money. It’s not as easy to “buy back” health. Of course, I understand not everyone is in a position to have the luxury of choices that I have. But the principles of food buying are still the same for those in a tighter financial situation-stick to the basic foods for savings and better health.

    Posted by David |
  3. You would think that yogurt is a healthy food for diabetics. I certainly is in Turkey. In Canada low fat yogurt is loaded with starch which is pure instantanious blood sugar.

    Posted by calgarydiabetic |
  4. What you say is very true, I was diagnosed last October, I didn’t know anything about carb counting until two months ago, I still don’t know how many carbs I can safely have, do you? It’s difficult to shop for food when you don’t know what to buy. So I find myself not eating very much food.

    It’s been difficult.

    Posted by Debbie R |
  5. Hey Debbie,

    Try and get yourself to a diabetes educator, nutritionist, or diabetes support group. They can help. There are also many books — you will find you have to take charge of educating yourself. “Not eating very much food” is not sustainable.

    Posted by David Spero RN |

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