CAN I EAT SUGAR?

Until quite recently, most diabetics were told to avoid, to minimize, even to fear foods rich in sugar. Sugar was the enemy, the source of high blood glucose, so sweets were avoided as a matter of life and death. But we know better now; we have a new understanding of what sugar is, where those high BG numbers come from, and how we must eat to keep them where they should be.

The key is understanding where blood glucose (the stuff we measure) comes from. During digestion, the human body breaks down carbohydrates (both simple and complex) and turns them into glucose, which feeds you, and shows up on your test strip. Doctors used to believe that "sugars" (sucrose, dextrose, fructose, glucose, maltose, levulose, etc.) were more rapidly absorbed by the body than were the "starches" (complex carbohydrates such as found in potatoes, pasta, bread, etc.), and thus were harmful for diabetics. This belief was strong, but when it was tested, it was found to be false. Sugar is absorbed no faster than is any other carbohydrate.

This breakthrough, endorsed by both the American Diabetes Association and the American Dietetic Association, has meant a broadening of the diabetic diet and a lessening of restrictions. Now, what matters is the total volume of carbohydrate consumed, and sugar is counted as a carbohydrate.

Imagine you want that cookie, or that piece of pie. You already know, from your meal plan, how much carbohydrate you can eat. Once you know how much carbohydrate is in that treat you want, you "pay for it" by deleting the equivalent amount of carb from somewhere else in your meal plan. It's like balancing your checkbook.

There is a problem. Many healthy and nutritious foods contain sugars, and that's OK if you allow for it, but most sweets are not particularly nutritious, and if you make space for them in your meal plan, you may not have any room left for the healthy foods you need. Just like the man with the checkbook, moderation is the rule -- the things you need have priority over the things you want.

By the way, some food labels proclaim "NO ADDED SUGAR!" As far as diabetes goes, this is a meaningless distinction. Whether sugar is naturally-occurring, or added by the cook, is of no account. What matters is the total.

What you need is to know your meal plan, and to know how much carbohydrate you can eat without raising your numbers too high. With that figure, and knowledge of how much carbohydrate is in that candy bar, that glass of juice, that slice of pizza, you can set up, and adhere to, a diet that will keep you as healthy as possible. Confer with your dietitian.

The American Diabetes Association (1-800-232-3472) has a pamphlet to help you: "The 1995 Exchange Lists for Meal Planning." If you need this useful pamphlet in Braille, or on 15/16 ips audiocassette, contact the National Federation of the Blind. (See "Resource Column" for complete ordering information.)