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| - CLAIM: Sugar does not cause diabetes
SOURCE: Social media post
VERDICT: Misleading
The relationship between sugar and diabetes is once again being discussed on ‘Twitter streets’, now X. This follows a post from Dr Misheck Ruwende that ‘sugar does not cause diabetes’.
This is not the first time he has posted this. He has a similar post from 2024.
He is not the first to say this on the platform either. Similar claims have been made here and here.
An account reacting to Dr Ruwende’s post wrote,
‘From a health education perspective, this is an irresponsible statement. You will get technical in your explanations and that will support your statement but it doesn’t change the fact that the statement is reckless.
Is it (sic) the statement correct? Yes.
Is it reckless? Yes.’
Other accounts that have sought to give context include journalist, Hopewell Chin’ono, here and another here.
Before we reached for more sugar like this account here, ‘Thanks doctor, was drinking my tea with too little sugar’, we checked if there’s some truth to Dr Ruwende’s claim. And we started with the most basic question.
What is sugar?
One definition states that sugar is sucrose, a disaccharide, made up of two sugars (glucose and fructose) bound together, that is naturally made by and found in all green plants. Sugar found in the food supply is harvested from sugar beets and sugar cane.
Britannica says ‘As a chemical term, “sugar” usually refers to all carbohydrates of the general formula Cn(H2O)n. Sucrose is a disaccharide, or double sugar, being composed of one molecule of glucose linked to one molecule of fructose’.
Sugar.org says that ‘in a nutshell, sugar is a carbohydrate’. It goes on to state that ‘no matter how complex a carbohydrate is to start with, once in the body, all carbohydrates are broken down to these three simple sugars: glucose, fructose and galactose’.
In simple terms, once in the body, an apple; sugar cane; or rice: are all broken down into simple sugars.
It is, therefore, important to note that sugar is not just the white or brown granulated stuff most people put in their tea, but includes all carbohydrates.
Diabetes
Also known as diabetes mellitus, it is in simple terms too much sugar in the blood. The World Health Organisation defines it as ‘a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces’.
A paper from the Michigan State University states that, ‘in the 1930s, up through the 1970s, society commonly referred to individuals with diabetes as having “sugar,” but the correct medical term for diabetes is “diabetes mellitus.”’
Mellitus is a Greek derived word meaning ‘pleasant tasting like honey’.
Sugar and diabetes
While directly consuming sugar doesn’t cause diabetes in the same way a virus causes a cold, it plays a significant role in the development of type 2 diabetes and can worsen the condition for those who already have it. It is crucial to understand the nuances.
There are two main types:
Type 1 Diabetes: The body’s immune system attacks and destroys cells in the pancreas that produce insulin.This results in the body not producing enough insulin. This is not directly related to sugar intake.
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Type 2 Diabetes: The body becomes resistant to insulin, or the pancreas doesn’t produce enough insulin.This is strongly linked to lifestyle factors, including diet, weight, and physical activity.
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The role of sugar:
Weight Gain: Consuming excessive sugar, particularly in sugary drinks, contributes significantly to weight gain. Being overweight or obese is a major risk factor for type 2 diabetes.
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Insulin Resistance: High sugar intake can lead to insulin resistance over time. This means the body’s cells do not respond properly to insulin, making it harder for glucose to enter the cells for energy. The pancreas then has to work harder to produce more insulin, and eventually, it may not be able to keep up.
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Indirect Link: Therefore, while sugar itself doesn’t directly cause type 2 diabetes, it significantly increases the risk by contributing to weight gain and insulin resistance.
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What about type 1 diabetes?
Type 1 diabetes is an autoimmune disease, and its cause is not related to sugar consumption. However, people with type 1 diabetes still need to manage their sugar intake to control their blood glucose levels.
Those who were agreeing with the claim that ‘sugar does not cause diabetes’ were quoting a myth buster from the UK National Health Services. It states that:
The key word for type 2 diabetes is directly – that it is not caused by sugar DIRECTLY. Meaning it does cause it, indirectly.
A 2017 study also stated that ‘taken together, lack of an adverse association between intakes of total sugars, fructose or sucrose and diabetes may reflect important contributions from these other food sources. In the absence of a clear signal for harm, sugars alone do not appear to explain the relation between sugar-sweetened beverages and type 2 diabetes. More “food-based” research is needed to assess whether the same relation holds for other important food sources of sugars, such as grain and grain-based products, fruit and fruit products, and dairy and dairy products’. The results were not that sugar does not cause diabetes. The finding was that the culprit may not just be the sugar sweetened beverages but other food sources of sugar.
Key takeaways:
Sugar is not the sole culprit: Type 2 diabetes is a complex condition influenced by multiple factors, including genetics, lifestyle, and diet.
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Moderation is key: Consuming sugar in moderation as part of a balanced diet is generally okay. However, excessive sugar intake, especially from sugary drinks, should be avoided.
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Focus on a healthy lifestyle: Maintaining a healthy weight, engaging in regular physical activity, and eating a balanced diet rich in fruits, vegetables, and whole grains are crucial for preventing type 2 diabetes.
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Consult a healthcare professional: If you have concerns about diabetes or your sugar intake, it’s essential to consult with a doctor or registered dietitian for personalised advice.
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Conclusion
Dr Ruwende’s claim that ‘sugar does not cause diabetes’ is rated as misleading because it does not contain full context. While sugar does not cause type 1 diabetes, it does, indirectly, cause type 2 diabetes. Sugar does not only refer to the granulated sucrose but all carbohydrates that the body breaks down into simple sugars. The missing context could be the difference between life and death for someone living with type 2 diabetes. Claims implying that sugar has no connection to diabetes are misleading and can be harmful. While not the direct cause, excessive sugar consumption plays a significant role in the development of type 2 diabetes.
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