The sugar thieves

Do you know any sugar thieves? Those well-meaning people who steal your real sugar and replace it with stevia, saccharin or other substitutes?

I think about one holiday celebration a few years ago. There was a table filled with pies, cakes and bars straight out of Willy Wonka's dream. The smell alone made my mouth water.

Next to that table was a smaller one with sugar-free apple pie and gummy bears, just for me. While it was extremely thoughtful and considerate of my diabetes, well, YUCK! I choked down a few forkfuls and watched the others enjoy their desserts.

Most people don't understand that there are carbohydrates in sugar-free foods too. It doesn't matter where the carbohydrate comes from. If you're on insulin, you adjust it to the amount of carbohydrate you eat. 

For example, a regular chocolate chip cookie has approximately 26 grams of carbohydrate in it. A similar sugar-free cookie has about 20 grams. Real apple pie has about 40 grams of carbohydrate per serving, and the sugar-free variety has about 37 grams. A slice of yellow cake with icing has about 40 grams of carbohydrate while the sugar-free version still delivers about 28 grams. The sugar-free ones are not free foods.

Why? Carbohydrates come from many sources, not just sugar. Sugar alcohols (usually ending in "tol" such as maltitol, xylitol and sorbitol) have fewer calories than sugar. In addition, many carb-free sugar substitutes can't be used in cooking. Higher-carb options are used instead.

Whatever you choose to eat, remember that it's not the amount of sugar or where carbs come from that affect the overall rise in blood sugar. It's simply the amount of carbohydrate. (Although the source of the carb may impact how quickly blood sugar rises.)

Show your friends that one healthy, sugar-free baked potato has approximately 29 grams of carbohydrate, while a sandwich cookie provides about 8 grams. Amazing!

Moreover, remember that even if the source of carbohydrate doesn't matter to your blood sugar, it will to the rest of your body. Carbohydrates, like everything you eat, should come from a variety of foods. One cannot live on cookies alone. Carbohydrates from whole grains, beans, fruits and dairy offer nutrients that are more essential, vitamins and minerals. Everyone living with diabetes or not, should follow that rule.

Carbohydrate counting is a great tool to help manage your diabetes. It can make your life and meals much more flexible and enjoyable, and your blood sugar more predictable. We need to educate the sugar thieves. Next year, I will be bringing a dessert to my family's dinner. I already have a few new recipes in mind—and nothing will be sugar-free!

By Karen Flanagan, MA, RD, CDE

Karen Flanagan is a registered dietitian and certified diabetes educator who previously worked with pump users through Roche Diabetes Care. She has been wearing an insulin pump since 1992.