Are Sugar-Free Products Better?

When taking a trip to the grocery store, you will find many products that are labeled “sugar free”. But, take caution as these products are not always an ideal choice when you have diabetes. “Sugar free” products can actually be quite deceiving. A common error that we have observed as diabetes educators is that many people read labels for the amount of sugar instead of for the amount of total carbohydrate. Even if there are zero grams of sugar in a product, the food can still have an impact on your blood sugar level. The reason for this is that it is that total carbohydrate, not only sugar, affects blood sugar levels.

Carbohydrates (Carbs) can be classified as either simple carbs or complex carbs. Simple Carbohydrates generally include foods with added sugars like regular sodas and sweets. They are called “simple” because the body does not have to perform much in the way of digestion to break them down. Simple carbs offer very little nutritional value. Complex Carbohydrates include foods that occur naturally and without processing. Foods such as fruits, starchy vegetables, whole grain breads and rice would fall into the complex category. While complex carbs will raise blood sugar levels just like simple carbs, they differ in that they contain more vitamins, minerals and fiber than simple carbs. Because of that, complex carbs are a better choice than simple carbs.

You will find sugar (simple carb) listed on the Nutrition Facts label. However, the only complex carb that you will find listed is fiber. Thus, a product may not have sugar but it can still have other carbohydrates. It is important to look at the total carbohydrate content, not only the sugar content, when you are reading a food label.

As an example, take a look at these two labels. This is a comparison of a Sugar Free and a Regular Version of cookies:

Sugar Free Cookie Food Label

Murrays Regular Chocolate Creme Cookies

Note the difference between the two cookies: other than the nutrition label showing that the sugar-free cookie contains 0g sugar, there is very little difference. Knowing that you need to look for total carbohydrate instead of sugar makes all the difference. The total carb in the sugar free cookie is 19 grams while the total carb in the regular cookie is 21 grams. (Two grams of carb will not make a notable difference in your blood sugar level.) One carb serving/exchange is equivalent to 15 grams of carbohydrate. Although carbohydrate needs are very individualized, most people with diabetes will need to keep their mealtime carbs between 30 to 60 grams (2 to 4 servings/exchanges) and their snacks between 15 to 30 grams (1 to 2 servings/exchanges). Registered Dietitians who are Certified Diabetes Educators, such as John and I at nutritionpair.com, can assist you in determining your individual carbohydrate needs.

Back to the cookies—I should note the price per cookie. The sugar-free cookies cost 15 cents per cookie and the regular cookies cost 4 cents per cookie. The sugar-free cookies cost almost four times as much as the regular cookie! As you can see from the comparison above, there is very little difference in the impact the two different products would have on your blood sugar level. Your blood sugar reading would likely be the same after the sugar-free cookies as it would after the regular cookies. As you can see, you really don’t need to spend the extra money on “diabetic” or “sugar-free” products when you have diabetes. Just be a label reader and look at the total carbohydrate instead of the sugar. While you’re at it, check to make sure the product is low in saturated fat, high in fiber and high in vitamins and minerals. But, remember, the healthiest foods do not even have a nutrition label on them (hint: they are in the produce section!!!).

~ Angie

John and I recently became Certified Pump Trainers for the OmniPod insulin pump. The OmniPod is the Insulet Corporation’s Insulin Management System. It is the first and only wireless insulin pump. The OmniPod consists of a “pod” that attaches to the skin and delivers insulin via communication with a personal data manager (PDM).

Some of the things we really like about the pump are:

• There are no wires or tubes
• The PDM has a built-in blood glucose monitor (less items to carry with you)
• No needles are ever seen by the wearer as the pods have an automated cannula
insertion system
• No need to detach for swimming, showering, etc
• The only supplies needed are the pods and the insulin. With other insulin pumps
you must order tubing, insulin, needles and needle insertion systems.

The OmniPod is a relatively new insulin delivery device. It received FDA approval in 2005. Last year, the company won three awards for the device: a Gold Medical Device Excellence Award from Canon Communications LLC, a New England Innovation Award from the Smaller Business Association of New England, and a Gold Industrial Design Excellence Award from the Industrial Designers Society of America.

It is a really cool design and John and I are excited to start training new OmniPod clients! For more information on the OmniPod, go to http://www.myomnipod.com/.

It’s Your Health. It’s Your Life. Make That Change!

~ Angie

John and I took part in another radio show on November 2nd with host Frank Roberts on Radio Cafe Hertford 103. Diabetes was our topic of discussion as November is Diabetes Awareness Month.

Some of the important points that were made include:
-14.6 million Americans have diagnosed diabetes
-6.2 million Americans have undiagnosed diabetes
-54 million Americans have Pre-diabetes

This means that approximately 7% of our population has diabetes and 15% have pre-diabetes. In other words, almost one in four Americans have either diabetes or pre-diabetes!

You can listen to all of our previous radio shows through this link:
http://www.rch103.com/?s=lamberson

It’s Your Health. It’s Your Life. Make That Change!

~ Angie

It happened again today. This makes the third time this week. However, it is always worse when it happens first thing in the morning. Whenever John sleeps later than I have, I know that something is wrong. We usually go about day to day without any problems with John’s diabetes. But, every once in a while we get a reminder of how serious diabetes can be.

John is always active, but he has been especially more so lately. He is running much these days and gearing up for basketball season.

I thought maybe he was just tired, so I let him sleep. Even after I got out of the shower he was still asleep. I then heard our six year old calling me from his room. “Mommy, why isn’t Daddy up yet?”, he asked (Jonathan is always up at 6 am and will keep John company during his morning work outs). Jonathan went into our bedroom and I could hear him talking to John. He came out to the kitchen and said, “Mommy, I need the thermometer, Daddy is not acting right”. I knew right then that it was his blood sugar. I felt guilty for not having tried to wake him up earlier. I walked into the bedroom and John looked at me with a glazed look and said “Wheww! Wheww!”. He sounded like a college boy who had just come in from drinking all night. I went to go get juice. Yes, you should check your blood glucose first to see what it is before you treat it. However, when John is hypoglycemic, this is almost impossible to do as he will often refuse. Because I did not get a response from him, I knew it was truly low. Right around this time our four year old daughter woke up ready to eat (as usual!). Jonathan took over and gave John a juice box. All the while, John is still in bed yelling, “Whew! Whew!”. Jonathan is quite confused but thinks it is funny. “Daddy says he doesn’t know who I am, I keep asking him and he won’t answer me”. I used this as a teaching moment for Jonathan and told him what to do if this happens when I am not around: “If he does not answer you, call 911. If he can still talk to you, give him some juice. If he won’t drink it, call 911.”

Diabetes makes me so angry sometimes. You cannot reason with John when his BG is low. I’m lucky if I can get him to drink juice, forget about getting him to eat something or take glucose tabs (by the way-4 glucose tabs is the best treatment for hypoglycemia). He will often spit out or spill what I give him. This makes me even more scared and angry because I know that if we don’t get any carb in his body that he will lose consciousness. I have even in the past had to forcibly squeeze glucose gel into his mouth. But it is nearly impossible to hold down someone who is 50 pounds heavier than you are and is fighting you because he does not understand what you are trying to do to him. We do keep Glucagon in the house (and this I recommend for all people with diabetes). However, the only way I could use this would be if he were totally passed out as I can’t imagine trying to give him an injection if he were fighting me. Fortunately, we have never had to use the Glucagon but we do keep it in the house and take it with us whenever we travel.

John eventually came around, got up and was able to make his own breakfast and get to work. I knew he did not feel well, though he would not admit to it. He always talks about how hypoglycemia is a horrible start to your day-similar to a hangover. He will usually have a headache all day.

The best thing for us to do is to try to prevent this from happening again. Hypoglycemia is one of the biggest risks of tight blood glucose control. Checking blood sugar prior to bedtime and having a bedtime snack of at least 1 protein and 1 carb if your blood sugar is under 100mg/dl before you go to bed is always a good idea if you have had an especially active day.

~Angie