Does sugar cause diabetes?

The Editor, Sir:

If public comments on radio talk shows so far are any indication, it seems noted expert on diabetes, Professor Errol Morrison is now marked to be tarred and feathered for comments he made recently discrediting popular perception of a causal relationship between sugar and diabetes.

Thankfully, I'm not diabetic. However, I have a vested interest in knowing the facts and nowadays that's often just a click away.

So I followed my instinct and came upon a rather interesting blog on the subject, written by Neal Barnard, M.D., F.A.C.C. Dr. Barnard has a string of remarkable credentials including the 2016 recipient of the American College of Lifestyle Medicine's Trailblazer Award. His bibliography a factor of paramount importance in researchis similarly very impressive.

Due to constraints of space, I'm confining myself to what I consider the most critical and relevant excerpts of Dr. Barnard's blog titled, "Does Sugar Cause Diabetes?" The complete article can be accessed at "Dr Barnard's Blog".

"Blood sugar levels are high in diabetes, so a common idea has held that eating sugar somehow triggers the disease process. However, the major diabetes organisations take a different view. The American Diabetes Association and Diabetes UK have labelled this notion a "myth," as has the Joslin Diabetes Centre which wrote, "Diabetes is not caused by eating too much sugar..." .

"The human body runs on glucose, a simple sugar. Just as gasoline powers your car, glucose powers your muscles, your brain, and the rest of your body. Glucose comes from fruit and from starchy foods, such as grains, beans, and potatoes, and your body can also produce it when needed. Without it you would die...".

"A number of studies have looked for relationships between sugar and diabetes risk. A 2017 meta-analysis, based on nine reports of 15 cohort studies including 251,261 participants, found no significant effect of total sugars on the risk of developing type 2 diabetes...".

"So our bodies actually run on sugarthat is, glucose. Moreover, sugar has only four calories per gram (much less than fats and oils, which have nine calories per gram), and sugar's calories can be used for metabolic needs or stored as glycogen. So does that mean that added sugars are innocuous?

No need for added sugars

"Certainly not. Although glucose is an important fuel for the body, there is no physiological need for added sugars.

Because sugar dissolves into sodas and snack foods, it is easy to consume surprisingly large quantities of it, potentially contributing to weight gain. In turn, higher body weight can make type 2 diabetes more likely to occur.

"Diabetes is a serious disease. Its most common form, type 2 diabetes, has become a worldwide epidemic as Western eating habits spread. An understanding of its causes is essential to identifying means of combating it.

"The roots of type 2 diabetes remain in insulin resistance and pancreatic failure, and the blame for the current diabetes epidemic lies in an overall dietary pattern emphasising meat, dairy products, and fatty foods, aided and abetted by sugary foods and beverages, rather than simply in sugar alone. A diet emphasising vegetables, fruits, whole grains, and legumes and avoiding animal products helps prevent diabetes and improves its management when it has been diagnosed.

"The idea that "eating sugar causes diabetes" is inaccurate. Nonetheless, avoiding added sugars is a helpful step, and it should be taken in addition to a healthful plant-based eating pattern, not instead of it."

I am etc.,

DERVAL GRAHAM