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What you need to know about carbs and diabetes

Do you need to avoid sugar? How safe are sugar substitutes? And what about the glycemic index? Here are some answers on eating carbs healthfully with diabetes:

Should I avoid sugar entirely?

Too much sugar is not the cause of diabetes, and studies have shown that sugar, honey, molasses and other caloric sweetening ingredients do not cause blood glucose to spike any higher or faster than equal amounts of starches.

Here’s the thing: Added sugars provide calories but next to no nutritive value. Too many calories can lead to weight gain. For that reason, you should eat added sugars in moderation and count the calories and carbohydrates as part of your total carbohydrate quota for that meal or snack.

Are sugar substitutes safe?

Sucralose, saccharin, aspartame, acesulfame potassium and neotame all have been approved by the U.S. Food and Drug Administration as food additives, provided the amounts consumed are below the Acceptable Daily Intake: the level a person can safely consume every day over a lifetime without risk.

These amounts are generous, and it’s unlikely you would ever exceed them. For example, you would have to drink 20 12-ounce diet soft drinks per day to reach the maximum Acceptable Daily Intake for aspartame.

Should I choose foods based on glycemic index?

The glycemic index (GI) categorizes foods based on how much a food containing 50 grams of carbohydrate raises blood-glucose levels after eating.

A GI under 55 is considered low, over 70 is high. But the system is controversial: blood-glucose responses to foods can vary widely from person to person; plus, the scale has some strange inconsistencies. For example, a Snickers bar has a GI of 55; black-bean soup, 64.

It’s best to think of GI as a system that generally can guide you toward better carb choices and not worry much about the actual numbers. Because you probably don’t need a scoring system to tell you to reach for whole grains, vegetables, beans and other high-fiber foods and pass over refined foods and sweets, right?