This year is a milestone year for me, as it marks the 50th anniversary of my first steps on an interesting, and so far, successful journey with my own type 1 diabetes.
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I have lived both professionally as a registered dietitian nutritionist (RDN) and certified diabetes educator (CDE) and personally with the evolution of diabetes treatment and self-management for many years, and I can testify that it is all about finding ways to feel normal.
One key area I have found as a person living with type 1 diabetes, and counseling others, is the role that low-calorie sweeteners can play in diabetes management, and it is far from trivial – I’ll tell you how.
The connection between diabetes and a sweetener that doesn’t add a lot of carbohydrate to our diet is somewhat obvious, and I could have written credibly about this connection simply as a professional. I didn’t have to mention the personal diabetes experience – I definitely didn’t have to mention the 50 year thing (which now makes it impossible to ever again claim that I’m 39). But sugar has been a dietary issue for so many people living with diabetes, not to mention the general population. Sugar raises blood glucose quickly, and besides calories, has no compensating nutritional value. But for many of us, a craving for sweets is hardwired into our brain, and sweets are embedded in just about every culture and social setting.
At my diagnosis, the “standard” diabetes eating plan was known as the “diabetic exchange list,” where a daily meal plan specified a certain number of choices from categories of foods – starches, fruit, milk, vegetables, meat and meat substitutes, fats, and “free” foods. The specific foods and portion sizes in each group (or subgroup, like “lean”, “medium-fat” or “high-fat” meat) contain similar calories, carbohydrate, protein and fat. Combination foods, like pizza for example, may count as 2 carbohydrates, 2 medium fat meats and 2 fats. Sweets were discouraged or outright prohibited except for vanilla wafers, graham crackers or 1/12th slice of angel food cake.
The diabetic exchange eating plan was way better than “Allen’s Starvation Diet,” the standard “treatment” to prolong life before the discovery of insulin. And, scientific studies like the Diabetes Control and Complications Trial supported the importance of lifestyle choices, like managing carbohydrate in our diet, by showing how diabetes complications of the eyes and kidneys relate directly to persistent high blood glucose levels. Over the years carbohydrate counting became accepted as a more intuitive and less complex way to manage post-meal blood glucose spikes, especially as the profile of diabetes patients has shifted dramatically to those with type 2 diabetes, who do not have insulin in their “toolbox.” Meal planning now may even include considerations of a food’s “glycemic index” or whether it contains “resistant starch.” But, the dilemma with sweets – lots of carbohydrate without compensating nutritional value – remains.
Fortunately, the evolution of diabetes eating plans has proceeded in tandem with the evolution of innovations in low calorie sweeteners like sucralose; found in the original SPLENDA® Sweeteners – better taste, more application options (like for baking), and more scientific studies to support their safety. There have been over 100 studies conducted over 20 years, showing the safety of sucralose. The SPLENDA® Brand is celebrating the 20th anniversary this year of sucralose obtaining FDA approval. The studies with sucralose show that it is safe to consume, does not cause any side effects; to include cancer, weight gain or increased appetite for sweet foods. Furthermore, sucralose does not affect gut function, as it is not metabolized in the GI tract). Last but not least, and possibly most important for us, low calorie-sweeteners do not raise blood sugar levels.
Through all of these changes in diabetes management, the availability of low calorie sweeteners, like sucralose, have given people living with diabetes, like myself, more flexibility and sense of normalcy. Nothing matters more to a person, than to feel like they have options and can live like everyone else.
Having the option to add sweetness to food without all the carbohydrate of sugar is priceless, and helps me and my patients with diabetes feel more normal and less restricted. Every morning I look forward to adding SPLENDA® Sweetener along with a sprinkle of cinnamon and some almonds to my oatmeal-delicious! And for holiday celebrations, I love that I now have the option to bake desserts with a low-calorie sweetener like SPLENDA® Sweetener. This allows me to confidently enjoy some sweetness knowing the carbohydrate and caloric content of my dessert, and to determine how it will fit into my meal plan.
For decades, managing diabetes “by the book” meant completely avoiding sugar. This is no longer the case as long as moderation is used. But, when sweetness comes without all the calories or carbohydrates of sugar or other full-calorie sweeteners, it’s a different life – it’s a more “normal” life.