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Eating with Diabetes: Desserts and Sweets

Can You Have Your Cake and Eat It, Too?
  -- By Amy Poetker, Registered Dietitian and Certified Diabetes Educator
I’d be willing to bet that most everyone has been told—and therefore believes—that people with diabetes cannot have any sugar and are resigned to living without dessert for the rest of their lives. Well, as a Certified Diabetes Educator, I'm here to tell you that this is a myth. People with diabetes can eat sugar, desserts, and almost any food that contains caloric sweeteners (molasses, honey, maple syrup, and more). Why? Because people with diabetes can eat foods that contain carbohydrates, whether those carbohydrates come from starchy foods like potatoes or sugary foods such as candy. It’s best to save sweets and desserts for special occasions so you don’t miss out on the more nutritious foods your body needs. However, when you do decide to include a sweet treat, make sure you keep portions small and use your carbohydrate counting plan

No sugar ever again? No way!
The idea that people with diabetes should avoid sugar is decades old. Logically, it makes sense. Diabetes is a condition that causes high blood sugar. Sugary foods cause blood sugar levels to increase. Therefore people with diabetes should avoid sugary foods in order to prevent hyperglycemia (high blood sugar) and keep their diabetes under control. However, simply avoiding sugary foods does not go very far in terms of controlling blood sugar. Here's why.

After you eat, your blood sugar level (aka postprandial blood glucose level) is largely determined by the total amount of carbohydrate you ate, not the source of the carbohydrates eaten. There are two types of carbohydrates that elevate your blood sugar levels: sugar and starch. Both will elevate your blood glucose to roughly the same level (assuming you ate the same amount of each). For example, if you were to eat a ½ cup of regular ice cream (15 grams of carbohydrate), your blood sugar would rise roughly the same amount as if you had eaten 1 slice of whole wheat bread (also 15 grams of carbohydrate). Because of this, it makes no sense that you can eat one type of carbohydrate (starch) but not the other (sugar).

It is important to remember that while foods with sugar in them can be incorporated into a diabetes meal plan with little impact on blood glucose control, most sweets and dessert are high in calories and have little to no nutritional value. So, while it is entirely possible to work these foods into any diabetes meal plan, they are still food choices that should be considered “treats” and should be eaten in limited quantities. This is also true regardless of the type of sweetener you choose to consume. "Natural" sweeteners (honey, agave syrup, cane sugar, etc.) still contain carbohydrates that elevate your blood sugar level and should not be thought of as any healthier for people with diabetes than other sweeteners. <pagebreak>

For optimal blood sugar control, use these sweet tips for sweet treats:
1. Budget your meal carbs. When the urge for a sweet treat hits, use some of your meal’s carbohydrate budget for a small dessert. This is the beauty of carbohydrate counting—the ability to use your carbohydrate allotment for any carbohydrate you choose. A typical carbohydrate allotment for one meal is usually around 45-60 grams (3-4 servings). If you would like to have a slice of pumpkin pie with your meal, for example, incorporate the amount of carbohydrate in the slice of pie into your total carbohydrate budget for the meal. One slice of pumpkin pie (1/8 of an 8-inch pie) contains roughly 23 grams of carbohydrate (1 ½ servings). Simply adjust your intake at meal time to account for your upcoming dessert. In this example, you'd still have 22-37 grams of carbohydrates (1 1/2 to 2 1/2 servings) remaining, which you can spend on more nutrient-rich, carbohydrate containing foods.

2. Snack attack. Most people with diabetes are able to enjoy 1-3 snacks throughout the day, spending 15 to 30 grams (1 to 2 servings) of carbohydrates on each snack. Instead of eating dessert with your meal, you could satisfy your sweet tooth during snack time by enjoying a dessert item that fits into your snacking budget. Just remember to eat it at least 2 hours after your meal.

3. Use low- and non-calorie sweeteners wisely. Some people with diabetes prefer to rely on artificial sweeteners as a way to cut down on carbohydrate intake. If you enjoy desserts, candies or recipes made with these non-caloric sweeteners, that's fine. But don't forget to account for the carbohydrates that may still be in the food you are eating. Packaged cookies with "no added sugars," candies made with artificial sweeteners, or homemade cookies baked with stevia are NOT carbohydrate-free foods. Be sure to read labels and still account for the carbohydrates you are consuming, whether the foods contain sugar or not. You can even use the free recipe calculator at SparkRecipes.com to find out exactly how many calories and carbohydrates are in your homemade treats!

4. Keep sweets away.  If you tend to overeat on sweets, don’t buy them in large amounts to store at home or at work. Instead, plan to have dessert only when away from home. Purchase a single-serving or split a larger dessert with a friend. Check out the nutrition facts of your sweet treat to stay on track with your carb counting plan.  

5. Step up your physical activity. Along with the carbohydrates, many desserts also add extra fat and calories as well. Consider incorporating some extra physical activity on, before, or after the days that you splurge on sweets. Exercising to burn more calories can help with weight management and blood sugar control.

6. Always monitor.  When consuming foods high in sugar, be diligent with monitoring your blood sugar level throughout the day. You may notice that some carbohydrate-containing foods increase your levels more than others--even when you eat the same grams of carbohydrates. If your levels are slightly higher, work with your health professional or Certified Diabetes Educator to obtain an individualized plan. Your educator will be able to tweak your plan and provide additional food suggestions to meet your specific needs for optimal blood sugar control.

7.  You’re Not Alone.  Everyone needs to limit sugar intake, not just folks with diabetes.  In fact, cutting back on the sweet stuff is one of the main messages in the 2015-2020 Dietary Guidelines for Americans. The new sugar guideline encourages everyone to develop a healthy eating pattern that limits added sugars to less than 10 percent of total calories per day.
The following chart shows the average carbohydrate-count and proper serving size for some common sweets and desserts. Use it as a reference when selecting sweets, but always refer to package nutritional labels whenever possible for best accuracy. Remember, having diabetes does not mean you will never have birthday cake or pumpkin pie again. With a little planning, you can have a small serving of your favorite dessert once in a while and still manage your diabetes. <pagebreak>

Chart information: (15 grams = 1 carbohydrate serving)

 Food  Serving Size  Carbohydrates
Apple pie 1/8 of pie 40 g (2 1/2 servings)
Banana bread 1 slice 33 g (2 servings)
Brownie, plain 2-inch square 15 g (1 serving)
Cake without frosting 2-inch square 15 g (1 serving)
Chocolate candy bar with almonds 1.45 oz bar 22 g (1 1/2 servings)
Chocolate-coated peanut butter granola bar 1 bar 15 g (1 serving)
Chocolate-covered peanuts 12 pieces 23 g (1 1/2 servings)
Coconut cream pie 1/8 of pie 31 g (2 servings)
Cinnamon coffee cake with crumb topping 1 piece 29 g (2 servings)
Cookie, molasses 1 large (3-1/2") 23 g (1 1/2 servings)
Cookies, general 2 small 15 g (1 serving)
Cupcake, low-fat with frosting 1 small 29 g (2 servings)
Frozen yogurt, regular 1/2 cup 15 g (1 serving)
Fudge 1 sq. in. piece 15 g (1 serving)
Glazed yeast doughnut or sweet roll 1 medium 30 g (2 servings)
Gummy bears or drops 11 pieces 23 g (1 1/2 servings)
Ice cream, light 1/2 cup 15 g (1 serving)
Pudding, sugar-free 1/2 cup 15 g (1 serving)
Pumpkin pie 1/8 of pie 23 g (1 1/2 servings)
Rice pudding 1/2 cup 22 g (1 1/2 servings)
Sherbet, orange 1/2 cup 23 g (1 1/2 servings)
Snickers bar 2 oz bar 35 g (2 servings)

This article has been reviewed and approved by Becky Hand, Licensed and Registered Dietitian.

Sources:
Carbohydrate Counting, from Diabetes.org
USDA National Nutrient Database for Standard Reference, from USDA.gov