Just an idea but could it be that starchy carbs actually more dangerous to T2s than sugar ?

Starchy carbs are still sugar (Glucose) as far as the body is concerned so you expect a rise in blood sugar levels. Table sugar is 50% Fructose and in my opinion that is more dangerous than any starchy carb. The reason is that Fructose is metabolised in a different way to other sugars and makes fat directly in the liver. Bad news for diabetics.

My body tolerates sugar far better than grains and starchy veg.

So yes, for me, sugar is the lesser of the various evils, as it were.

We also tend to eat a lot more of the starchy foods. I mean, imagine trying to eat sugar in the same quantities that you might eat pizza base, or mashed potato. Even allowing for the water in these foods, it is possible the portion sizes mean that they will have a huge impact.

Yes of course. Sugar is split 50/50 in glucose and fructose. Fructose isn't that bad for blood glucose levels, it only damages the liver. while 100 % of the starch will be turned into glucose once inside us.

Dont eat sugar unless unavoidable. Large potatoes never. Rice rarely. Pasta occasionally.
Bread - Pure rye bread with added seeds from the local German bakery. Not too much. Just
for breakfast with egg and bacon or a tomato mixture. Cook with butter and extra virgin olive oil.
Any meat or fish.In general high fat low carbo. Survived for 10 years plus. Sweeteners instead of sugar.

Your theory is pretty much accurate Sirmione, as bread has a higher Glycemic Index than sugar.

In 'Grain Brain', Dr David Perlmutter MD, the neurologist, says that he shows slides to doctors and gets them to guess which has the highest GI - a Snickers bar, a slice of whole-wheat bread, a banana or a tablespoon of white table (granulated) sugar and they always get it wrong, because it's the bread.

On the back of 'Wheat Belly' by Dr William Davis MD, there's a photo of two slices of brown bread, with the startling message that they can raise blood glucose more than 2 tablespoons of sugar.

Generally, bread doesn't taste sweet, until we toast it, because toasting it caramelizes the sugars. They didn't appear out of thin air though, they were always lurking in the bread.

My husband has NCGS so I read that kind of book and don't keep anything with gluten in the house.

If you are generally low carb then starch is almost surely worse than sugar. The idea that fructose is processed differently than glucose and uniquely effects fat in the liver is a huge exaggerration and, if important at all, only applies at high total carbohydrate intake. Sugar hysteria is not generally good science and has really done a disservice to the population. Ice cream is probably good because the fat slows the absorption of the sugar. The problem is that we don't know all the answers because the people who get funded for studying sugar do not study effects at low total carbohydrate for whatever reason. At low total carbohydrate, any fructose that you do eat is probably converted to glucose anyway but probably appears in the blood slower than ingested glucose.

Brunneria said:

My body tolerates sugar far better than grains and starchy veg.

So yes, for me, sugar is the lesser of the various evils, as it were.

We also tend to eat a lot more of the starchy foods. I mean, imagine trying to eat sugar in the same quantities that you might eat pizza base, or mashed potato. Even allowing for the water in these foods, it is possible the portion sizes mean that they will have a huge impact.

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Same here. I have a generous amount of honey or sugar in my morning coffee and 2 hours later my numbers are perfect. If I eat a potato or pasta it sky rockets.

Celeriac said:

Your theory is pretty much accurate Sirmione, as bread has a higher Glycemic Index than sugar.

In 'Grain Brain', Dr David Perlmutter MD, the neurologist, says that he shows slides to doctors and gets them to guess which has the highest GI - a Snickers bar, a slice of whole-wheat bread, a banana or a tablespoon of white table (granulated) sugar and they always get it wrong, because it's the bread.

On the back of 'Wheat Belly' by Dr William Davis MD, there's a photo of two slices of brown bread, with the startling message that they can raise blood glucose more than 2 tablespoons of sugar.

Generally, bread doesn't taste sweet, until we toast it, because toasting it caramelizes the sugars. They didn't appear out of thin air though, they were always lurking in the bread.

My husband has NCGS so I read that kind of book and don't keep anything with gluten in the house.

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Thanks for the info on toast! Didn't know that, no more toast for me. Any more advice? All advice welcome. Thanks again.

Definitely true, I can eat a chocolate bar and be back in the 5's after an hour but I can't eat a potato.

Spuds and grains are my nemesis. I count rice in that!
Small pieces of fruit are ok.
Dairy is a real baddie for me!

Sugar, I veer away from as much as possible, no matter how it's delivered or presented!

Glucose is the problem for me, whatever happens when I eat and is converted into glucose, I spike very quickly and it's really high. I have been known to go from normal levels of around 5mmols to 12-13mmols within half an hour. At an hour it could be just starting to descend around a little higher, then my journey into hypo!

How do you treat a reaction to glucose when it is so necessary for your body?

I have always had the feeling that sugar was less problematic than starch for me. But really for me it amounts to this - is a short lived spike in blood glucose better or worse for a diabetic compared to the slow drip - drip of a modest rise in blood sugar over a longer period in time? In other words if I eat a dark choc bar it may raise my blood sugar to 12mmols after 2 hours but by 3 hours it's back in the 5s. If I eat s bowl of porridge (assume same quantity of 'carb' as the choc bar) if may only raise my blood sugar to 8.5mmols after 2 hours but it will stay at that level for 4 or 5 hours after eating. Which is the lesser of the two evils? The sudden drop in blood glucose after sugar consumption is always going to make me feel like I want to eat again but the bloated feeling after some more liquid starches such as porridge or soup is unbearable. I eat chocolate rather than other sweets because I assume the fat content slowers the digestion. I think the danger of eating too much sugar is the addictive nature of it. You begin to tolerate more and more which is probably not a good direction to be going.

Fizzylaa said:

I have always had the feeling that sugar was less problematic than starch for me. But really for me it amounts to this - is a short lived spike in blood glucose better or worse for a diabetic compared to the slow drip - drip of a modest rise in blood sugar over a longer period in time? In other words if I eat a dark choc bar it may raise my blood sugar to 12mmols after 2 hours but by 3 hours it's back in the 5s. If I eat s bowl of porridge (assume same quantity of 'carb' as the choc bar) if may only raise my blood sugar to 8.5mmols after 2 hours but it will stay at that level for 4 or 5 hours after eating. Which is the lesser of the two evils? The sudden drop in blood glucose after sugar consumption is always going to make me feel like I want to eat again but the bloated feeling after some more liquid starches such as porridge or soup is unbearable. I eat chocolate rather than other sweets because I assume the fat content slowers the digestion. I think the danger of eating too much sugar is the addictive nature of it. You begin to tolerate more and more which is probably not a good direction to be going.

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For me, your question gets to the heart of my problem:
Is a short lived spike in blood glucose better or worse for a diabetic compared to the slow drip - drip of a modest rise in blood sugar over a longer period in time?
I've asked GPs and diabetes nurses this, specifying "What about the spikes, up to 11.5 after 2 hours then down to 6 an hour later?" none ever answer my question but fall back on "Your HbA1C shows it's well controlled". Yet alternative American diabetes doctors warn spiking is dangerous. Who is right, does spiking matter, if the average is acceptable?

There is some discussion of this point on Jenny Rhul's Bloodsugar101 website.

After reading that, and having a good think, my personal view is that raised BG kills beta cells, because they curl up and die in high concentrations of glucose (that is a very simplified description). Doesn't matter to me whether the spike is a sharp mountain peak, or a long slow foothill. One will kill beta cells more quickly for a shorter time, the other will kill fewer beta cells for a longer time.

I try to avoid blood glucose spikes higher than 7 at any time.

Happy for others to disagree, poo poo and dismiss my views, but I would much rather be safe than sorry, and have my remaining beta cells in fine fettle for the next 40 years, than kill them off with 'unimportant' spikes.

Let's face it, very few of these dismissive and uninterested health care professionals are going to be around to see the complications that I will suffer, if I follow their bad advice.

rant over.

My ophthalmologist says spikes cause damage to the eyes and the NHS leaflet on retinopathy treatment says that people on insulin get it more often so I theorise that's because of the rollercoaster also.

Dr Robert Lustig MD is a paediatric endocrinologist in San Francisco and runs an obesity clinic at UCSF Benioff Hospital as well lecturing at UCSF. He wrote a great book called 'Fat Chance' about sugar, obesity and disease.

His great hero is Professor John Yudkin, who was a British scientist who wrote 'Pure White and Deadly' in 1972. He was rubbished by Ancel Keys publicly but Keys had no qualifications in medicine or nutrition and his postgraduate subjects were zoology, oceanography and physiology - primarily in fish. Yudkin was a scientist and MD and all the things Yudkin prophesied about sugar, came true.

Thanks to the popularity of Dr Lustig's YouTube video 'Sugar: The Bitter Truth', seen by millions, Penguin reissued Yudkin's book in 2012 and his theories were discussed in the BMJ in 2013.

I think in my case, it's more likely that soya, pasta, rice, root veg and bread made me develop T2DM, but sugar is hidden everywhere. You don't need to have a sweet tooth to be consuming too much of it, as Damon Gameau's film showed thatsugarfilm.com

It's counter intuitive I know to be eating more refined sugar than complex carbs but my hba1c is lower that way. Would it suggest that less damage is happening? Without any meds the reverse is true. But on meds they seem to affect blood glucose rises from sugar intake better than blood glucose rises from starch. I think the longer term worry is the desperate attempt the body makes to acquire glucose from whatever it can. Also excersize seems to lower blood sugar quicker if it has come from sugars rather than starch. And don't get me started on low GI starches. Just think of popcorn. It looks really small before you apply heat. Energy expands it 10 times its size! That's a load more glucose than you first imagine. That's what happens in your stomach. So lowGI pasta has a high glycemic load. That will be like eating a portion 10 times the size you actually ate. I love pasta! It's my Achilles heal.

I love popcorn <sniffle> but last time I had some as an experiment in August, it threw my BG out for 10 days

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I would concur!

Personal experience is that after being diagnosed in January with an A1C of 101, and following basically an Atkins diet that kept the carbs low, but cut out as much as possible Bread, Rice, Pasta as well as cutting sugar back as much as possible,

I now have an A1C of 42 and have lost 38.6KG/85lbs/6st 1lb.

On the rare occasions I do have the carbs I feel awful.

There is a theory that when the health professionals proclaimed war on salt the food industry responded with sugar, so where we had salt we now have sugar e.g. soup used to be salty and now it's sweet

AndyC65 said:

I would concur!

Personal experience is that after being diagnosed in January with an A1C of 101, and following basically an Atkins diet that kept the carbs low, but cut out as much as possible Bread, Rice, Pasta as well as cutting sugar back as much as possible,

I now have an A1C of 42 and have lost 38.6KG/85lbs/6st 1lb.

On the rare occasions I do have the carbs I feel awful.

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If you don't mind me asking what kind of meals do you eat if you cut out bread pasta and rice. Thanks