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Recommendations Summary

DM: Sucrose and Diabetes 2008

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.


  • Recommendation(s)

    DM: Sucrose Intake

    If persons with diabetes choose to eat foods containing sucrose,  the sucrose-containing foods should be substituted for other carbohydrate foods. Sucrose intakes of 10 to 35 percent of total energy intake do not have a negative effect on glycemic or lipid responses when substituted for isocaloric amounts of starch.

    Rating: Strong
    Conditional

    • Risks/Harms of Implementing This Recommendation

      • Excessive substitution of sucrose for starches could potentially contribute to inadequate intake of foods contributing other essential nutrients.  If sucrose-containing foods are habitually added to usual intake, excessive energy intake is a concern.

    • Conditions of Application

      None.

    • Potential Costs Associated with Application

      • Although costs of MNT sessions and reimbursement vary, medical nutrition therapy sessions are essential for improved outcomes.

    • Recommendation Narrative

      • Sucrose intakes of 10 percent to 35 percent of total energy intake do not have a negative effect on glycemic or lipid responses in persons with either type 1 or type 2 diabetes when sucrose is substituted for isocaloric amounts of starch.
      • Ten randomized crossover/controlled studies (Cooper et al, 1988, Loghmani et al, 1991, Nadeau et al, 2001, Peterson et al, 1986, Bantle, Laine et al, 1986, Bantle, Swanson et al, 1993, Buysschaert et al, 1987, Chantelau et al, 1985, Rickard et al, 2001, Santacroce et al, 1993), four non-randomized crossover studies (Malerbi et al, 1996, Coulston et al, 1985, Bantle, Laine et al, 1983, Schwingshandl et al, 1994), and one cross-over study (Shimakawa et al, 1993) examined the effect of sucrose on glycemic control.  All but one study (Coulston et al, 1985) showed no effect of sucrose.

    • Recommendation Strength Rationale

      • Conclusion statement was given Grade I

    • Minority Opinions

      Consensus reached.