Teaching Subjects With Type 2 Diabetes How to Incorporate Sugar Choices Into Their Daily Meal Plan Promotes Dietary Compliance and Does Not Deteriorate Metabolic Profile

  1. Julie Nadeau, MSC, RD,
  2. Kristine G. Koski, PHD, RD,
  3. Irene Strychar, EDD, RD and
  4. Jean-François Yale, MD
  1. From the McGill Nutrition and Food Science Centre (K.G.K., J.-F.Y.) and the School of Dietetics and Human Nutrition (J.N., K.G.K., J.-F.Y.), McGill University; and Centre Hospitalier de l'Université de Montréal (I.S.), Notre-Dame Hospital, University of Montreal, Montreal, Quebec, Canada.
  1. Address correspondence and reprint requests to Jean-François Yale, MD, McGill Nutrition and Food Science Centre, Royal Victoria Hospital, 687 Pine Ave. West, Montreal, PQ, Canada H3A 1A1. E-mail: yale{at} .


OBJECTIVE— To determine whether teaching free-living subjects with type 2 diabetes how to incorporate added sugars or sweets into their daily meal plan results in a greater consumption of calories (fat or sugar) and deteriorates their glycemic or lipid profiles but improves their perceived quality of life.

RESEARCH DESIGN AND METHODS— In an 8-month randomized controlled trial, 48 free-living subjects with type 2 diabetes were taught either a conventional (C) meal plan (no concentrated sweets) or one permitting as much as 10% of total energy as added sugars or sweets (S). Mean individual nutrient intake was determined using the average of six 24-h telephone recalls per 4 months. Metabolic control and quality of life were evaluated every 2 months. Quality of life was assessed using the Medical Outcome Survey and the Diabetes Quality of Life questionnaire.

RESULTS— The S group did not consume more calories (fat or sugar) and in fact ate significantly less carbohydrate (- 15 vs. 10 g) and less starch (- 7 vs. 8 g) and had a tendency to eat fewer calories (- 77 vs. 81 kcal) than the C group. Weight remained stable, and there was no evidence that consuming more sugar worsened metabolic profile or improved their perceived quality of life.

CONCLUSIONS— Giving individuals with type 2 diabetes the freedom to include sugar in their daily meal plan had no negative impact on dietary habits or metabolic control. Health professionals can be reassured and encouraged to teach the new “sugar guidelines,” because doing so may result in a more conscientious carbohydrate consumption.


  • Abbreviations: BMRcalc, calculated basal metabolic rate; C, conventional; CDA, Canadian Diabetes Association; CHO, carbohydrate; DQOL, Diabetes Quality of Life; EI, energy intake; FPG, fasting plasma glucose; MOS, Medical Outcome Survey; S, sugar; TC, total cholesterol; TG, triglyceride.

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted October 20, 2000.
    • Received February 16, 2000.
| Table of Contents