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What does the sugar-diabetes finding mean for Type 1 diabetes?

As media coverage of the new research on sugar exposure and diabetes has expanded, a few readers have asked me why our coverage did not specify that the findings apply only to Type 2 diabetes. The short answer is that the study itself did not distinguish between Type 1 and Type 2 diabetes.

Some quick background: Although both forms of diabetes affect the sugar-handling hormone insulin, the diseases have different origins. Type 1 diabetes is thought to be an autoimmune disease, beginning when, for poorly understood reasons, the body attacks the cells that manufacture insulin. In contrast, Type 2 diabetes occurs when the body stops responding to the insulin it is making. This "insulin resistance" has been thought to be the product of metabolic disturbances associated with overweight and obesity.

The new research, which found an association between sugar countries' food supplies and diabetes their populations, was based on diabetes rates in adults from 175 countries. Unfortunately, the scientists were not able to obtain data that differentiated between Type 1 and Type 2 diabetes, so they analyzed total diabetes rates.

In the discussion section of the PLOS ONE scientific paper, the researchers address this issue:

“…the International Diabetes Federation database contains diabetes prevalence data based on multiple surveys of varying quality; as many diabetics go undiagnosed, these are likely underestimates, and do not distinguish between Type 1 (approximately 10%) and Type 2 diabetes (90%), which would tend to produce regression towards the mean (underestimating the relationship between sugar and diabetes).”

In other words, the authors expect that if they could get data on Type 2 diabetes rates only, the sugar-diabetes relationship would look even stronger.

But back to Type 1 – do the findings mean that this form of the disease could potentially be caused by sugar? Without data separating the two forms of the disease, we can't say for sure. But since the scientists know their data is very heavily skewed toward people with Type 2, the reasonable answer is "probably not."

Previously: New evidence for a direct sugar-to-diabetes link and Sugar intake, diabetes and kids: Q&A with a pediatric obesity expert
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