diabetic chocolate bars?

StrwbryblndRN · Feb 11, 2007

A relative who controls her diabetes through diet eats balance bars. These were suggested by her doc because of percentages of dietary protein, carbs and fat. (40/30/30). I would not say they are the best replacement for chocolate bars but then again if you are diabetic they could hit the spot.

Here is a website for them.

http://www.balance.com/nutrition/high_protein.asp

casi, ASN, RN · Feb 11, 2007

Check out your local grocery store's main candy aisle. The Hershey's company makes a lot of their candies sugar free or low carb.

GingerSue · Feb 11, 2007

thanks, these are good ideas

nurseangel47 · Feb 11, 2007

I see these in every drug store chain I've ever entered. Diabetic candies are usually displayed along with the regular sugary candies in the same aisle right next to each other. (you must not eat much candy! LOL!)

GingerSue · Feb 11, 2007

(you must not eat much candy! LOL!)

right!

Myxel67 · Feb 11, 2007

Sugarfree candies/chocolate are usually sweetened with sugar alcohols (sorbitol, mannitol, xylitol, etc). Eating too much sugar alcohols can cause diarrhea. If the person with diabetes wants chocolate or some other candy, they should just have the regular kind, but be sure to count the carbs & calories in diet. All of these sugarfree products feed the misconception that sugar is bad and must be avoided by those with DM. Also the person eating them often thinks of them as free foods, which they are not. Sugarfree cookies still have a lot of carbs because the flour is still there. And SF chocolate still has a lot of caloriesbecause the fat is still there.

If you think I'm spreading heresy, check out this article/editorial from "Clinical Diabetes" which is the journal of the American Diabetes Association:

http://clinical.diabetesjournals.org/cgi/content/full/20/2/51

llg, PhD, RN · Feb 11, 2007

Sugarfree candies/chocolate are usually sweetened with sugar alcohols (sorbitol, mannitol, xylitol, etc). Eating too much sugar alcohols can cause diarrhea. If the person with diabetes wants chocolate or some other candy, they should just have the regular kind, but be sure to count the carbs & calories in diet. All of these sugarfree products feed the misconception that sugar is bad and must be avoided by those with DM. Also the person eating them often thinks of them as free foods, which they are not. Sugarfree cookies still have a lot of carbs because the flour is still there. And SF chocolate still has a lot of caloriesbecause the fat is still there.
If you think I'm spreading heresy, check out this article/editorial from "Clinical Diabetes" which is the journal of the American Diabetes Association:
http://clinical.diabetesjournals.org/cgi/content/full/20/2/51

I just read the article that the link above connected me to. It doesn't discuss the issues you mentioned in your post at all. It discusses the need to individualize diets to accommodate the fact that each individual is unique -- and that the old stand-by "1800 cal/day ADA diet" should not be automatically ordered for all hospitalized patients. It says nothing about the use of sugar free products to help maintain normal blood glucose levels in otherwise healthy, active people who would like a snack now and then -- but don't want to see a big surge in their glucose levels.

Are you sure you posted the right link?

Personally, I have found that the ocassional use of such sugar-free products has helped me maintain satisfactory blood glucose levels. When I have a snack of "regular sweets," my blood glucose shoots up. When I have a sugar-free substitute, it doesn't. That seems pretty simple and straight-forward to me. I don't eat enough of the stuff to cause diarhhea: so, that is not an issue. I'm also not using those products as part of a diet to lose weight: I know that they can be high in calories and take that into consideration. I see them as a big help -- but like most things in life, they should be used in moderation and not over-used.

Myxel67 · Feb 11, 2007

I don't think you read the whole article. What you said about individualizing diet is true, but the crux of the article deals with counting total carbs--not restricting sucrose (people use art sweeteners and SF products to restrict sucrose):

This is direct quote (C%P) from article, so link is correct:

There are several key points that require emphasis. First, the total amount of carbohydrate in meals and snacks is more important than the source or type of the carbohydrate consumed. Although different forms of carbohydrate do induce differing glycemic responses, the data reveal no clear trend in outcome benefit for any specific type of carbohydrate. The position statement notes that dietary sucrose does not increase glycemia more than isocaloric amounts of starch. Therefore, "intake of sucrose and sucrose-containing foods by people with diabetes does not need to be restricted because of concern about aggravating hyperglycemia. Sucrose should be substituted for other carbohydrate sources in the food/meal plan or, if added to the food/meal plan, adequately covered with insulin or other glucose-lowering medication."3

Because there is a great deal of individual variation in response to different sources of carbohydrate, it is difficult to make recommendations that apply to everyone with diabetes. By considering the total amount of carbohydrate in a meal and reviewing premeal and postmeal glucose measurements, it is possible to see how individuals respond to different types of food. Certainly, we see this on a daily basis in our clinic, particularly in those who frequently measure their blood glucose level.

Also relevant to my patient is the fact that he was acutely ill and had additional nutritional challenges other than his chronic illness. Why is it that everyone with diabetes seems to end up with the same dietary prescription when hospitalized? The ADA does not even endorse the "ADA diet"; it no longer recommends any single meal plan or any specified percentages of macronutrients for people with diabetes.4

Meal plans that specify "no concentrated sugars" or "no sweets" are no longer appropriate. These diets do not reflect current nutrition recommendations and unnecessarily restrict sucrose. Furthermore, they perpetuate the notion that restricting sucrose will result in improvement in diabetes control.

He goes on to state that restricting sugar often leads the person with diabetes to believe s/he will have better outcomes by avoiding sugar--and that is just not the case

Editorial Team / Admin · Feb 11, 2007

Sweeteners & Desserts

http://www.diabetes.org/nutrition-and-recipes/nutrition/sweeteners.jsp

Types of Carbohydrate

http://www.diabetes.org/nutrition-and-recipes/nutrition/types-of-carb.jsp

8. Can I use low calorie sweeteners?
Low calorie sweeteners are safe for everyone except people with phenylketonuria, who should not use aspartame. Calorie-free sweeteners like aspartame, saccharin, sucralose and acesulfame-K won't increase your blood glucose level. The sugar alcohols -- xylitol, mannitol, and sorbitol -- have some calories and do slightly increase your blood glucose level. Eating too much of any of these can cause gas and diarrhea.

http://www.diabetes.org/nutrition-and-recipes/nutrition/faqs.jsp

Myxel67 · Feb 11, 2007

I'm not saying artificial sweeteners can't be used safely--just that we don't need to restrict sucrose more so than starches in the mistaken belief that it will make a big difference in BG management.

For example, a man who puts 1 or 2 tsp. of sugar in his coffee in the a.m. and can't stand the taste of the art. sweet, will not be harmed by this use of sugar. Just when he is looking at total carb content of breakfast, should reduce by 1/2 carb serving if using 2 tsp sugar.

No one likes seeing their sacred cows butchered, but this is not new information. The article in ADA journal is from 2002. I'm a Certified Diabetes Educator in a hospital outpatient facility. We provide teaching in DM self management to inpatients as well. A big part of my job is serving as a clinical resource to our physicians and nurses to ensure better outcomes for hospitalized pts with DM.

llg, PhD, RN · Feb 11, 2007

I'm not saying artificial sweeteners can't be used safely--just that we don't need to restrict sucrose more so than starches in the mistaken belief that it will make a big difference in BG management.
ForQUOTE]
I don't think anyone her was saying that we shouldn't restrict startches or that total carbs aren't important. I'm beginning to think we are "talking past each other" here -- in other words, comparing apples and oranges.
The original question was whether or not "sugar free" products have a place in diabetes management and where a patient might be able to find a suitable substitute for chocolate bars. We seem to have gotten a bit off track.