Q: Are sugar-free candies and treats always a better choice for children with type 1 diabetes?

A: Sugar-free foods can have less impact on blood sugar, but they are not a free ride. For parents concerned about accurately counting carbs as part of their child’s type 1 diabetes management, it’s important to know that sugar-free does not always mean carbohydrate-free. It is the total number of carbohydrate grams in a food that impacts blood sugar levels, and sugar is only one portion of this total. Read food labels carefully. Depending on a treat’s other ingredients, including flour or rice, the total carb count of a sugar-free food could still be considerable (and require covering with insulin). Even sugar substitutes themselves can contain carbohydrates.

The FDA has outlined an Acceptable Daily Intake (ADI) of each type of sugar substitute. Eating too much of certain sugar substitutes, especially sweeteners made from sugar alcohols (like maltitol or sorbitol), may cause gastrointestinal side effects such as gas, bloating, and diarrhea, as these sweeteners are not always well absorbed by the body.

Children with type 1 diabetes should be able to enjoy their favorite foods. Thanks to individualized insulin dosing, children are better able to eat what they like, when they would like, as long as carbohydrate grams are calculated and covered by insulin. This includes occasional treats like a piece of sugar-sweetened candy with lunch or a cupcake at a friend’s birthday party.

The key word is “occasional,” because we want children with type 1 diabetes—and all children—to eat healthy and nutritious foods. For example, parents can increase children’s fruit and vegetable intake (and decrease processed treats) by encouraging them to explore new foods. Sugar-filled beverages should be limited, as should diet sodas and other diet drinks.

If you need help steering your child’s food choices in the right direction, get in touch with a registered dietitian for healthy meal and snack suggestions.

Courtney Ferreira—Courtney Ferreira, M.S., R.D., L.D.N., is a registered dietitian at the University of Maryland Medical Center in Baltimore.


How Other Parents Deal

“We’ve made it a point to avoid sugar-free candy for one main reason: It’s really easy to confuse sugar-free candy with regular candy that we have on hand in case our daughter goes low. I got rid of all sugar-free treats after inadvertently giving my daughter sugar-free [zero-carb] candy when she was feeling low. Her numbers fell even more, and then I checked the label and realized my mistake.”

—Liz R., Bryn Mawr, Pa., mom of 18-year-old Erica

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Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.