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fructose versus dextrose

Discussion in 'Parents of Children with Type 1' started by Lakeman, Sep 2, 2015.

  1. Lakeman

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    I have read that different kinds of sugar effect the body differently. So are the claims true? What has your experience been like? Do smarties or tabs (dextrose) work any faster or slower than fructose (most soda and some juices)? To be fair the tabs would have to be taken with water so we are comparing two liquids rather than a solid and a liquid.

    So far I can only say that all fast sugars (not chocolate for example) appear to work equally fast. Hard candy needs to be chewed and beverages seem a little faster than solids. But I have not been very systematic about this and my experience may not be the same as yours. We have never tried honey or other syrups.
     
  2. nebby3

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    We've never (in almost 12 yrs) noticed significant differences.But I will say we use the things differently -- juice boxes for night or when she needs 20+ grams of carbs. Tabs for when we are out and about or she only needs 4,8 or maybe 12g. Add to that that it's really hard to compare one low to another. She might be 50 one day but have been holding steady or slowly coming down and so respond quickly. Another day might be 50 and dropping fast and it takes forever to bring her up. Or there could be activity involved, or high fat meals beforehand . . . The list goes on as I'm sure you know.
     
  3. Sarah Maddie's Mom

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    I think it's one of those things that seems to mater a lot on paper but in real life means little. :)

    Fwiw, we treat almost exclusively with juice or tabs.
     
  4. Theo's dad Joe

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    Soda, juice, table sugar, sugar present in fruit and fruit juice, high fructose corn syrup and candy all have close to 50% fructose and 50% glucose. Sucrose breaks into 1 molecule of fructose and 1 molecule of glucose almost instantly. There may be a few fruits that are higher in glucose (maybe 60%. I think Apricots) and HFCS is aorund 60% fructose, but basically non-milk sugar is about half fructose half glucose.

    So we really have two categories in terms of sugar content. Dextabs/liquid which is all glucose, and everything else which is close to 50/50. Now I realize that some fruits seem to spike faster or slower too so I don't want to get too absolute here on effects.

    Starch is also going to yield 100% glucose, and studies have found white rice and potato to raise blood sugar as fast as sugar.

    I don't know the answer to your question on speed so I am interested to see what people say. Fructose gets absorbed by some gut lining cells and turned into glucose and released into the blood eventually, maybe fast, and some fructose goes straight to the liver without entering the general bloodflow, and without insulin, and gets made into glycogen which can be released later. Some studies have found that small amounts of fructose added to glucose will supress glucagon and slow down liver dumping after a meal.

    By the way, pretzels raise my son's blood sugar as fast as fruit, and fish crackers take a LONG time. Rice bread (gluten free bread) seems to raise it very fast.

    I have virtually no experience treating lows. I myself have done pure glucose glucose tolerance tests and pure glucose spikes my blood sugar at about 30 minutes and then around 2 hours from liver dumping (presumably). The 2 hour mark is even higher.

    I don't like to overuse category 1 sugars too much because they yield fructose which is fine in moderation but raises triglycerides at high levels. I have not seen any evidence that it raises triglycerides at less that 25 grams fructose per day or 4% of daily calories and that 25 grams of fructose would require 40-60 grams of sugar (excluding milk sugar).

    If my son was very low I'd give him glucose liquid or juice because highly concentrated sugar in the stomach can block absorption. (drinking a lot of liquid with a meal by the way will also theoretically speed up absorption and spike blood sugar-again this is something I have seen in non-D's), but because it increases blood volume, water can lower blood sugar after the sugar has been absorbed.

    Not meaning to overload, just want to throw everything out there all at once. I DO think it is important not to raise lows to highs if at all possible. I have read research that during a sustained low, (even in the 60s) cells start to try to actively pull in glucose, then during the following high, the cells remain in "suck up glucose" mode now with lots of glucose available and they will pull in even more than with a sustained high. (cells will resist pulling in blood sugar during a sustained high as a protective mechanism, but a fast high after a long low can cause the hyper rebound.
     
    Last edited: Sep 2, 2015
  5. msschiel

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    100% juicy juices (4 oz) seem to make my son go too high, so we usually treat with peanut butter crackers with 15 grams of carbs. Easier to carry around, although they do get crushed quite easily! We have never used candy to raise a low, mainly because I don't keep it in the house. He usually feels his lows before they get too low, thankfully.
     
  6. jenm999

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    This is fascinating. We treat with tabs during waking hours because they are easy to measure and carry around. We treat with juice at night because the straw minimizes contact with teeth. Here's a chart of foods highest in glucose: http://nutritiondata.self.com/foods-009010000000000000000.html?maxCount=78 Apple juice is the highest of the liquids and pretty far down the list! I think most of the juicy juices (which we use) are primarily apple and pear juice.

    One of my son's friend's dads is T1 and he says the thing that brings him up the fastest is two saltines. Go figure. Probably a lot cheaper than this other stuff, though will also get crushed!
     
  7. msschiel

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    I bought tabs when we were first diagnosed, but we have never used them. My dad always eats peanut butter crackers (or full sized candy bars if he has to buy something, but the best option in my opinion). I will have to remember to buy grape juice boxes when I buy again. We haven't had too many lows lately, thankfully, but hopefully we will be pumping soon and I anticipate changes will have to be made.
     
  8. StacyMM

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    For both of mine, glucose tabs are the fastest product we use, which is why they use them if they are under 55. Above, they have choices and it really varies by kid. My son gets a relatively quick rise from juice and Airheads, but my daughter does not. She may as well be drinking water and eating bacon for the immediate impact they have on her. They both responds pretty well to Skittles and Starburst. I see others that can use crackers, milk, fruit, granola bars...but those aren't quick carbs for mine. No idea on the type of -ose in each of those things or what other ingredients impact the reaction, but that's what we do :)
     
  9. forHisglory

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    We do low-fat choc milk middle of night. I feel like the bit of fat and protein works well to sustain him back into range. He is hard to wake up so a straw seems easiest. He's tired of juice, and the tabs are so chalky (according to him). Starburst are the favorite. They are easy to carry, don't melt, get him up quick. Meticulous about teeth brushing with all this sugar.
     
  10. quiltinmom

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    I agree with this. If one type takes 4 minutes, and another 5 or 6, to me, that is splitting hairs. It would be an interesting study, though, if you could find a way to scientifically measure accurately enough (and filter out all the other variables).


    I wonder if the sugar studies, done by people trying to get you to eat less sugar I assume, are good studies. Some people seem to think sugar is evil and should be avoided at all costs, and they will do anything to get you to believe it. Maybe there is a small difference in metabolism between fructose, honey, HFCS, etc. but I wonder how much of it is hype. Any differences there may be are probably tiny, especially if all you are looking at is time it takes to bring bg up. Although, we have never been able to study it thoroughly, as we don't use cgm (yet).

    Fwiw, we use all kinds of things to bring bg up...tabs, fruit snacks, bread, milk, etc. it depends on the situation as a whole, not just the number.
     
  11. Lakeman

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    I guess enough people have answered now that I can more fully address my concern without biasing what people have to say. I think the two of you (quoted above) are on the right track. When I get out there on the www the echo chamber is filled up with people claiming that no one should eat fructose because it gets converted to fat in the liver rather than raising blood glucose. Maybe they mean only a part of it but that is not how what they say reads. So when I came across that I put on my skeptics hat because if fructose really did go straight to the liver in any appreciable amount then it would not be useful for treating lows. I think our children, who in some ways are excellent test subjects to figure this kind of stuff out, have proved that you can't trust this hype about fructose.
     
  12. dpr

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    And there you have it. Where reality trumps theory. The difference isn't worth arguing over...

    And if the low continues and they're on a pump, take the insulin away. Temp basal. The low can only last so long without insulin.

    For us the fastest and spikeyest carb for a low is a bag of fruit snacks washed down with a little apple juice = rocket fuel. I only use it for bad lows because it overshoots like crazy.
     
  13. Theo's dad Joe

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    I just read that the american journal of clinical nutrition did a study that showed that glucose gel or liquid raised lows twice as fast as fruit juice, FWIW.
     
  14. cdninct

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    We generally use tabs during the day and juice at night, like many others, because sticking with tabs at night was wrecking his teeth. I do think the tabs work a bit faster, but as others have mentioned, the difference is pretty negligible.
     
  15. Michelle'sMom

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    Tabs or sticks during the day. Juice boxes at night. She never cared for candy unless it was chocolate, & that doesnt work well.

    Studies don't always translate well to the real world. We used liquid glucose for a while. It made her so nauseous we went back to juice boxes. I couldn't tell much difference in how fast her BG came up.
     
  16. MomofSweetOne

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    I find your posts about how differently your kids' bodies react to the same things fascinating. It really shows the YDMV within the same house, same diet, same parental manager.
     
  17. sugarmonkey

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    We use juice boxes at home and candy when out. Juice boxes always get crushed in his bag so better left at home. He doesn't like candy, so we use whatever his latest preference is. If he's at work, he carries a little bag of candy in his pocket and can just grab one or two while he's working. I don't think there's much difference in how fast they act. It really depends on the low like someone else said.
     
  18. Theo's dad Joe

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    After reading the ingredients on smarties and sweet tarts, they actually have dextrose (glucose) and maltodextrin as their main ingredients, so they are virtually the same composition as glucose tablets. If a candy lists "sugar" it means sucrose which is half fructose and half glucose. If it lists HFCS it is about 55% fructose and 45% glucose, but dextrose is just glucose.
     
  19. rgcainmd

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    Actually, glucose and dextrose are two different molecules. A glucose molecule is comprised of a pair of enantiomers (or mirror-image pieces), while a dextrose molecule is only one of these enantiomers.

    But in reality, there is no practical difference when it comes to caring for a child with T1D...
     
  20. rgcainmd

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    Do you even proofread what you write?

    Glucose is, indeed, comprised of an enantiomeric pair and one of those enantiomers is dextrose. And there is, in all practicality, no difference in the way a child with T1D responds to glucose versus dextrose.

    ETA:
    Clarification: Glucose comes in two isomeric forms that are enantiomers of each other. Not all glucose is dextrose, however. When I said there was no difference, I was NOT referring to glucose versus sucrose or fructose, but glucose v. dextrose.

    I wish you would be more aware of how your posts divert threads from the subject at hand...
     
    Last edited: Sep 19, 2015

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