It is a common question that I am asked by my patients: What can I drink? This is an especially important topic when discussing diabetes, as many choices are laden with sugar, often disguised as "high-fructose corn syrup." Sugary beverages can cause blood sugars to sky-rocket, and then plummet like a penny from the Empire State Building. This scenario can make glycemic control unpredictable and difficult. Here is a guide to choosing beverages.
Do not drink soda. I am firm on this one. Filled with high-fructose corn syrup, it can have a detrimental effect on cholesterol and triglyceride levels. The high sugar content can cause people with diabetes to experience a high blood sugar, and then a quick drop, which may result in hypoglycemia. No good, my friends. The same goes for sweetened iced teas and lemonades (not homemade; I'm talking about the stuff that you get at your local deli). If you want to enjoy tea, make your own and experiment with different flavors--there are a ton out there.
What about diet soda? you ask. The only time I suggest drinking diet soda, or other diet drinks, is when I am dealing with a patient with diabetes who tells me she will not give up soda, ever. And that is fine, that is her prerogative, and I respect that. Diet sodas, flavored waters, iced teas, and the like are sugar-free, so they do not cause a glycemic response the way regular sodas do. In this sense it may be perceived as "better" for you; however, it does not have any known benefit to our physical health. The issue of artificial ingredients is, in my opinion, a personal one. All major sugar substitutes (aspartame in Equal, sucralose in Splenda, saccharine in Sweet'N Low) are considered GRAS (generally recognized as safe) by the U.S. Food & Drug Administration, meaning adequate research has been conducted to deem it safe for human consumption in its intended use. Some people evade these ingredients because they are not natural.
Juice is good, in small amounts. One serving of juice is 4 ounces, or 1/2 cup. Measure it--it's not that much. It is better to eat a whole fruit instead of its liquid counterpart, as the actual fruit contains fiber. But if you choose juice, make sure its made with 100% fruit juice, and be aware of the serving size.
Milk provides calcium, vitamins A and D, phosphorus, protein, and some B vitamins. If you are a milk-drinker, choose low-fat (1%) or fat-free (skim). Whole milk should only be given to babies, and even they should discontinue drinking it after the age of two. Two-percent (reduced-fat) milk is very similar in fat content to whole milk, so you're not doing yourself a huge favor by choosing this type of milk. Chocolate milk is okay if you buy your own syrup and are mindful of the amount you add. Steer clear of the packaged chocolate (or strawberry or vanilla or banana or any other flavors that exist) milk drinks; they may be advertised as "low-fat," but are usually packed with sweeteners.
Gatorade, Powerade, etc. Let's face it, most of us are not professional athletes, training several hours a day and losing essential electrolytes. These drinks contain sugar, and therefore calories, and pose no real benefit to those of us who do not exercise for a living.
Water. We have all heard how great it is. With no calories or additives, water is an excellent beverage that keeps us hydrated without causing us to worry about what we are putting into our bodies. If drinking water seems a little boring to you, add fresh lemons or limes for a refreshing change. Seltzer is a great option too, especially for those who crave the bubbles. (Seltzer is also an excellent substitute for soda, and it can be mixed with juice to satisfy the craving we may feel for a sweet beverage.)
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