Otherindependent cross-checkabstract checked I-SUG-102 standard review
Sugar in a meal acts like starch
Postprandial glucose and insulin responses to meals containing different carbohydrates in normal and diabetic subjects.
Overview
Bantle JP et al.. N Engl J Med 1983 · PMID 6343873 · DOI 10.1056/NEJM198307073090102
In 1983, meals containing table sugar raised blood sugar about as much as meals with potato or wheat starch, in healthy people and people with diabetes.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Test whether the type of carbohydrate changes blood sugar and insulin after a meal.
- How was the study done?
Participants ate five meals that differed only in the type of carbohydrate.
- How many people, animals or samples were studied?
10 healthy adults, 12 with type 1 and 10 with type 2 diabetes.
- What was actually found?
Sucrose meals did not raise blood sugar more than starch meals; insulin peaks were similar.
- How large was the observed effect?
No significant differences between sucrose and starch meals.
- What do the results mean in everyday life?
A small amount of sugar inside a balanced meal is handled like other carbohydrates.
- What are the study's limitations?
Short single-meal tests; old study; small groups.
- What does it say about Elawady's specific claim?
Supports including some sugar in a meal plan; gives no support for stopping insulin.
- Do the results apply to Germany and Europe?
Physiology applies in Europe and Egypt.
- What can explicitly not be concluded from this study?
Cannot show that large sugar intakes or stopping insulin are safe.
Scientific in-depth review
1. Full reference
- Authors
- Bantle JP et al.
- Journal
- N Engl J Med
- Year
- 1983
- Identifier
- PMID 6343873 DOI 10.1056/NEJM198307073090102
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Supported by NIH (NCRR) and other public grants (PubMed record)
2. Research question
Does the form of dietary carbohydrate (glucose, fructose, sucrose, potato starch, wheat starch) change glucose and insulin responses?
3. Study design and population
- Study design
- Other – Within-subject feeding comparison of five test meals differing only in carbohydrate type
- Population
Healthy adults, adults with type 1 diabetes, adults with type 2 diabetes
- Country
USA
- Period
early 1980s
- Sample size
32 (10 healthy, 12 type 1, 10 type 2)
- Inclusion and exclusion criteria
Not detailed in abstract
4. Methods and endpoints
- Exposure / intervention
Meal containing sucrose as test carbohydrate
- Comparator
Meals with glucose, fructose, potato starch or wheat starch with near-identical total carbohydrate, protein and fat
- Endpoints
Peak increments and AUC of plasma glucose; serum insulin; urinary glucose
- Statistical methods
Within-subject comparisons
5. Actual results
- Results
In all three groups, the sucrose meal did not produce significantly greater peak glucose increments or glucose AUC than meals with potato, wheat or glucose. Urinary glucose after the sucrose meal was not greater in diabetes. The fructose meal produced the smallest glucose increments. In healthy subjects and type 2 diabetes, peak insulin concentrations did not differ significantly between the five carbohydrates.
- Absolute risks
not applicable
- Authors' conclusion
The data do not support the view that dietary sucrose, consumed as part of a meal, aggravates postprandial hyperglycaemia.
6. Strengths
- Includes people with type 1 and type 2 diabetes
- Controlled meal composition
- Published in a high-quality journal
7. Weaknesses
- Single-meal acute study
- Small groups
- 1983 insulin regimens differ from today
- Abstract only reviewed
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Acute crossover-type feeding study; randomisation of meal order not stated in abstract.
9. Assessment of the statistical interpretation
Shows sucrose behaves like other digestible carbohydrates in a mixed meal; it does not show that sugar is harmless in unlimited amounts or without insulin in type 1 diabetes.
10. Relevance to the specific claim
Gives the correct part of 'eat sugar normally': moderate sucrose within a planned meal raised glucose like starch did in people already on treatment. It does not support stopping insulin; all participants with type 1 diabetes remained on insulin.
11. Independent contrary findings
Long-term trials and guidelines (ADA 2026, WHO 2015) still advise limiting added sugars and sugary drinks.
12. Transferability to Germany and Europe
Physiology transferable; treatment context dated.
13. Overall methodological judgement
Useful nuance: sucrose in a mixed meal is not uniquely glycaemic, which is why modern diabetes guidance allows small amounts within a meal plan. It provides no support for stopping insulin.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | indirect |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
None for the claim.
15. Linked fact checks
- Advice given live to a viewer: stop insulin, it is not needed; eat sugar normally. – Studies with mixed or unclear results
- On the Tayyibat system, eating white sugar does not raise insulin at all. – Studies contradicting or limiting the claim