Diabetes Mellitus: Influence of Sugar
Introduction:
From 1980 to 2014 there has been an increase in the amount of people who suffer from diabetes and obesity. There has been an increase of 3.4% in men and 8.9% in women. (South African Medical Research Council, 2019)
As a result, government has implemented sugar tax in order to counteract weight gain amongst South Africans. Government hopes to see a 10% decrease in the amount of victims who face obesity. (Quartz Africa, 2019)
The question becomes, will sugar tax reduce the onset of obesity and diabetes in South Africa?
1.1) What is the role of insulin in the regulation of blood glucose levels?
Insulin and glucagon are used to regulate blood glucose levels. Islet cells located in the pancreas are responsible for the secretion of these hormones. (James Norman MD, 2016) Beta cells are responsible for the secretion of insulin and Alpha cells are responsible for the secretion of glucagon. The balance in blood sugar levels is used to provide energy to cells as well as prevent nerve damage which may occur due to high blood sugar levels. When sugar levels are high insulin is released as it helps with sugar absorption in cells. (Alan Carter and Villines, 2019)
1.2) Define the term Diabetes.
Diabetes is a disease that affects the production of insulin secreted by the pancreas. Diabetes occurs when the pancreas provides little to no insulin or when a person’s body resists insulin. This results in high glucose levels. (Davita, 2019)
1.3) Compare the differences between Diabetes Mellitus 1 and Diabetes Mellitus 2.
Type 1 (Insulin-dependent Diabetes or Juvenile-onset Diabetes):
Diabetes type 1 is usually diagnosed among children. It is a result of anti-bodies that attack the pancreas prohibiting the production of insulin. It may be a result of genetics or faulty beta cells that produce insulin. It may be treated by injecting insulin into fatty tissue. (WebMD, 2019)
Type 2 (Adult-onset Diabetes or Non-insulin dependent Diabetes):
Diabetes type 2 usually occurs among adults but has recently been occurring among teenagers. It is a result of the pancreas not producing sufficient insulin or by resistant or insensitive body cells. It usually occurs in fat, muscle cells and the liver. It mainly happens among people who are overweight. Although there is not a cure, it can be maintained through the management of weight, nutrition and exercise. Medication may be needed if the disease develops. (WebMD, 2019)
1.4) What are the symptoms of Diabetes Mellitus 2?
According to Galan and Prelipcean (2018) the symptoms of Diabetes Mellitus 2 are as follows:
- Frequent Urination: The kidneys try to remove excess sugar by filtering it out of the blood.
- Increased Thirst: Frequent urination leads to water loss which causes dehydration resulting in thirst.
- Hunger: People who suffer from diabetes do not get sufficient energy from the food they consume. As a result, they feel hungry constantly.
- Fatigue: Insufficient glucose enters body cells resulting in exhaustion.
- Blurred Vision: Excess glucose may cause damage to small blood vessels in the eyes which results in blurry vision that may occur in one or both eye(s).
- Slow healing of wounds and cuts: High glucose levels may impair nerves and blood vessels which may damage blood circulation. As a result, wounds take longer to heal.
- Neuropathy: high sugar levels affects blood circulation which results in numbing, tingling or pain in hands or feet.
- Acanthosis Nigricans: A skin condition that results in dark patches forming in the creases of the neck, armpits or groin.
- Yeast Infections: Excess sugar and urine provides a suitable environment for yeast to form. This may occur in moist areas such as the mouth, genitals and armpits which results in itching.
1.5) What is the most common treatment of diabetes?
Type 1 is managed with insulin which may be injected as well as diet changes and exercise.
Type 2 is managed with non-insulin medications, insulin, weight supervision and diet changes. Medication is either used to increase insulin sensitivity or glucose excretion in cells. (Robert Ferry Jr., 2018)
1.6) What role does the general intake of sugar in our meals and drinks, play on the prevalence of Diabetes in our society?
Sugar intake does not cause Diabetes but it rather causes weight gain or obesity which increases the risk of diabetes. Once a person has diabetes, consuming excessive sugar may worsen symptoms as it is more difficult to manage blood glucose levels. (Deborah Weatherspoon, 2019)
Sugar Content in Sweetened Drinks
Name of sweetened drink Amount of sugar per 100ml (g)
- Coca-Cola original 10.6
- Dr. pepper 7.2
- Energade Orange 5.6
- Fanta Orange 9.9
- Liqui Fruit Orange Juice 9.5
- Pepsi 11.0
- PowerAde Orange 4.1
- Red Bull 11.0
- Steri-stumpie Strawberry 9.0
- Schweppes Bitter Lemon 4.5
- Yogi-sip Granadilla 9.5
1.7) Sweetened Drinks
KEY
- Coca-Cola original
- Dr. pepper
- Energade Orange
- Fanta Orange
- Liqui Fruit Orange Juice
- Pepsi
- PowerAde Orange
- Red Bull
- Steri-stumpie Strawberry
- Schweppes Bitter Lemon
- Yogi-sip Granadilla
1.8) Survey:
Aim: To determine by the use of 20 surveys whether sweetened beverage consumption is the main or only cause for diabetes or obesity within teenagers between grades 8 to 12.
Sampling technique: Surveys will be used to gather information from teenagers. Four learners from each grade (8 to 12), two of each gender that will be selected at random. In total there will be 20 teenagers completing the survey.
I conducted a survey which I then distributed using the app SurveyMonkey. The survey consisted of the following questions:
1. What grade are you in?
- 8
- 9
- 10
- 11
- 12
2. Gender:
- le
- Female
3. Do you consider yourself healthy?
- Yes
- No
4. On average, how much sweetened beverages do you consume in a week?
- 0 to 1ℓ
- 1 to 2ℓ
- 3ℓ +
5. Do you consider yourself :
- Underweight
- Correct weight
- Overweight
6. How many hours do you exercise in a week?
7. Do you suffer from diabetes, if so what type?
8. Are you aware of the amount of sugar in the beverages that you drink?
- Yes
- No
9. What type of sweetener do you use? (e.g. artificial sweeteners, honey …)
10. Do you believe that increasing the tax on sugar-sweetened beverages will help reduce the increase of obesity and diabetes in South Africa? Provide a reason for your answer.
Analysis of Data:
Upon obtaining results from teenagers, data will be separated into different age groups or answers or gender. Tables will be drawn up and then placed into bar graphs. This will make it easier to observe data. The data obtained may be compared to scientific results obtained from the internet.
Results:
Question 3:
Table showing the amount of candidates that believe they are healthy
Grade Amount of candidates that said:
Yes No
8 3 1
9 3 1
10 4 0
11 3 1
12 4 0
KEY
Yes
No
This question was based off of the self-perception of the candidates which may not be accurate. This means that the candidates may not be living a healthy lifestyle but they do not know it. It has been recorded that only 3% of people actually live a healthy lifestyle which consists of the following:
- A non-smoker
- Have a healthy fat percentage in their body
- Have a least 2 hours and 30 minutes of moderate to intense exercise weekly.
- Follow a healthy diet.
(Cathe Friedrich, 2019)
Question 4:
Table showing sweetened beverage consumption among teenagers in a week
Grade Average amount of sweetened beverages consumed in a week (ml)
8 1625
9 1375
10 1375
11 1750
12 1000
Question 5:
Table showing candidates beliefs on their weight
Belief Overweight Correct weight Underweight
Number of candidates 2 12 6
KEY
Overweight
Correct weight
Underweight
These results are based off the candidates own personal beliefs and may not be accurate reflections. According to Question 3, 17 out of the 20 candidates believe that they live a healthy lifestyle. However, 6 out the 20 candidates believe that they are underweight which means that they do not live a balanced lifestyle.
Question 6:
Average amount of exercise obtained by different grades per week
Grade Average amount of exercise per week (h)
8 7.625
9 7.625
10 4.25
11 4.4375
12 4.25
The average teenager should obtain about an hour of exercise daily. Based on the graph, grade 10s, 11s and 12s do not get enough exercise in a week. This may cause weight gain that may lead to obesity and thereafter diabetes.
Question 7:
Table showing the amount of candidates that have diabetes and what type
Diabetes None Type 1 Type 2
Amount of candidates 20 0 0
KEY
None
Type 1
Type 2
Diabetes may not affect the chosen candidates as it has not been genetically inherited or because they only be more susceptible at an older age. (Mayo Clinic, 2019)
Question 8:
Table showing the number of candidates that are aware of the amount of sugar consumed through beverages
Grade Yes No
8 3 1
9 3 1
10 4 0
11 2 2
12 3 1
KEY
Yes
No
75% of candidates answered “yes” which means that beverages are consumed based on choices as they are aware of the amount of sugar that they are consuming.
Question 9:
The respondents’ answers varied. They reported that they use sugars such as brown sugar, white sugar, honey and artificial sweeteners.
Question 10:
Table showing candidates that believe that believe sugar tax will decrease the onset of obesity and diabetes
Grade Yes No
8 2 2
9 2 2
10 2 2
11 1 3
12 2 2
KEY
Yes
No
Most of the candidates believe that sugar tax will not decrease the onset of diabetes and obesity as sugar is consumed by choice. Some also believe that it will only increase poverty. The candidates who believe that it will decrease obesity and diabetes believe that it will encourage people to make healthier decisions as sugary drinks will be less affordable.
1.9) What is the current rate of tax on sugar South Africa?
The South African Revenue Service began collecting the Sugary Beverages Levy on the 1 April 2018. The levy has been fixed at 2, 1 cents per gram of sugar on items that exceed 4 grams of sugar per 100 ml, the first 4 grams of sugar per 100ml are hence free.
1.10) Evaluate whether increasing the taxes on sugar will help reduce obesity and the onset of Diabetes amongst our youth?
Economists have determined that if the price of sugary drinks goes up 10 percent, consumption will go down by about 10-12 percent. (Friedman, 2013) This may reduce obesity among youth as weight loss with be easier to obtain. However diabetes type 1 is not caused by sugar consumption but rather obtained through genetics. Diabetes type 2 is caused by excess weight which may also be as a result of insufficient exercise. Sugar does not directly cause diabetes but rather contributes to weight gain which may cause diabetes. However 12 out of the 20 candidates believe that sugar tax will not help reduce obesity as sugar consumption through beverages is a choice and they are willing to pay the added amount. Therefore sugar tax may help reduce the amount of sugar consumed but may not solve the issue.
1.11) Is it ethical to have people pay sugar tax in line with the other sin taxes? Justify your answer.
It is not ethical to increase sugar tax as people are already burdened by the increased costs in fuel , electricity, food prices etc. the sugar tax just adds to the consumer’s burden and places more pressure on lose who live below the bread line. Fuel prices influence food prices as the cost of transportation of goods increases.
1.12) Globalisation: Compare your results based on South Africa’s implementation of a sugar tax to that of similar programs implementations across the globe. Where has it worked, where didn’t it work. Where it has worked, how much tax do they pay on the use of sugar?
Norway faces an enormous percentage on sugar tax with 83% as of 2018 on products such as sweets and chocolates , as a result Norway’s sugar consumption is lower. (Harris, 2018) Only 1 out of 6 children are overweight. In 2014 sugar tax was introduced in Mexico with a rate of 10%, within the first year they saw a decease of 12% in fizzy beverage consumption. When Hungary introduced sugar tax companies had decreased their sugar usage by 40% in products resulting in less sugar consumption. (Birchall et al., 2018)
1.13) Conclusion:
Sugar is not the direct cause of diabetes but rather excess weight that may be gained through the consumption of sugar. However weight gain may also be caused by an unbalanced lifestyle or insufficient exercise. Diabetes type 1, however, is not caused by the consumption of sugar but is rather obtained genetically and sugar may make symptoms worse. Therefor sugar tax on sweetened beverages may not help reduce the onset of obesity and diabetes as diabetes type 2 is a result of overall lifestyle choices.
