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Sugar Reformulation and your clinical practice

26 July 2017Pav Kalsi, Senior Clinical Advisor, Diabetes UK

The Government’s plan to reduce the amount of sugar in sugar sweetened soft drinks and sugary foods in an effort to reduce childhood obesity levels, means that a number of soft drink companies are reducing the amount of sugar in their products. This will happen at different speeds and times. Some manufacturers are already doing this, some may choose to gradually reduce sugar over the coming months and years, and some will choose not to reduce the amount of sugar in their products at all. This means that a number of popular soft drinks are likely to change their sugar (and carbohydrate) content over the coming months and years.

We know that some sugary drinks may be used in clinical practice and this will have an impact on:

  • healthcare professionals in clinical settings, as part of an oral glucose tolerance test (OGTT) in the diagnosis of diabetes or gestational diabetes
  • treatment of hypos.

As these drinks will be reformulated to contain less sugar, it is likely that a larger volume (that contains the same amount of glucose) will be required for an OGTT and to treat a hypo. This will have a number of implications and so it is important that these changes are communicated and disseminated as widely as possible to healthcare professionals and people with diabetes (and their carers).

We are monitoring the composition of these products and are keeping in touch with the manufacturers to ensure that we are giving up to date advice on the correct amount needed for an OGTT and to treat a hypo and these changes are communicated as widely as possible.

We have been working with Lucozade to help inform their communications about the sugar reduction across their drinks. More information is available onthe Lucozade website website.

Hypos

It is also worth remembering that using sugary drinks is one way to treat a hypo, but there are alternatives, some of which can be prescribed – read our guide onHypos and Hypers.

Oral glucose tolerance testing

An OGTT is one way to diagnose diabetes and gestational diabetes. It involves giving a patient a drink containing 75g of anhydrous glucose or its equivalent in a volume of 300 ml over 5 minutes (WHO).

Various different glucose solutions could be used to provide 75g of anhydrous glucose. This could be a sugary drink, powdered dextrose dissolved in water, 113 ml Polycal with extra fluid to administer a total volume of 200–300 ml, or as Rapilose OGTT oral solution.

Refer toNICE guideline (NG3)and the BNF.

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