Excess Sugar Consumption among Adults with Type 2 Diabetes in the US, 2021-2023: Behavioral and Demographic Correlates

Nearly 1 in 6 adults in the US were diagnosed with type 2 diabetes mellitus (T2DM) between 2021 and 2023. Excess sugar consumption among diabetics adversely affects numerous metabolic pathways and processes. The US Centers for Disease Control and Prevention (CDC) recommends ≤10% of daily calories come from sugar. In this study, I sought to estimate the average proportion of daily calories consumed from sugar among US adult diabetics. I hypothesized that the risk of excess sugar consumption would be higher for [1] adult diabetics with lower income-to-poverty ratios compared to those with higher income-to-poverty ratios [2] adult diabetes with worse oral health compared to those with better oral health, and [3] adult diabetics with depression compared to those without. I utilized nationally representative data from the 2021-2023 National Health and Nutrition Examination Survey collected by CDC. I fit a weighted linear regression model to identify socio-demographic and health-related correlates of the proportion of daily calories consumed from sugar. I found that, overall, the proportion equaled 18.2% (95% confidence interval [CI]: 17.2% to 19.2%). Compared to adult diabetics who reported not feeling down, depressed, or hopeless nearly every day over the past two weeks, those who felt so nearly every day consumed an average of 8.3 percentage points more calories from sugar (95% CI: 0.7 to 15.8 percentage points). With greater patient education on nutrition, mental health support, and cardiovascular health initiatives, adult diabetics may be able to reduce sugar consumption to recommended levels.