While at the grocery store recently, I picked up one of our more favorable sugar free cookies. They taste pretty good and I don’t even mind eating them myself. I thought this was another good way to show how sugar and carbs affect glucose levels and insulin usage. Although these cookies are sugar free, they will still affect Vince’s glucose level. Some sugar free foods are also carb free and some are not. If he were to eat 3 of these cookies and not take his insulin, his sugar would begin to rise as the carbohydrates digest and without insulin, it would stay elevated with no hope of coming back down. The difference between regular sugar cookies, and sugar free, is the rate in which his glucose would be rising. The pure sugar would raise his glucose faster than the carbohydrates will, but the outcome would be the same. This is the reason that pure sugar is given to a diabetic in a low reaction. Carbs alone would raise the persons glucose in this situation as well, but it wouldn’t happen quickly enough in an emergency situation. For this snack, per the label, for every 3 cookies consumed, there are 20g total carbohydrates. Taking into account Vince’s ratio of units of insulin-to-carbs, he would have to bolus his insulin before eating the cookies and would give himself about 3 units using his pump to counteract the sugar that the carbs will be digested into. So when it comes to sugar free foods, sugar free is a good, healthy option, but since it is not always carb free, it is still not an insulin free food. The only foods that you can truly eat without any insulin are zero sugar and zero carb options.