Diabetes Q&A #6: Q&A – Milk Options, Red Wine, Giving Up Sugar, Sleep and more

Dr Jedha, Host

Hello wonderful people and thanks for joining me for another Q&A episode where we cover the questions you’ve sent in for us on the DMP blog, by messaging us directly or questions asked by our members. 

If you have a question, please send it in to cover in a future Q&A episode. Head to Type2DiabetesTalk.com/message to leave a voice message or email so we can cover your question. 

These are always interesting episodes, as we explore a variety of different topics and today we’ll be answering questions sent in by Julia, Catherine, Ann, Marge, Jill and Ondrej covering milk options, red wine, neuropathy supplements, quitting sugar, V8 juice, chickpeas, sleep quality, Atkins products, and ozempic side effects. For our members, you can find more detailed information on all the topics we cover today, inside the members library alongside episode 82. 

So, we’ll be starting with Julia’s questions and she sent in a few great questions: 

2:14

First, Julia asked: Lactose free milk tastes sweeter. Is it a better or less good option for diabetics?

Julia, that’s a great observation—lactose-free milk does often taste sweeter, but that doesn’t necessarily mean it’s less suitable for people with diabetes. Let me explain why.

Lactose-free milk is made by breaking down lactose, the natural sugar in regular milk, into its simpler components: glucose and galactose. These simpler sugars are naturally sweeter on your taste buds, even though the total carb and sugar content is the same as in regular milk. This sweetness doesn’t mean it will raise your blood sugar more than regular milk, as the carbohydrate content remains comparable.

For people with diabetes, whether lactose-free or regular milk is better depends on your tolerance and dietary needs. If you’re lactose intolerant, lactose-free milk is a great option. Otherwise, the key factor is portion control, as milk contains natural sugars that can still impact your blood sugar, if consumed in large quantities.

If you’re looking for lower-carb milk alternatives, unsweetened almond, soy or coconut milk can be excellent options. These have significantly fewer carbs and may have less impact on blood sugar.

3:53

Julia’s second question was: Red wine. My morning figures have gone down since my daughter introduced me to red wine at dinner. Do all types of red wine do this?

Red wine, when consumed in moderation, can have some positive science-backed effects on blood sugar and cholesterol levels in diabetes, and it sounds like it’s making a difference for you, Julia, but it’s important to point out that this is not the case for everyone. 

Red wine contains compounds like polyphenols and antioxidants like resveratrol, anthocyanin, and quercetin, which may improve insulin sensitivity and help stabilize blood sugar, in some people. As for your question Julia, not all types of red wine are equal. Dry red wines like cab sav, merlot, and pinot noir, typically contain less residual sugar and are better choices for managing blood sugar. 

For anyone listening who may consider trying this, it’s important to enjoy red wine in moderation. “Moderate wine consumption” refers to 1 glass daily for women and up to 2 glasses daily for men. However, research suggests optimal intake levels may be lower than that. In many cases, people with diabetes report being better off without any alcohol, preferring food or natural supplements to achieve better results with morning figures, and we spoke more about lowering fasting numbers back in episode 38.

5:56

Julia’s last question is: Lions mane. I have heard this is good for neuropathy. Do you know any research that says it is ok to take.

Lion’s mane mushroom has gained attention for its potential benefits, particularly in nerve regeneration and cognitive health, which makes it an interesting consideration for conditions like neuropathy. But, the research on lion’s mane and neuropathy is still in its early stages and is very limited. Studies in animal models and on cells in the lab suggest that compounds in lion’s mane promote healthy nerve function. Very limited animal studies show there may be benefits of lion’s mane for specifically treating neuropathy. So, while these results are encouraging, clinical research in humans is currently non-existent. Human clinical trials have primarily looked at the effect of lion’s mane on cognitive health, rather than its impact on nerves or neuropathy. 

While there’s no definitive evidence yet, lion’s mane could be worth exploring as part of your approach to managing neuropathy and if you are looking for a natural treatment approach to neuropathy, we covered some great science-backed approaches in episode 35, and members, you can find more detailed info on these treatment options in the members library. 

8:10

Catherine said: I’m trying very hard to survive just thinking of giving up sugar. You are saying give up sugar…OK…I just saw diabetic Recipes for desserts. They all have sugar in the Recipes. What gives? I truly am confused.

Catherine, thank you for sharing your thoughts, and I completely get where you’re coming from. It can be so confusing when you’re trying to do the right thing, but then you go surfing out on the wild west web and come across “diabetic recipes” that still include sugar—or worse, way too much of it.

Unfortunately, the term “diabetic recipe” isn’t regulated, so anyone can label a recipe as such, even if it’s not truly supportive of healthy blood sugar management. Many of these recipes may still include added sugar or high-carb ingredients that don’t align with what you’re trying to achieve. This is why it’s so important to approach these recipes with caution. Even recipes on diabetes organization websites can have carbohydrates and sugars amounting to 60g per meal, and that’s not going to help you regulate your blood sugar levels. 

In reality, for managing diabetes, the goal is to reduce or eliminate added sugars, as much as you possibly can. This doesn’t mean you can’t enjoy dessert—it just means choosing recipes that are genuinely low in carbohydrates and use safe, diabetes-friendly sweeteners, which we covered in episode 49. Alternative options provide sweetness without spiking your blood sugar.

I know it can feel overwhelming when you’re just trying to get your head around what it even means to give up sugar and when there is so much contradictory information out there, it can send your head into a spin. I’d highly recommend you listen to previous episodes of the podcast, visit our website for info to help get you started or consider joining us as a member, because all these options will provide trusted information that is clear about what works for blood sugar management. 

One thing is for sure, you’re absolutely on the right track by questioning what you see Catherine! And just know that while the whole concept of no sugar may seem difficult now, if you start taking small steps forward, you’ll be looking back in no time to see that it’s certainly more than possible and still highly enjoyable too. 

10:51

Ann said:  My blood sugar is borderline prediabetes. I love my original v8 juice, not the fruit juice variety. Can I drink it in moderation?

V8 offers a variety of juice, starting with their Original 100% Vegetable Juice. Just as it sounds, this one is all vegetables (tomato, carrot, celery, beets, parsley, lettuce, watercress, and spinach) along with natural flavors, salt, citric acid (a preservative) and a few added antioxidants.

Out of all the V8 juices, V8 Original is the best choice. A cup of V8 Original contains about 9 grams of carbohydrates, 7 grams sugars, primarily from natural vegetable sugars, and 2 grams fiber. Compare this to one of the V8 fruit juice varieties and you could be consuming 22 grams of carbs, 19 grams of sugars with zero fiber, so there is a stark difference between the vegetable and fruit juice options. V8 100% vegetable juices are suitable options to choose. 

Keep in mind though, juice isn’t filling and it definitely doesn’t make a good meal replacement because it’s so low in calories. So don’t go skipping out on a real dinner thinking that a V8 juice is healthier. You need fiber, protein, and fat in order to feel your best and stabilize blood sugar…and juice contains none of these. Certainly enjoy your V8 juice in moderation Ann but juice is not a good replacement for eating real food. 

12:40

Marge also had a few questions and asked: 

I read that Canadian chickpeas are high in glycemic index at 33, vs. Philippines’ only 6.

Marge, that’s an interesting observation about chickpeas! The glycemic index of foods can vary, but a difference as large as 33 compared to 6 is likely due to a misunderstanding or misrepresentation in the data rather than an actual difference in the chickpeas themselves.

Here’s why: The glycemic index of a food is influenced by factors like how it’s prepared (boiled, roasted, cooled, or processed), portion size, and even an individual’s unique response to carbs. For chickpeas, the glycemic index is generally reported to be a low glycemic index, and depending on the preparation method, the glycemic index can range from 5 to 51. So while it may not be Canadian chickpeas or Philippine chickpeas themselves that are different, it’s more likely the preparation of those chickpeas that has produced this variation in glycemic index. 

If chickpeas are prepared by soaking them overnight, boiling them, then cooling them again before use, the glycemic index is very low, around 5 or 6. Chickpeas that are boiled in salted water come in around 35 GI, while canned chickpeas are around 38-51 GI. 

14:48 

Marge also asked, Does sleep quality affect insulin/ blood sugar, & vise versa?

That’s a fantastic question! Yes, sleep quality and blood sugar levels are closely connected, and it’s a two-way relationship—each can influence the other.

Let’s start with how poor sleep affects blood sugar. When you don’t get enough sleep or your sleep quality is poor, your body experiences higher levels of stress hormones like cortisol. Cortisol increases blood sugar levels by signaling your liver to release more glucose into your bloodstream. Additionally, sleep deprivation can reduce your body’s sensitivity to insulin, the hormone that helps regulate blood sugar. This combination can lead to higher blood sugar levels over time.

On the flip side, if blood sugar is poorly controlled—especially if levels are very high or very low—it can disrupt sleep. For example, high blood sugar can cause symptoms like frequent urination or thirst, which can wake you during the night. Conversely, low blood sugar at night can trigger the release of stress hormones, leading to restlessness or even waking up feeling shaky and hungry.

Improving one can often help the other. Prioritizing good sleep hygiene—such as keeping a consistent sleep schedule, reducing screen time before bed, and creating a calming bedtime routine—can help support better blood sugar control. Similarly, stabilizing blood sugar through diet, exercise, and stress management can lead to deeper, more restorative sleep.

So, if you’re working on your blood sugar, don’t underestimate the power of a good night’s sleep—it’s definitely a vital piece of the puzzle!

Thanks for sending in those questions Marge. 

16:46

Our next question is from Jill, who asked: ​Are the atkins diet products, meal replacement bars, treats, snacks okay to eat with diabetes? They seem to have a low net carb count so I feel like they would work.

This is such a great question to cover. Atkins products are often marketed as low carb, which makes them seem like a good fit for managing diabetes. And while some of their products can work in a diabetes-friendly eating plan, not all of them are created equal, so it’s important to be selective.

The main thing to watch out for is that Atkins sells a lot of highly processed “low carb” versions of junk food—bars, shakes, and snacks that may technically fit within a low net-carb count but aren’t necessarily great for everyday eating. Many of these products contain artificial sweeteners, sugar alcohols, or highly refined ingredients, which can still impact blood sugar and digestion in different ways. And consuming these less-than-ideal ingredients or processed foods might be okay on occasion, but if you’re moving from eating a junk food diet high in carbs to a junk food diet low in carbs, then your metabolism isn’t going to experience the same benefits that it would with, let’s say, eating ‘CLEAN’ whole foods. 

And that’s the thing, there are a lot of products that are now technically low in carbs and could be assumed to be diabetes friendly, but many of them are just junk foods. If you’re using Atkins products, or any other products that might seem low carb, focus on the ones with minimal ingredients and whole food-based sources of protein and fats. Yes, there are some good options, but there are lots of less ideal options as well. Just make sure you read the ingredients list on the label and look at the nutrition facts as well to assess the quality of the food. And just keep in mind that prioritizing real, whole foods—like healthy proteins, non-starchy vegetables, and natural fats—will always be the best approach for stable blood sugar and long-term health. So, Atkins and other brands can be an occasional option, but they shouldn’t replace real, nutrient-dense meals or become an everyday food.

Now I just want to mention that the last question of the day has some sensitive information in relation to men’s sexual health. 

20:06

Ondrej asked: I am now on insulin and Ozempic. Ozempic side effects have been bothering me: Nausea, burping and constipation. Hope they stop soon as I am now over three months on this therapy. But the most disturbing side effect is losing my sexual drive, erectile dysfunction etc. Is this common with Ozempic? Is there any way to reverse that?

Ondrej, thanks for your question. It sounds like you’ve been dealing with some frustrating side effects from Ozempic, and it’s completely understandable why you’re feeling concerned. We talked about GLP-1 agonist drugs like ozempic in episode 55 and they do come with a wide array of side effects and complications that any person taking these drugs should be aware of, so please take a listen to episode 55. Nausea, burping, and constipation are commonly reported side effects, and unfortunately, for many people, they don’t improve over time, especially since you say you’ve been on the medication for over three months.

Sexual side effects like reduced libido and erectile dysfunction aren’t officially listed as common with Ozempic, but you’re not alone in experiencing them. There have been growing reports of people noticing these kinds of issues, and all kinds of issues that may not be officially listed on the label. While side effects vary from person to person, it’s important to pay attention to how your body is responding.

If these side effects are impacting your quality of life, then I wouldn’t delay in having a discussion with your doctor about whether ozempic is right for you and what other options you may have. If you’re using insulin and ozempic to lower blood sugar and A1c, it would be wise to also look toward managing your blood sugar naturally. The other thing to consider is that high blood sugar and A1c can impact sexual health and cause erectile dysfunction. We won’t go into that in detail but we’ll leave more information alongside the show notes with today’s episode. It is really very important to get your blood sugar and A1c into a normal range, as it helps prevent complications, and we talked about that more in episode 30. Importantly, consider exploring a nutrition-based approach to lower blood sugar and A1c into the normal range. The nutrition approach we use has helped many people reduce their need for medications altogether, many people getting off medication completely. You can head to our website to find lots of valuable nutrition information to help you get started. Or for more support, you could consider joining us as a member. 

That brings us to the end of today’s Q&A episode! We’ve covered a lot of ground—from making informed choices about foods like V8 juice and Atkins products, to understanding the effects of red wine on blood sugar, sleep and insulin resistance, and the potential side effects of Ozempic. Each of these topics highlights a common theme: the importance of being proactive and informed about your health.

If today’s episode has helped you in any way, I’d love for you to take the time to leave the podcast a 5-star rating and review on Apple, Spotify or head to our website to do so. And if you have a question you’d like answered in a future Q&A episode, head to Type2DiabetesTalk.com/message to send it in. 

Until next time, keep taking small steps toward better health.

Dr Jedha, over and out.