View source for Sugars - Nutrition

==What are Sugars?==
Sugars are '''short chain soluble [[Carbohydrates Overview - Nutrition|carbohydrates]]''', which include the '''[[Nutrition Glossary#Monosaccharides|monosaccharides]] glucose, galactose''', and '''fructose''' and the '''[[Nutrition Glossary#Disaccharides|disaccharides]] sucrose''' (combination of glucose and fructose), '''lactose''' (combination of glucose and galactose) and '''maltose''' (combination of glucose and glucose). The sugar alcohols mannitol, sorbitol, and xylitol are commonly included in this group, though are not used in foods intended for dogs and cats.

==Why are they Important?== 
Dogs have taste receptors and a flavour preference for sugars<ref>Batchelor DJ, et al. Sodium/glucose cotransporter-1, sweet receptor, and disaccharidase expression in the intestine of the domestic dog and cat: two species of different dietary habit. Am J Physiol Regul Integr Comp Physiol 2011;300:R67–R75.</ref>, while cats lack lingual sweet receptors<ref>Li X, et al. Cats Lack a Sweet Taste Receptor. J Nutr 2006;136:1932S–1934S.</ref> and tend not to select preferentially for or against sugars in the diet. The monosaccharide sugars glucose, galactose, and fructose are readily transported across the small intestinal mucosa. '''Glucose itself can be transported directly into cells for further metabolism to form ATP, and can also be used to form glycogen in [[Liver - Anatomy & Physiology|liver]] or [[Muscles - Anatomy & Physiology|muscle]]'''<ref name="Ebiner">Ebiner JR, et al. Comparison of carbohydrate utilization in man using indirect calorimetry and mass spectrometry after oral load of 100 g naturally-labelled (13C) glucose. Br J Nutr 1979;41:419-429.</ref>, or for lipid synthesis<ref name="Flatt">Flatt JP, et al. Effects of dietary fat on postprandial substrate oxidation and on carbohydrate and fat balances. J Clin Invest 1985;76:1019-1024.</ref>.
Sugar alcohols exert an osmotic effect in food and in the body<ref>National Research Council (NRC). Carbohydrates and Fiber. In Nutrient Requirements for Dogs and Cats. 2006 Washington, DC: National Academies Press p.49-80.</ref>. Sorbitol and xylitol are primarily used as sweeteners or thickening agents in foods intended for human consumption and are not used in foods for dogs and cats. Mannitol is used therapeutically in veterinary medicine as an osmotic agent to decrease swelling in body compartments such as the brain or interstitium. 

==Roles in the Body==
All body tissues have a requirement for glucose and it must be obtained regularly from either the diet or synthesised through hepatic gluconeogenesis. <br>
Once absorbed through the intestinal epithelium, glucose enters the portal circulation and can be undergo intercellular transport for intermediate metabolism and formation of ATP. Glucose, galactose and fructose can also be used to synthesise additional molecules, such as glycogen and [[Fatty Acids Overview - Nutrition|fatty acids]]<ref name="Ebiner"/><ref name="Flatt"/>. In the absence of dietary [[Starch - Nutrition|starches]] and sugar, or during periods of starvation, hepatic gluconeogenesis can support maintenance of normal blood glucose concentrations in adult animals as long as adequate amounts of [[Amino Acids Overview - Nutrition|gluconeogenic amino acids]] are present<ref name="Romsos">Romsos DR, et al. Influence of low carbohydrate diet on performance of pregnant and lactating dogs. J Nutr 1981;111:678-689.</ref>.

==Consequences of Sugar Deficiency==
====Dogs:==== 
Puppies, especially small and toy breeds, may be unable to maintain blood glucose concentrations from hepatic gluconeogenesis alone and can become hypoglycaemic with low intake of dietary absorbable carbohydrates<ref>Vroom MW and Slappendel RJ. Transient juvenile hypoglycaemia in a Yorkshire terrier and in a Chihuahua. Vet Q 1987;9:172-176.</ref>. Hepatic gluconeogenesis may also be inadequate to meet glucose demands during late gestation and lactation unless increased intake of gluconeogenic amino acids are provided in the diet<ref name="Romsos"/>. There are no clinical signs of feeding a sugar-free diet in otherwise healthy adult dogs.
====Cats:==== 
There are no clinical signs of feeding sugar-free diet to cats at any life-stage. Adult cats and growing kittens are able to maintain blood glucose concentrations through hepatic gluconeogenesis<ref>Morris JG, et al. Carbohydrate digestion in the domestic cat (Felis catus). Br J Nutr 1977;37:365-373.</ref>.

==Toxicity==
'''The sugar alcohol, xylitol, is toxic to dogs and cats and ingestion can lead to hypoglycaemia, [[Liver Failure|liver failure]] and death'''<ref>Xia Z, et al. Experimental acute toxicity of xylitol in dogs. J Vet Pharmacol Ther 2009;32:465-469.</ref> and should not be fed to dogs and cats. No toxicity has been associated with high dietary intake of other sugars in otherwise healthy dogs and cats, though cats do not appear to regulate fructose and galactose excretion and will readily become fructos- or galactosuricuric if these monosaccharides are given directly in the diet<ref>Kienzle E. Blood sugar levels and renal sugar excretion after intake of high carbohydrate diets in cats. J Nutr 1994;124:2563S-2567S.</ref>. Increased feeding of sugars in dogs and cats with pre-existing [[Diabetes Mellitus|diabetes mellitus]] can contribute to post-prandial hyperglycaemia and increase [[insulin]] requirements<ref>Bennett N, et al. Comparison of a low carbohydrate-low fiber diet and a moderate carbohydrate-high fiber diet in the management of feline diabetes mellitus. J Feline Med Surg 2006;8:73-84.</ref><ref>Elliot KF, et al. A diet lower in digestible [[Digestibility of Carbohydrates|carbohydrate]] results in lower postprandial glucose concentrations compared with a traditional canine diabetes diet and an adult maintenance diet in healthy dogs. Res Vet Sci 2012;93:288-295.</ref>.

==Dietary Sources==
Naturally occurring sugars are found in fruits, cereal grains, and pulses (i.e. legumes). Sucrose may be added to foods as sweeteners or improve texture. Sorbitol is not commonly found in commercial pet foods, but may be included in commercial pet treats or human foods to improve texture.

==Diagnosing Sugar Deficiency==
If low to absent total carbohydrate intake with insufficient hepatic gluconeogenesis, clinical signs of hypoglycemia can occur (e.g. lethargy, depression and [[seizures]]). Blood sugar concentrations below the normal laboratory reference interval (< 5 mmol/L) may be noted on serum biochemistry profiles.

==References==
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[[Category:Carbohydrates]]