Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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False Scientifically refuted Certainty of evidence: high provisional C-DIAB-01

High blood sugar is not a disease but the body's protective response that 'rescues' you; there is no such thing as diabetes ('drink sugar'); sugar intake has no upper limit; HbA1c is a lie.

Safety note: Do not ignore persistently high blood glucose or HbA1c. Persistently high glucose (e.g. fasting above 250-300 mg/dL), weight loss, thirst and frequent urination require prompt medical evaluation.
In short: This claim is false. Randomised trials and large cohorts show that chronically high blood glucose causes eye, kidney, nerve and heart damage and earlier death, HbA1c reliably reflects average glucose, and health agencies set upper limits for sugar; only a short rise of glucose during acute illness may be adaptive.
Conclusion: Chronic high blood sugar is harmful; denying diabetes is false and dangerous.
  1. Original statement
  2. Scientific assessment
  3. Scientific evidence in detail
  4. In plain language
  5. Studies on this claim
  6. Regional context
  7. What applies in my country?
  8. References

Original statement

ان السكر عالي فسبب مشاكلك ده هو عالي عشان يلحقك اصلا

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

High blood sugar is not a disease but the body's protective response that 'rescues' you; there is no such thing as diabetes ('drink sugar'); sugar intake has no upper limit; HbA1c is a lie.

Origin

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr Diaa Al Awady د ضياء العوضي is live! الكورتيزون حياتك (Open source)
Published
17 October 2025
Timestamp
1:57:07 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.
Claimed mechanism

Stress hormones raise glucose to supply the brain; complications come from gut problems, not glucose.

Claimed health effect

Denial of hyperglycaemia as harmful

Population concerned

People with diabetes

Geographic restriction by Elawady

none found

Diverging source versions

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr.D Clinics - Diaa Al Awady is live! (Open source)
Published
12 January 2025
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.
Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr Diaa Al Awady د ضياء العوضي is live! مفيش حاجه سعرات مفيش حاجه اسمها نشويات (Open source)
Published
7 August 2025
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.
Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
أكذوبة السكر التراكمي (Open source)
Published
17 April 2025
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.

السكر العالي السكر العالي السكر العالي السكر العالي ماله مفيد لدماغك ومخك وشبكيتك الفيديو بتاع ياسر ومراته كان سكره 700

High sugar, high sugar - what is wrong with it? It is beneficial for your brain, your mind and your retina. The video of Yasser and his wife: his sugar was 700.

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
بدأت قناة ＂Dr Diaa Al Awady د ضياء العوضي＂ بثًا مباشرًا ذكري يوم ميلادي 😂😂❤️❤️❤️ (Open source)
Published
26 March 2026
Timestamp
1:08:26 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; wording may contain speech-recognition errors; speaker turns are not marked, the excerpt was judged to be Elawady's own speech from context.

يعني انت عايز تقول ان السكر طول ما هو عالي بيحافظ عليك اه ومجرد ما توقعه مجرد ما توقع السكر عن المستوى اللي وصل له بقى ال 500 ولا ال 700 اللي انت شفتهم تنزلهم 200اني انت تطفي بقى كل حاجه

'So you mean that as long as the sugar is high it protects you?' 'Yes. As soon as you drop the sugar from the level it reached - the 500 or 700 you saw - down to 200, you switch everything off.'

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Live highlight (Open source)
Published
6 April 2026
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; wording may contain speech-recognition errors; speaker turns are not marked, the excerpt was judged to be Elawady's own speech from context. Question-and-answer passage in a short highlight clip: the question may be spoken by an interviewer; the affirmative answer and continuation are attributed to Elawady.

Scientific assessment

False – The statement contradicts the robust evidence.

Certainty of evidence: high – Further research is very unlikely to change the assessment.

1. What was claimed?

High sugar is protective; diabetes does not exist; HbA1c is a lie; unlimited sugar is fine.

2. What is demonstrably correct?

Acute stress (illness, surgery, exercise) raises glucose through cortisol, adrenaline and glucagon; transient stress hyperglycaemia is a real phenomenon and some critical-care researchers consider it adaptive (I-DIAB-107); tight glucose control in critically ill patients increased mortality (A-INS-02). HbA1c can be misleading in anaemia, haemoglobin disorders or G6PD deficiency (I-DIAB-108). Overly aggressive glucose lowering can harm (C-INS-04).

3. What is wrong or exaggerated?

Each 1% reduction in HbA1c was associated with 21% fewer diabetes-related deaths, 14% fewer myocardial infarctions and 37% fewer microvascular complications, with no threshold (I-INS-04). Intensive therapy reduced retinopathy by 76% in type 1 diabetes (I-INS-03) and microvascular endpoints by 25% in type 2 (A-INS-16). HbA1c is a validated measure of average glucose. 'Drink sugar' and 'no upper limit' contradict evidence on sugar-sweetened beverages and diabetes risk (topic of another rule).

4. What remains unclear?

It is unclear how literally followers understand slogans such as 'there is no such thing as diabetes'; no outcome data among followers were found. The adaptive role of short-term stress hyperglycaemia in acute illness is still studied, but this does not apply to chronic hyperglycaemia.

5. Which studies support it?

None for the general claim.

6. Which studies contradict it?

I-INS-03, I-INS-04, A-INS-16, I-INS-02, I-INS-103 (mortality rises with HbA1c in T1D), I-INS-104, I-DIAB-106 (HbA1c tracks average glucose, R2 0.84), I-SUG-03 and A-SOD-01 (sugars and sugar-sweetened beverages).

7. What applies to Germany and Europe?

European (EASD) and German (DDG) guidance follow the same evidence base as the ADA/EASD consensus: individualised HbA1c targets, insulin as mandatory therapy in type 1 diabetes, and SGLT2 inhibitors/GLP-1 receptor agonists for people with cardiovascular or kidney disease. No country-specific difference changes the assessment.

8. What is known about Egypt?

Egypt has one of the highest diabetes prevalences in the region; the same drug classes and insulins are used. Access barriers and cost may make advice to stop medication attractive, which increases the practical risk of this claim. No Egypt-specific evidence changes the assessment.

9. What practical conclusion is appropriate?

Chronically high blood glucose damages eyes, kidneys, nerves and vessels. Avoiding very low targets is reasonable; ignoring high glucose is not.

Assessment details

Rationale for certainty of evidence

Prospective data (UKPDS 35) show a continuous relationship between HbA1c and complications without threshold; RCTs (DCCT, UKPDS) show that lowering glucose reduces retinopathy, nephropathy and neuropathy. Stress hyperglycaemia exists (kernel), but chronic hyperglycaemia causes organ damage.

Source quality

Own words, several machine transcripts.

Regional transferability

Universal.

Regional scope of the claim
general (biological/medical)
Last reviewed
26 October 2026 provisional

Scientific evidence in detail

Scientifically refuted – High-quality evidence shows the opposite, or the claim contradicts well-established physiology.

Research question: In people with diabetes, is chronically raised blood glucose (HbA1c) harmless or protective, is HbA1c an invalid measure, and is there no upper limit for sugar intake?

Research question in detail (PECO)
Population
People with type 1 or type 2 diabetes; general population for sugar intake
Intervention or exposure
Chronic hyperglycaemia (higher HbA1c); high sugar intake
Comparison
Lower HbA1c; lower sugar intake
Geographic scope
universal biology
Outcomes
  • Microvascular and macrovascular complications
  • Mortality
  • Validity of HbA1c as average glucose
  • Type 2 diabetes incidence (sugar-sweetened beverages)

Study results as reported by the authors. Our assessment follows below.

What speaks for the claim?

  • Is high blood sugar during severe illness protective?

    Marik PE, Bellomo R. Crit Care 2013 · PMID 23470218 · DOI 10.1186/cc12514 Narrative reviewabstract checkednewly added

    Critical-care review arguing that short-term stress hyperglycaemia in acute illness is an adaptive survival response.

    Actual result
    No quantitative result; argues tight ICU glucose control did not improve outcomes.
    Methodological quality
    low (opinion/narrative review)
    Relevance
    indirect: acute critical illness, not chronic diabetes
    Limitations
    Does not concern chronic hyperglycaemia; opinion-based.

    Original publication

  • Very tight blood sugar control in intensive care

    NICE-SUGAR Study Investigators; Finfer S et al.. N Engl J Med 2009 · PMID 19318384 · DOI 10.1056/NEJMoa0810625 Randomised controlled trialabstract checked

    NICE-SUGAR: tight glucose control in critically ill patients increased mortality.

    Actual result
    Death 27.5% vs 24.9%, OR 1.14 (1.02-1.28).
    Methodological quality
    high (large RCT)
    Relevance
    indirect: supports that aggressive lowering in acute illness harms, not that high glucose is protective in diabetes
    Limitations
    ICU setting only.

    Original publication

  • When HbA1c can be misleading

    Samajdar SS et al.. Lancet Reg Health Southeast Asia 2026 · PMID 41743216 · DOI 10.1016/j.lansea.2026.100724 Narrative reviewabstract checkednewly added

    Review of HbA1c pitfalls (anaemia, haemoglobinopathies, G6PD deficiency, assay problems).

    Actual result
    Narrative; recommends adding glucose measures.
    Methodological quality
    low (narrative review)
    Relevance
    indirect: shows HbA1c can mislead in specific conditions
    Limitations
    Does not show HbA1c is invalid in general.

    Original publication

What speaks against the claim?

What does the overall evidence say?

Editorial assessment based on the studies above – not itself a study result.

Which position is better supported?

Chronic hyperglycaemia causes organ damage and death; HbA1c is a validated measure of average glucose; sugar intake has upper limits recommended by WHO/EFSA.

Why some studies weigh more

RCTs (DCCT, UKPDS) and large cohorts with dose-response outweigh an opinion paper on acute stress hyperglycaemia and a review of HbA1c pitfalls.

Is a causal relationship established? Yes, established Randomised lowering of glucose reduces complications (DCCT, UKPDS) with dose-response in cohorts.

Remaining uncertainty

Optimal glucose in acute critical illness; HbA1c accuracy in anaemia/haemoglobinopathies.

Justified conclusion

The claim is false; only the acute-stress kernel and HbA1c caveats are correct.

Why do studies seem to disagree?

Apparent conflict between 'stress hyperglycaemia is adaptive' (I-DIAB-107, A-INS-02) and 'hyperglycaemia is harmful' (I-INS-03/04) reflects different questions: hours to days of acute illness versus months to years of diabetes. HbA1c limitations (I-DIAB-108) concern specific blood disorders, not the general validity shown by ADAG (I-DIAB-106).

Does this depend on the country?
General biological effects
Insulin physiology, autoimmune type 1 diabetes and ketoacidosis are universal human biology.
Eating habits
High intake of sugar-sweetened beverages occurs in Egypt and Europe; WHO/EFSA limits apply to both.
Origin of the food
Not relevant.
Contaminants
Not relevant.
National production conditions
Not relevant.
Legal rules
Insulin is an essential medicine (WHO list) in Egypt and the EU; prescription rules not relevant to the scientific question.
Actual monitoring data
HbA1c can be distorted by anaemia and haemoglobin disorders, which are common in Egypt; this calls for added glucose testing, not abandonment of measurement.

A regional difference that changes the conclusion is not supported by robust data.

Statistical re-check
  • Convert HbA1c to estimated average glucose with the published regression – HbA1c 7% = 154 mg/dL, 9% = 212 mg/dL, 12% = 298 mg/dL; R2 0.84 indicates strong but imperfect individual agreement recalculated
  • Crude mortality and CI symmetry – Crude death 8.0% vs 2.9% (crude ratio 2.79); CIs log-symmetric recalculated
Certainty of the overall evidence (GRADE, simplified)
Main outcome
Microvascular complications and mortality with chronic hyperglycaemia
Starting level
high (randomised trials)
Reasons for upgrading
  • dose-response (UKPDS 35, Lind 2014)
Result
high

Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.

Clinical guidelines and official statements checked
  • ADA: 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026 (2026) · Original publication
    People at risk for DKA should have ketone testing tools and sick-day advice; people on intensive insulin therapy should not stop or hold basal insulin even if not eating; caution with near-normal A1C goals in long-standing T2D using hypoglycaemia-prone drugs (ACCORD).
  • WHO: Diabetes fact sheet (14 November 2024) (2024) · Original publication
    Type 1 diabetes 'requires daily administration of insulin'; chronic hyperglycaemia leads to serious damage to many body systems.
  • WHO: WHO calls on countries to reduce sugars intake (I-SUG-05) (2015) · Original publication
    Free sugars <10% of energy (strong), ideally <5%.
  • ADA/EASD: The management of type 1 diabetes in adults: updated 2026 consensus report (2026) · Original publication
    'Lifelong insulin therapy is essential in type 1 diabetes'; all individuals need glucose and ketone testing supplies; insulin omission or under-dosing is a DKA precipitant.
Search strategy

Documented literature searches for this review (search strings in the original database syntax).

DatabaseDateSearchLooking forHitsIncluded
PubMed26 October 2026stress hyperglycemia AND (adaptive OR "survival response" OR protective)supporting evidence4899
PubMed26 October 2026Marik PE[au] AND stress hyperglycemia[ti]supporting evidence5
PubMed26 October 2026(hyperglycemia OR "high blood glucose") AND (beneficial OR protective) AND (retina OR brain OR cognition) AND diabetes AND (cohort OR randomized)supporting evidence65
Europe PMC26 October 2026"stress hyperglycemia" AND (adaptive OR protective OR "survival response") AND (TITLE:"hyperglycemia" OR TITLE:"hyperglycaemia")supporting evidence245
Europe PMC26 October 2026("HbA1c" OR "glycated haemoglobin" OR "glycated hemoglobin") AND (TITLE:"validity" OR TITLE:"accuracy" OR TITLE:"limitations") AND (anaemia OR anemia OR hemoglobinopathy) AND reviewsupporting evidence44
PubMed26 October 2026Nathan DM[au] AND "Translating the A1C assay"contradicting evidence1
PubMed26 October 2026(HbA1c[ti] OR "glycated hemoglobin"[ti]) AND (complications OR mortality) AND (meta-analysis[pt] OR "cohort"[ti])contradicting evidence142
PubMed26 October 2026Lind M[au] AND "Glycemic control and excess mortality in type 1 diabetes"contradicting evidence6
PubMed26 October 2026DCCT EDIC AND mortality AND JAMA[ta] AND 2015[dp]contradicting evidence1
WHO website26 October 2026Fetched https://www.who.int/news-room/fact-sheets/detail/diabetesguidelines1

Open questions

No outcome data exist on followers who ignored high glucose.

How deeply was this checked?

13 linked studies: 3 checked in full text (2 of them with a structured risk-of-bias assessment), 10 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.

Last scientific review: 26 October 2026

History of the verdict
  1. 25 October 2026 · Phase 1 · Initial assessment: False (high)
  2. 26 October 2026 · Phase 4 (systematic evidence review) · Re-examined with extended evidence; verdict unchanged: False (high)
    New studies (ADAG validation of HbA1c, Swedish registry mortality, DCCT/EDIC mortality) strengthen the existing assessment; the only supporting items concern acute stress hyperglycaemia and HbA1c caveats in blood disorders.
    New sources: I-DIAB-106 I-INS-103 I-INS-104 I-DIAB-107 I-DIAB-108 I-INS-137

In plain language

Blood sugar can rise briefly during stress, and that is normal. But sugar that stays high for months and years damages the eyes, kidneys, nerves and blood vessels. Large studies show that the higher the long-term sugar (HbA1c), the more complications occur, and that lowering it prevents blindness and kidney failure.

Studies on this claim

Studies supporting the claim (0)

No studies in this group.

Studies contradicting or limiting the claim (10)

  • DCCT: better insulin treatment in type 1 diabetes

    Diabetes Control and Complications Trial Research Group; Nathan DM et al.. N Engl J Med 1993 · PMID 8366922 · DOI 10.1056/NEJM199309303291401
    Randomised controlled trialindependent cross-checkabstract checked★ key study

    Intensive insulin cut the risk of eye damage by three-quarters and nerve damage by 60%, with more low-sugar episodes.

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Does intensive insulin therapy reduce long-term complications in type 1 diabetes?

    How was the study done?

    Multicentre RCT (DCCT)

    How many people, animals or samples were studied?

    1,441; Insulin-dependent (type 1) diabetes

    What was actually found?

    Large reductions in all microvascular complications.

    How large was the observed effect?

    Retinopathy -76%

    What do the results mean in everyday life?

    Insulin protects eyes, kidneys and nerves in type 1 diabetes.

    What are the study's limitations?

    Open-label; Selected young population

    What does it say about Elawady's specific claim?

    Contradicts C-INS-07, C-INS-09, C-DIAB-01; shows insulin efficacy and hypoglycaemia cost (C-INS-02 kernel).

    Do the results apply to Germany and Europe?

    North American; universally accepted.

    What can explicitly not be concluded from this study?

    Effects in type 2 diabetes directly.

    Scientific details →

  • How much long-term blood sugar matters (UKPDS 35)

    Stratton IM et al.. BMJ 2000 · PMID 10938048 · DOI 10.1136/bmj.321.7258.405
    Cohort studyindependent cross-checkabstract checked★ key study

    Each 1% lower HbA1c was linked to 21% fewer diabetes deaths and 37% fewer eye/kidney complications.

    Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Relation of glycaemia over time to complications

    How was the study done?

    Prospective observational analysis within UKPDS (UKPDS 35)

    How many people, animals or samples were studied?

    4,585 (3,642 for RR); UKPDS patients (white, Asian Indian, Afro-Caribbean)

    What was actually found?

    Graded risk with HbA1c, no threshold.

    How large was the observed effect?

    -21% per 1% HbA1c

    What do the results mean in everyday life?

    High sugar damages the body.

    What are the study's limitations?

    Observational

    What does it say about Elawady's specific claim?

    Contradicts C-DIAB-01, C-DIAB-02, C-ODD-06 (hyperglycaemia causes complications incl. amputation).

    Do the results apply to Germany and Europe?

    UK.

    What can explicitly not be concluded from this study?

    That pushing HbA1c to normal is always safe.

    Scientific details →

  • UKPDS: tablets or insulin for new type 2 diabetes

    UKPDS Group. Lancet 1998 · PMID 9742976
    Randomised controlled trialcited by the Tayebat archiveabstract checked★ key study

    Better sugar control with tablets or insulin cut eye/kidney complications by a quarter; insulin caused more weight gain and low-sugar episodes.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Intensive control with sulfonylurea or insulin vs diet on complications

    How was the study done?

    Multicentre RCT (UKPDS 33)

    How many people, animals or samples were studied?

    3,867; Newly diagnosed type 2 diabetes, median age 54

    What was actually found?

    Microvascular -25%; more hypoglycaemia and weight gain with insulin.

    How large was the observed effect?

    RR reduction 25% microvascular

    What do the results mean in everyday life?

    Insulin helps prevent complications but has side effects.

    What are the study's limitations?

    Open-label; Older drug regimens

    What does it say about Elawady's specific claim?

    Supports weight/hypoglycaemia (C-INS-01); contradicts C-INS-03, C-INS-05, C-DIAB-01.

    Do the results apply to Germany and Europe?

    UK; directly relevant.

    What can explicitly not be concluded from this study?

    That insulin is harmful overall.

    Scientific details →

  • UKPDS legacy: 10 years after the trial

    Holman RR et al.. N Engl J Med 2008 · PMID 18784090 · DOI 10.1056/NEJMoa0806470
    Randomised controlled trialindependent cross-checkabstract checked★ key study

    People treated intensively early with sulfonylureas or insulin had 15% fewer heart attacks and 13% fewer deaths years later.

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Do UKPDS benefits persist and do macrovascular effects emerge?

    How was the study done?

    Post-trial monitoring of an RCT (UKPDS 80)

    How many people, animals or samples were studied?

    4,209 randomised; 3,277 monitored; Newly diagnosed type 2 diabetes from UKPDS

    What was actually found?

    Legacy reductions in MI and death.

    How large was the observed effect?

    Death -13% (SU/insulin), -27% (metformin)

    What do the results mean in everyday life?

    Early good control pays off for decades.

    What are the study's limitations?

    Post-trial therapy not controlled; Questionnaire follow-up

    What does it say about Elawady's specific claim?

    Contradicts C-INS-03, C-INS-05 and C-DIAB-01: early insulin/SU therapy reduced MI and death long-term.

    Do the results apply to Germany and Europe?

    UK; directly relevant.

    What can explicitly not be concluded from this study?

    Effects of extreme targets in late disease.

    Scientific details →

  • EFSA: how much sugar is safe?

    EFSA NDA Panel et al.. EFSA J 2022 · PMID 35251356 · DOI 10.2903/j.efsa.2022.7074
    Risk assessmentindependent cross-checkfull text, structured risk-of-bias assessment★ key study

    EFSA found no safe intake level and advises keeping added and free sugars as low as possible.

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Can a UL or safe level for dietary sugars be set?

    How was the study done?

    Regulatory scientific opinion with systematic reviews.

    How many people, animals or samples were studied?

    Not applicable; General population

    What was actually found?

    Sugars are a well-established hazard for caries; RCTs on surrogate endpoints show causal positive relationship of added/free sugars with obesity and dyslipidaemia (moderate certainty), NAFLD and T2D (low), hypertension (very low); no safe level identified; intake of added and free sugars should be as low as possible in a nutritionally adequate diet.

    How large was the observed effect?

    Not applicable

    What do the results mean in everyday life?

    Applies to sugar, honey and syrups alike.

    What are the study's limitations?

    Trials looked at markers (weight, liver fat, blood fats) rather than diseases; cohort studies mostly compared sugar with other calories at equal total energy; few data below 10% of energy.

    What does it say about Elawady's specific claim?

    Contradicts C-SUG-01, C-SUG-05 (health relevance); supports C-SOD-01.

    Do the results apply to Germany and Europe?

    Directly applicable in EU/Germany.

    What can explicitly not be concluded from this study?

    It cannot name a safe daily amount of sugar; it does not show that sugar is harmful when it does not add extra calories, except for tooth decay.

    Scientific details →

  • Sugary drinks and diabetes risk: pooled cohorts

    Malik VS et al.. Diabetes Care 2010 · PMID 20693348 · DOI 10.2337/dc10-1079
    Meta-analysiscited by the Tayebat archivefull text, structured risk-of-bias assessment★ key study

    People in the highest intake group had a 26% higher risk of type 2 diabetes than those drinking almost none.

    Does the study support the specific claim? Yes · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Is SSB intake associated with incident metabolic syndrome and type 2 diabetes?

    How was the study done?

    Systematic search (MEDLINE to May 2010) and random-effects meta-analysis of prospective cohorts, highest vs lowest SSB quantile.

    How many people, animals or samples were studied?

    11 cohorts; 310,819 participants; 15,043 T2D cases; 19,431 participants/5,803 cases for metabolic syndrome; Adults in prospective cohorts

    What was actually found?

    T2D: RR 1.26 (95% CI 1.12-1.41); metabolic syndrome: RR 1.20 (1.02-1.42).

    How large was the observed effect?

    RR 1.26 (1.12-1.41)

    What do the results mean in everyday life?

    Regular sugary drinks are linked with more diabetes.

    What are the study's limitations?

    Only MEDLINE; no risk-of-bias assessment; high heterogeneity; observational studies; overlaps with later meta-analyses

    What does it say about Elawady's specific claim?

    Core evidence for C-SOD-01.

    Do the results apply to Germany and Europe?

    High; cohorts from Western populations.

    What can explicitly not be concluded from this study?

    That sugary drinks alone cause the difference.

    Scientific details →

  • HbA1c reflects average blood sugar

    Nathan DM et al.. Diabetes Care 2008 · PMID 18540046 · DOI 10.2337/dc08-0545
    Otherindependent cross-checkabstract checked★ key study

    In 507 people with about 2,700 glucose readings each, HbA1c closely matched the 3-month average blood sugar.

    HbA1c strongly correlates with measured average glucose (R2 0.84).

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Link HbA1c to average glucose.

    How was the study done?

    Observational method study.

    How many people, animals or samples were studied?

    507 people.

    What was actually found?

    eAG = 28.7 x A1C - 46.7; R2 0.84.

    How large was the observed effect?

    HbA1c 7% = about 154 mg/dL.

    What do the results mean in everyday life?

    HbA1c is a reliable average-sugar measure for most people.

    What are the study's limitations?

    Some individuals deviate.

    What does it say about Elawady's specific claim?

    Contradicts 'HbA1c is a lie'.

    Do the results apply to Germany and Europe?

    Used in Europe.

    What can explicitly not be concluded from this study?

    Cannot replace glucose checks in anaemia or haemoglobin disorders.

    Scientific details →

  • Blood sugar control and death in type 1 diabetes in Sweden

    Lind M et al.. N Engl J Med 2014 · PMID 25409370 · DOI 10.1056/NEJMoa1408214
    Cohort studyindependent cross-checkabstract checked★ key study

    People with type 1 diabetes died about 3.5 times as often as matched controls; with very high HbA1c the risk was about 8.5 times higher.

    Mortality rises steeply with HbA1c (HR 8.51 at >=9.7%).

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Measure excess mortality in T1D by glucose control.

    How was the study done?

    Nationwide register with matched controls.

    How many people, animals or samples were studied?

    33,915 patients, 169,249 controls.

    What was actually found?

    Higher HbA1c, higher death risk; excess risk even with good control.

    How large was the observed effect?

    HR 3.52 overall; 8.51 at HbA1c >=9.7%.

    What do the results mean in everyday life?

    Type 1 diabetes shortens life, especially with high sugar.

    What are the study's limitations?

    Observational data.

    What does it say about Elawady's specific claim?

    Contradicts denial of T1D complications and 'high sugar protects'.

    Do the results apply to Germany and Europe?

    Swedish data, directly applicable to Europe.

    What can explicitly not be concluded from this study?

    Cannot prove that lowering HbA1c alone removes all excess risk.

    Scientific details →

  • Long-term survival after intensive insulin treatment in type 1 diabetes

    Writing Group for the DCCT/EDIC Research Group et al.. JAMA 2015 · PMID 25562265 · DOI 10.1001/jama.2014.16107
    Randomised controlled trialindependent cross-checkabstract checked★ key study

    People who received intensive insulin treatment for about 6.5 years had about one third lower death risk 27 years later.

    Higher HbA1c associated with mortality (HR 1.56 per 10% relative increase).

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Test whether intensive insulin therapy affects long-term survival.

    How was the study done?

    Follow-up of a randomised trial.

    How many people, animals or samples were studied?

    1,441 young adults with T1D.

    What was actually found?

    43 vs 64 deaths; HR 0.67.

    How large was the observed effect?

    -109 deaths per 100,000 patient-years.

    What do the results mean in everyday life?

    Good insulin treatment helps people with type 1 diabetes live longer.

    What are the study's limitations?

    Few deaths; later years observational.

    What does it say about Elawady's specific claim?

    Contradicts 'insulin does not treat diabetes'.

    Do the results apply to Germany and Europe?

    Applicable to Europe.

    What can explicitly not be concluded from this study?

    Cannot separate effects of later care.

    Scientific details →

  • WHO: key facts on diabetes

    World Health Organization. WHO fact sheet 2024
    Guideline / position statementindependent cross-checkfull text checked★ key study

    Type 1 diabetes requires daily insulin; long-term high blood sugar damages nerves, blood vessels and organs.

    Chronic hyperglycaemia causes serious organ damage.

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Inform the public.

    How was the study done?

    Fact sheet.

    How many people, animals or samples were studied?

    Not applicable.

    What was actually found?

    T1D needs daily insulin.

    How large was the observed effect?

    Not applicable.

    What do the results mean in everyday life?

    Type 1 diabetes needs insulin every day.

    What are the study's limitations?

    Not graded.

    What does it say about Elawady's specific claim?

    Contradicts C-INS-07 and C-DIAB-01.

    Do the results apply to Germany and Europe?

    Global.

    What can explicitly not be concluded from this study?

    Not applicable.

    Scientific details →

Studies with mixed or unclear results (3)

  • Very tight blood sugar control in intensive care

    NICE-SUGAR Study Investigators; Finfer S et al.. N Engl J Med 2009 · PMID 19318384 · DOI 10.1056/NEJMoa0810625
    Randomised controlled trialcited by the Tayebat archiveabstract checked

    Aiming for normal blood sugar in ICU patients raised deaths from 24.9% to 27.5%.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Optimal blood glucose target in critically ill ICU patients

    How was the study done?

    International multicentre RCT

    How many people, animals or samples were studied?

    6,104; Adult ICU patients expected to stay >=3 days

    What was actually found?

    Higher 90-day mortality and 13-fold more severe hypoglycaemia with intensive control.

    How large was the observed effect?

    OR 1.14 (1.02-1.28)

    What do the results mean in everyday life?

    In very sick hospital patients, moderate sugar targets are safer.

    What are the study's limitations?

    ICU population, not ambulatory diabetes; Open-label

    What does it say about Elawady's specific claim?

    Supports that overly tight targets harm (C-INS-04); both arms received insulin, so it does not support insulin avoidance.

    Do the results apply to Germany and Europe?

    Multinational/US/UK/European data; directly transferable to Germany/EU clinical practice.

    What can explicitly not be concluded from this study?

    Anything about insulin therapy in people with diabetes at home.

    Scientific details →

  • Is high blood sugar during severe illness protective?

    Marik PE, Bellomo R. Crit Care 2013 · PMID 23470218 · DOI 10.1186/cc12514
    Narrative reviewindependent cross-checkabstract checked★ key study

    Critical-care experts argue that a short-term rise in sugar during severe illness may be a survival response; this does not apply to long-term diabetes.

    Acute stress hyperglycaemia may be adaptive; does not apply to chronic diabetes.

    Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Argue that acute stress hyperglycaemia is adaptive.

    How was the study done?

    Narrative review.

    How many people, animals or samples were studied?

    Not applicable.

    What was actually found?

    Tight ICU glucose control did not help; stress hyperglycaemia may be protective short term.

    How large was the observed effect?

    Not applicable.

    What do the results mean in everyday life?

    Brief high sugar in acute illness is not the same as diabetes.

    What are the study's limitations?

    Opinion piece.

    What does it say about Elawady's specific claim?

    Supports only the acute kernel of C-DIAB-01.

    Do the results apply to Germany and Europe?

    Applicable.

    What can explicitly not be concluded from this study?

    Cannot justify ignoring chronic high glucose.

    Scientific details →

  • When HbA1c can be misleading

    Samajdar SS et al.. Lancet Reg Health Southeast Asia 2026 · PMID 41743216 · DOI 10.1016/j.lansea.2026.100724
    Narrative reviewindependent cross-checkabstract checked★ key study

    Anaemia, inherited haemoglobin disorders and G6PD deficiency can distort HbA1c, so it should be combined with direct glucose measurements.

    HbA1c has known limitations in anaemia/haemoglobinopathies; does not make it 'a lie'.

    Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Review HbA1c pitfalls in India.

    How was the study done?

    Narrative review.

    How many people, animals or samples were studied?

    Not applicable.

    What was actually found?

    HbA1c unreliable in some conditions.

    How large was the observed effect?

    Not applicable.

    What do the results mean in everyday life?

    HbA1c is useful but must be interpreted with care.

    What are the study's limitations?

    Narrative.

    What does it say about Elawady's specific claim?

    Partly supports scepticism about HbA1c in specific conditions.

    Do the results apply to Germany and Europe?

    Same caveats in Europe/Egypt.

    What can explicitly not be concluded from this study?

    Cannot support abandoning HbA1c or glucose testing.

    Scientific details →

Regional context

Germany / EU

European (EASD) and German (DDG) guidance follow the same evidence base as the ADA/EASD consensus: individualised HbA1c targets, insulin as mandatory therapy in type 1 diabetes, and SGLT2 inhibitors/GLP-1 receptor agonists for people with cardiovascular or kidney disease. No country-specific difference changes the assessment.

Egypt

Egypt has one of the highest diabetes prevalences in the region; the same drug classes and insulins are used. Access barriers and cost may make advice to stop medication attractive, which increases the practical risk of this claim. No Egypt-specific evidence changes the assessment.

What applies in my country?

General scientific assessment

False Chronic high blood sugar is harmful; denying diabetes is false and dangerous.

This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.

References

  1. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.. Diabetes Control and Complications Trial Research Group; Nathan DM et al.. N Engl J Med 1993 · PMID 8366922 · DOI 10.1056/NEJM199309303291401
  2. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study.. Stratton IM et al.. BMJ 2000 · PMID 10938048 · DOI 10.1136/bmj.321.7258.405
  3. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group.. UKPDS Group. Lancet 1998 · PMID 9742976
  4. 10-year follow-up of intensive glucose control in type 2 diabetes.. Holman RR et al.. N Engl J Med 2008 · PMID 18784090 · DOI 10.1056/NEJMoa0806470
  5. Tolerable upper intake level for dietary sugars.. EFSA NDA Panel et al.. EFSA J 2022 · PMID 35251356 · DOI 10.2903/j.efsa.2022.7074
  6. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis.. Malik VS et al.. Diabetes Care 2010 · PMID 20693348 · DOI 10.2337/dc10-1079
  7. Translating the A1C assay into estimated average glucose values.. Nathan DM et al.. Diabetes Care 2008 · PMID 18540046 · DOI 10.2337/dc08-0545
  8. Glycemic control and excess mortality in type 1 diabetes.. Lind M et al.. N Engl J Med 2014 · PMID 25409370 · DOI 10.1056/NEJMoa1408214
  9. Association between 7 years of intensive treatment of type 1 diabetes and long-term mortality.. Writing Group for the DCCT/EDIC Research Group et al.. JAMA 2015 · PMID 25562265 · DOI 10.1001/jama.2014.16107
  10. Diabetes (fact sheet). World Health Organization. WHO fact sheet 2024
  11. Intensive versus conventional glucose control in critically ill patients.. NICE-SUGAR Study Investigators; Finfer S et al.. N Engl J Med 2009 · PMID 19318384 · DOI 10.1056/NEJMoa0810625
  12. Stress hyperglycemia: an essential survival response!. Marik PE, Bellomo R. Crit Care 2013 · PMID 23470218 · DOI 10.1186/cc12514
  13. The limitations and fallacies of relying on glycosylated hemoglobin for diagnosing and monitoring diabetes in Indian populations.. Samajdar SS et al.. Lancet Reg Health Southeast Asia 2026 · PMID 41743216 · DOI 10.1016/j.lansea.2026.100724

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