The difference between sugar and other carbohydrates is that most carbs are made up of long chains of glucose molecules, which is the sugar we are talking about when we speak of “blood sugar.” But sugar in the context of food generally means table sugar, sucrose, which is formed from a glucose molecule bonded to a fructose molecule. (Fructose is found in fruits, hence its other name, “fruit sugar.”)
Glucose is handled by the body with no problem. Carbohydrates break the chains into individual glucose molecues, they enter the bloodstream and are carried to muscles and fat. The insulin response to all that glucose signals the muscles to burn glucose for energy, and fat cells to store it as tryglycerides. So far so good (except for that spare tire).
Fructose, on the other hand, can be metabolized only in the liver, where it follows the same pathway as the ethyl alcohol in your Scotch. Because it’s metabolized by the same pathway, it causes the same problems in the liver, inflammation, de novo lipogenesis leading to fatty liver disease, elevated liver enzymes, that sort of thing. Fructose also acts upon the nucleus accumbens, the brain’s reward center, the same way alcohol and cocaine do, stimulating cravings and down-regulating dopamine receptors. (It doesn’t destroy brain cells the way alcohol does, however.) About the same percentage of the population gets addicted to sugar as gets addicted to alcohol, although I don’t believe they are all the same people.
So that’s why sugar is an especially bad carbohydrate to eat, especially if you are on a ketogenic diet for the metabolic benefits, or if you are a sugar addict.