Best Sugar Substitutes for People with Diabetes

The Best Sugar Substitutes for People with Diabetes

Should you use artificail sweeteners?

With a low to no calorie sugar count, artificial sweeteners may seem like a treat for people with diabetes. But recent research indicates that artificial sweeteners may actually be counterintuitive, especially if you’re looking to manage or prevent diabetes.

In fact, the increased consumption of these sugar substitutes may correlate to the increase of obesity and diabetes cases.

The good news is that there are sugar alternatives you can choose from, including:

  • stevia or stevia products such as Truvia
  • tagatose
  • monk fruit extract
  • coconut palm sugar
  • date sugar
  • sugar alcohols, such as erythritol or xylitol

You’ll still want to watch your intake for glucose management, but these options are far better than the products marketed as “sugar-free.”

What is Stevia

Stevia is a low-calorie sweetener that has antioxidant and antidiabetic properties. It’s been approved by the U.S. Food and Drug Administration (FDA).

Unlike artificial sweeteners and sugar, stevia can suppress your plasma glucose levels and significantly increase glucose tolerance. It’s also not an artificial sweetener, technically speaking. That’s because it’s made from the leaves of the steviaplant.

Stevia alsohas the ability to:

  • increase insulin production
  • increase insulin’s effect on cell membranes
  • stabilize blood sugar levels
  • counter the mechanics of type 2 diabetes and its complications

You can find steviaunder brand names such as:

  • Pure Via
  • Sun Crystals
  • SweetLeaf
  • Truvia

While steviais natural, these brands are usually highly processed and may contain other ingredients. For example, Truvia goes through 40 processing steps before it’s ready to be sold. It also contains the sugar alcohol erythritol.

Future research may shed more light on the impact of consuming these processed stevia sweeteners.

The best way to consume stevia is to grow the plant yourself and use the whole leaves to sweeten foods.

Shop: stevia

What is Tagatose

Tagatose is another naturally occurring sugar that researchers are studying. Preliminary studies show that tagatose:

  • may be a potential antidiabetic and antiobesity medication
  • can lower your blood sugar and insulin response
  • interferes with the absorption of carbohydrates

A 2018 review of studies concluded tagatose is “promising as a sweetener without major adverse effects observed.”

But tagatose needs more studies for more definitive answers. Talk to your doctor before trying newer sweeteners such as tagatose.

Shop: tagatose

What are some other sweet options

Monk fruit extract is another alternative that is gaining popularity. But no processed sweetener can beat using fresh whole fruit to sweeten foods.

Another excellent option is date sugar, made of whole dates that are dried and ground. It doesn’t provide fewer calories, but date sugar is made of the whole fruit with the fiber still intact.

You can also subtract fiber from total grams of carbohydrates, if you count carbs for meal planning. This will give you net carbs consumed. The more fibrous a food, the lower impact it will have on your blood sugar.

Shop: monk fruit extract or date sugar

Why are Artificial sweeteners bad for diabetic people.

Some artificial sweeteners say “sugar-free” or “diabetic-friendly,” but research suggests these sugars actually have the opposite of effect.

Your body responds to artificial sweeteners differently than it does regular sugar. Artificial sugar can interfere with your body’s learned taste. This can confuse your brain, which will send signals telling you to eat more, especially more sweet foods.

Artificial sweeteners can still raise your glucose levels

One 2016 study saw normal-weight individuals who ate more artificial sweeteners were more likely to have diabetes than people who were overweight or obese.

Another 2014 study found that these sugars, such as saccharin, can change your gut bacteria composition. This change can cause glucose intolerance, which is the first step towards metabolic syndrome and diabetes in adults.

For people who don’t develop a glucose intolerance, artificial sweeteners may help with weight-loss or diabetes control. But switching to this sugar replacement still requires long-term management and controlled intake.

if you’re thinking of replacing sugar regularly, talk to your doctor and dietitian about your concerns.

Artificial sweeteners may also contribute to weight gain

Marketing for food products can lead you to think non-caloric artificial sweeteners help with weight loss, but studies show the opposite.

That’s because artificial sweeteners:

  • may lead to cravings, overeating and weight gain
  • alter gut bacteria which is important for weight management

For people with diabetes looking to manage their weight or sugar intake, artificial sweeteners may not be a good substitute.

Being overweight or obese can also increase your risk factors for several other health issues such as high blood pressure, body pain, and stroke.

Safety rating for artificial sweeteners

The Center for Science in the Public Interest currently deems artificial sweeteners a product to “avoid.” Avoid means the product is unsafe or poorly tested and not worth any risk.

What about sugar Alcohols

Sugar alcohols are naturally found in plants and berries. The types most often used in the food industry are synthetically created. You can find them in food products that are labeled as “sugar-free” or “no sugar added.”

Labels such as this are misleading because sugar alcohols are still carbohydrates. They can still raise your blood sugar, but not as much as regular sugar.

Common FDA-approved sugar alcohols are:

  • erythritol
  • xylitol
  • sorbitol
  • lactitol
  • isomalt
  • maltitol

Swerve is a newer consumer brand that contains erythritol. It’s available in many grocery stores. The brand Ideal contains both sucralose and xylitol.

Shop: erythritol, xylitol, sorbitol, isomalt, or maltitol

Different from artificial sweeteners

Sugar alcohols are often synthetic, similar to artificial sweeteners. But these two classifications of sugar alternatives aren’t the same. Sugar alcohols are different because they:

  • can be metabolized without insulin
  • are less sweet than artificial sweeteners and sugar
  • can be partially digested in the intestine
  • don’t have the aftertaste of artificial sweeteners

Research suggests that sugar alcohols can be a sufficient replacement for sugar. But reports also say that it won’t play a significant role in weight loss. You should treat sugar alcohols the same as sugar and limit your intake.

Sugar alcohols are also known to produce side effects such as gas, bloating, and abdominal discomfort. However, erythritol is usually better tolerated, if you’re concerned about these side effects.


Recent studies indicate that artificial sweeteners are no longer the healthy alternatives to sugar. In fact, they may increase a person’s risk for diabetes, glucose intolerance, and weight gain.

If you’re looking for a healthier alternative, try stevia. Based on research to date, this alternative sweetener is one of your better options. It’s known for its antidiabetic properties and ability to stabilize blood sugar levels.

You can get stevia in raw form, grow the plant yourself, or buy it under brand names such as Sweet Leaf and Truvia.

However, you should still limit your total added sugar intake rather than switching to sugar substitutes.

The more you consume any kind of added sweeteners, the more your palate is exposed to sweet tastes. Palate research shows that the food you prefer and crave is the food that you eat most often.

You’ll see the most benefit for managing your sugar cravings and diabetes when you reduce all forms of added sugar.

Comparing Sweeteners: Xylitol vs. Stevia

Xylitol and stevia are both considered artificial sweeteners, although they occur naturally in nature. As neither contain any actual sugar, they’re helpful alternatives for people who have to monitor their sugar intake, such as people with diabetes or those who are trying to lose weight.

What is Stevia

Stevia is derived from Stevia rebaudiana, a plant native to South America that’s been used there for centuries to sweeten teas and make medicines go down easier.

But the kind you’ll find in stores involves a good amount of processing to make it table ready. It is hundreds of times sweeter than sugar, so it is calorie-free. And the difference between the two is even more apparent when you use them for baking: Stevia lacks sugar’s bulk and baking brings out its natural licorice flavor.

It can be purchased or found in coffee houses in green packets as the name brands Stevia in the Raw, Sweet Leaf, Rebiana, Enliten, and Erylite Stevia. It’s also the main sweetener in Coca-Cola’s Truvia and Pepsi’s PureVia.

What is Xylitol

Xylitol is a naturally occurring sugar alcohol that’s used in gums, candies, toothpaste, and other items. It’s also sold in higher concentrations in oral health-related products, with a focus on preventing tooth decay.

Xylitol is extracted from various fruits and vegetables, although modern production of it primarily comes from corn cobs. It’s nearly identical to sugar in sweetness, but it contains a third of the calories, which means it is not calorie-free.

What Are the Benefits and Side Effects of Stevia?

The major benefit of both stevia and xylitol is as a sweetener for people with diabetes, as they have to closely monitor their blood sugar and insulin levels.

Since they don’t contain sugar, xylitol and stevia don’t require insulin to be processed through the body.

There’s also some evidence that stevia has natural hypoglycemic properties Trusted Sources Trusted Source and can help insulin secretion in people with type 2 diabetes by directly acting on beta cells. Still, medical researchers note that the combination of stevia and blood sugar-lowering medications could actually cause blood sugar levels to drop too far.

The U.S. Food and Drug Administration Trusted Source (FDA) has not approved crude stevia as a food additive, citing concerns over its effects on the body’s ability to control blood sugar levels, as well as possible negative effects on the reproductive, renal, and cardiovascular systems.

Animal studies have linked high amounts of stevia with decreased fertility and potential genetic mutations in offspring. Still, the FDA has approved stevia-containing sweeteners for commercial use, so long as they’re labeled as a dietary supplement.

After reviewing the scientific evidence, the World Health Organization determined that the acceptable daily intake of stevia is 4 mg per kilogram of a person’s body weight. For example, an average American man who weighs 195.5 pounds (or 88.7 kilograms) can safely consume 0.35 grams of stevia per day.

What are the Benefits and side effects of Xylitol

Like stevia, xylitol is a good sweetener option, though it will have a small effect on blood sugar since it does contain some carbohydrate.

Some people report having gastrointestinal problems when consuming xylitol. These are usually diarrhea, abdominal bloating, and gas. They typically occur at doses of 100 grams or more a day, which is why the general consensus is that 50 grams a day or less is best.

Xylitol, however, has been shown to have added benefits for a person’s teeth, namely preventing tooth decay. The California Dental Association says that xylitol has been proven to prevent teeth decay by reducing cavities and strengthening tooth enamel as well.

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