Sugar Substitutes for Diabetes

• By Beth Gilbert | Medically reviewed by Lindsey Marcellin, MD, MPH

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  If you think that people with diabetes should always avoid sugar, think again — they can enjoy the sweet stuff, in moderation. "The best bet is to use a very minimal amount of real sugar as part of a balanced diabetic diet," says Keri Glassman, MS, RD, CDN, of Nutritious Life, a nutrition practice based in New York City. That being said, sugar substitutes offer sweetness while controllingcarbohydrate intake and blood glucose. There are many sugar substitutes to choose from, but they’re not all calorie-free and they vary in terms of their impact on blood sugar. "The major difference between the sugar substitutes is whether they are nutritive or non-nutritive sweeteners," says Melissa Mullins, MS, RD, a certified diabetes educator with Johnston Memorial Hospital in Abingdon, Va. "Non-nutritive sweeteners provide no calories and no changes in blood glucose levels, which is perfect for people with diabetes.”

  

  Sugar Alcohols: Low-Calorie Sweeteners

  Sugar alcohols, or polyols, are derived from the natural fibers in fruits and vegetables. They do contain carbohydrates, so they are considered nutritive sweeteners. Though sugar alcohols are relatively low in calories and blood-sugar friendly, they can cause indigestion, bloating, diarrhea, and headaches. See how you respond to a small amount before incorporating them into your daily diet. Examples of sugar alcohols include sorbitol, mannitol, and xylitol.

  Mullins says that sugar alcohols contain some carbohydrates, and some types break down more completely than others. "I recommend that people who are going to use these sugar substitutes keep track of carbohydrate levels," says Mullins. "Subtract half the amount of sugar alcohols from the total number of carbohydrates to understand how many carbs are actually being consumed and the impact on blood glucose levels."

  Splenda is a brand name for sucralose, a non-nutritive or artificial sweetener, which is excellent for people with diabetes — type 2 diabetes in particular. Splenda is 600 times sweeter than sugar, says Glassman, but those little yellow packets have no effect on blood sugar. In addition, Splenda passes through the body with minimal absorption.

  
  
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  Sugar Alcohols: Low-Calorie Sweeteners

  Sugar alcohols, or polyols, are derived from the natural fibers in fruits and vegetables. They do contain carbohydrates, so they are considered nutritive sweeteners. Though sugar alcohols are relatively low in calories and blood-sugar friendly, they can cause indigestion, bloating, diarrhea, and headaches. See how you respond to a small amount before incorporating them into your daily diet. Examples of sugar alcohols include sorbitol, mannitol, and xylitol.
  Mullins says that sugar alcohols contain some carbohydrates, and some types break down more completely than others. "I recommend that people who are going to use these sugar substitutes keep track of carbohydrate levels," says Mullins. "Subtract half the amount of sugar alcohols from the total number of carbohydrates to understand how many carbs are actually being consumed and the impact on blood glucose levels."