Sugar Substitutes for Diabetes
with diabetes, not all sugar substitutes are created equal. Find out which ones
are safe for your diabetes diet.
By Beth Gilbert
Medically reviewed by Lindsey Marcellin, MD, MPH
Splenda: Good for
Splenda or sucralose is excellent for people with diabetes — type 2
diabetes in particular. It has no effect on blood sugar and passes through the
body with minimal absorption.
Saccharin: Watch Out for Weight
Saccharin, under the brand name Sweet 'N' Low, is calorie-free and
though it can be a sugar substitute option for those with diabetes,
"research has shown that the intake of saccharin can lead to weight
gain," Glassman warns. "Usually, when one eats a sweet food, the body
expects calories to accompany that food. When the body does not get those
calories, it looks for them elsewhere. This can lead to greater calorie
consumption throughout the day as your body craves the caloric satisfaction it
has missed," she explains.
Aspartame: Possible Side Effects
Aspartame, sold as Equal and NutraSweet, is not zero calories like some
other artificial sweeteners, but is still very low in calories. Even though the
U.S. Food and Drug Administration has reviewed the scientific research and
found aspartame to be safe for human consumption, there have also been some
conflicting study results on aspartame's safety. “It has been linked to many
negative side effects," Glassman says. "Some research shows linkage
to leukemia, lymphoma, and breast cancer. Other research shows a linkage to
migraines." In addition, people with phenylketonuria (PKU), a rare
condition in which they are unable to metabolize phenylalanine (a key component
of aspertame), should not consume this sugar substitute.
Stevia: An All-Natural Option
Truvia is one brand of the sweetener derived from the leaf of the stevia plant,
native to Central and South America. Truvia is calorie-free and has been shown
to have little to no impact on blood sugar, which is why it is an excellent
sugar substitute for diabetic people. Other brands are Pure Via and Sun
Crystals. There have been anecdotal reports of side effects associated with
over-consumption of stevia, including headaches and gastrointestinal symptoms,
but to date there is no solid scientific research to back this up.
Agave: Super Sweetener
Agave nectar is a form of sugar derived from the sap of the agave plant
and it is low on the glycemic index.
This means it is absorbed more slowly by the body, causing a relatively lower
spike in blood sugar and less of a sugar rush than other forms of the real thing.
"Its low glycemic index makes it a good sugar substitute for diabetic
people," says Glassman. One caveat: agave has about 60 calories per
tablespoon, making portion control essential, however it is 1.5 times sweeter
than sugar, so you can use less."
Sugar Alcohols: Low-Calorie
Sugar alcohols, or polyols, include
sorbitol, mannitol, and xylitol are derived from the natural fibers in fruits
and vegetables. They do contain carbohydrates, so they are considered nutritive
sweeteners. Though 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.
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."