I am often asked about what the best sweeteners for people with diabetes are and what can be used as a replacement for sugar that won’t raise blood sugar. That’s why I have created this in-depth guide to natural and artificial sweeteners for people with diabetes.
I get a little frustrated when reading or hearing outright incorrect claims and marketing spin about how some of the natural and artificial sweeteners affect your blood sugar. As a person with diabetes, I want to know exactly what will happen to my blood sugar when I eat or drink something, and I don’t take kindly to half-true marketing claims.
I’ve decided to focus on which natural and artificial sweeteners are good for people with diabetes as it relates to impact on blood sugar, rather than on whether they are healthy choices in general since I think that is somewhat out of my domain and because plenty of others have already covered that.
What are natural & artificial sweeteners?
FDA defines sweeteners as: “…commonly used as sugar substitutes or sugar alternatives because they are many times sweeter than sugar but contribute only a few or no calories when added to foods”.
This means that regular sugar, honey, and Agave nectar/syrup don’t fall into the sweetener category. However, I do want to address these shortly before moving on to the real natural and artificial sweeteners, since I’ve seen claims of how honey and agave won’t impact blood sugar in the same way as sugar.
Sugar substitutes that are NOT blood sugar friendly
Honey
Let’s start with honey because, let’s face it, it’s sugar in liquid form (82% of honey is sugar, the rest is water and small amounts of pollen, etc.). It’s delicious, but an October 2015 study in the Journal of Nutrition found that when subjects were given honey, cane sugar, or high-fructose corn syrup, they saw no notable difference in blood sugar increase.
The only benefit of honey over regular table sugar from a blood sugar perspective is that honey is slightly sweeter so you can use a little bit less of it and achieve the same sweetness. But that still doesn’t make it a good option for people with diabetes!
Agave Nectar
As for agave, I think that the corporate marketing machine has been very clever when declaring this a health food, for as Dr. Jonny Bowden points out“..It’s basically high-fructose corn syrup masquerading as healthy food.” Agave nectar may have a lower glycemic index than sugar or honey, but it’s still up to 90 percent liquid fructose.
At the end of the day, sugar is sugar. Honey or agave nectar may be slightly better for you than pure white sugar from an overall nutrition perspective, but don’t get tricked into thinking that they are healthy alternatives.
Natural & artificial sweeteners that won’t affect blood sugar
None of the natural and artificial sweeteners I list below will affect your blood sugar in their raw form, but you have to make sure that the manufacturer hasn’t added anything else to the product such as fillers or flavors.
With the exception of aspartame, none of the sweeteners can actually be broken down by the body, which is why they won’t affect your blood sugar. Instead, they’ll pass through your systems without being digested, so they provide no extra calories.
Natural Sweeteners
Stevia
I’m often asked if Stevia good for people with diabetes. And I love that I can answer YES! Stevia is great for people with diabetes and will not raise blood sugars levels. It’s actually my sweetener of choice.
So, what is Stevia? Stevia a completely natural sweetener since it’s simply an extract from the leaves of the plant species Stevia rebaudiana. Most grocery stores carry it and you can purchase it as a powder, extract, or as flavored drops.
Stevia powder: I used to buy the standard supermarket brand Stevia powder until I realized that they mix it with fillers to make it behave more like sugar. This actually has some calorie impact as well as a minimal effect on your blood sugar if you use large amounts. The nutritional label will claim that it’s a zero calorie food, but that’s only because the FDA allows all food with less than 0.5 g sugar per serving to be categorized as having zero calories. All that being said, I do still use powdered Stevia as a sugar replacement for baking as it reacts well to heat. If you use a brand like Stevia in the Raw, it substitutes one-for-one to sugar and I just acknowledge that it might have a minimal/neglectable impact on blood sugars.
Stevia extract: In general, I recommend buying Stevia extract instead of powdered stevia because it’s pure Stevia with nothing added. The extract has a more intense flavor but you’ll get the sweetness without any calories or blood sugar impact whatsoever. To me, that’s a winner if you want a natural sweetener to sweeten up your morning coffee or oatmeal. I use the NOW brand Stevia Extract.
Flavored Stevia drops: If you have a hard time drinking enough water (or just think plain water is boring), you have to try Sweet Leaf’s Liquid Stevia Drops. You simply squirt a few drops into your water and it tastes like lemonade, but without the blood sugar impact.
Monk fruit
Monk fruit is another good choice for people with diabetes since it’s a natural sweetener that won’t affect your blood sugar. I’ve tried it, but it’s not a product I really use simply because I prefer the taste of Stevia (monk fruit has a slightly fruity aftertaste), but that’s a personal preference. It’s a good alternative if you are looking for a natural sweetener but don’t like the taste of Stevia.
Always carefully read the nutrition label when buying monk fruit extract as some brands combine the monk fruit with sweeteners like Erythritol or even sugar and molasses.
Artificial Sweeteners (FDA approved only)
The list below covers the FDA approved artificial sweeteners and their brand names. None of them should affect your blood sugar but there is a lot of controversy about whether or not they have long-term health implications. I won’t go into that, but my personal preference is to stick to the natural stuff. I mean, if it pretty much tastes the same, why take the chance?
- Acesulfame potassium (also called acesulfame K) – Sunett & Sweet One
- Aspartame – Equal & Nutrasweet
- Saccharin – Sweet ‘N Low, Sweet Twin & Sugar Twin
- Sucralose – Splenda
- Neotame – NA
- Advantame – A Sweet Leaf, Sun Crystals, Steviva, Truvia & PureVia
Low-calorie alternatives
Other sweeteners, which are often used in diet foods, food labeled as “sugar-free”, and sugar-free gum, are sugar alcohols. Per FDA: “Sugar alcohols are slightly lower in calories than sugar and do not promote tooth decay or cause a sudden increase in blood glucose.”
The most common sugar alcohols are Maltitol, Sorbitol, Xylitol, Erythritol, and Isomalt (that’s a lot of names to remember, so I generally just categorize them as the ‘ols’). They do indeed affect your blood sugar less than regular sugar, but their main problem is that they also work as laxatives. This means that they most likely will give you gas or cause bloating. I can eat some of them in small amounts but my body reacts badly to Xylitol.
Sugar alcohols give you about 2.5 calories/gram versus 4 calories/gram for regular sugar so if you can stomach them (pun intended), you can reduce the blood sugar impact by 50% by using any of these sweeteners. To me, this is not really worth the potential health issues and side effects.
So what are the best sweeteners for people with diabetes?
In general, there is no reason not to choose one of the natural sweeteners that don’t affect blood sugar – Stevia or monk fruit. They are both great for people with diabetes and you can choose whichever one you think tastes the best. For baking, Stevia in the Raw is my preferred sweetener as it retains its taste and acts the most like sugar when heated.
Artificial sweeteners and sugar alcohols are not terrible, but they do potentially have side effects, the most common of which is digestive issues. I therefore see no reason to use them when natural and safe alternatives are available.
Sugar substitutes such as honey and agave nectar are essentially identical to normal sugar when it comes to blood sugar impact. I do keep both sugar and honey in the house for the rare occasions where I want to bake something really decadent (like a birthday cake), but I try to use it as little as possible.
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A great article indeed! I have benefited a lot from it, I have been skeptical to use sweeteners because I feared the side effects. At least you have guided me. I know what to look for. Thank you very much.
Hi,
Thanks for a great article!
I am a recent Diabetic (Type 2). You mention that with the correct exercise and diet it can be reversed, but you say only for some. How do I know where I fit? I also noticed that my sugar level when I wake up i.e while fasting is relatively high. What causes it to be high at this time? Is it related to a bad diet? I don’t usually snack, just have my three meals a day.
Thanks!
You won’t know until you try. Many can utilize exercise and diet to improve their glucose levels so that they get back into normal levels. The reason why I write “most” is that some people will need meds as well, and I want to highlight that that does not mean that they haven’t done all they can and it’s not failure. The body is complex and diabetes is still not well understood.
You’ll need to talk to your doctor if you’re running high in the morning despite eating well and exercise. You might be one of those people who needs a little medical help, and it might only be for a period of time
Hi I’ve just been diagnosed type2 diabetes and on meds twice a day I love your recipes and will try some this weekend. I’m interested in the snack recipes to have some lunch ready as I feel ill with the hunger midday and will need to be more perpered, thank you for all the information I am hoping to reverse the type 2.diabetes with diet and exercise any ideas and tips I would appreciate .
If hungry I would recommend eating something. Many try to wait until dinner and end up so hungry that they overeat later.
Not all type 2 can be reversed BUT the way to do your best to try is by losing weight (if you have weight to lose) and including more movement in your day. Optimally it would be a combination of cardio and resistance training 3-4 times a week. You can look up some of my exercise videos if you need a little support getting started
I am reading everything and I am so confused. I just found out that I am diabetic and I’m trying to figure out what I can and cant eat. I have this stuff called Coconut Agave with Stevia extract. 0 calories 0 sugar. can I use it? I would drink tea with a little honey and lemon but now I find out I cant use honey so I got this stuff. But reading different web pages one said no and one said yes. I’m so confused. any help would be greatly loved.
I don’t know the exact product you’re using but in general look for the carb content. If it says 0 G carb you’re generally OK. And second test it out, measure your blood sugar before and 20-30 min after and see if it impacts you.
Be aware of serving size, FDA allows products to list 0 calories/ 0 carbs if the product only has up to 0.5 G sugar per serving. But let’s say a serving is minimal, so you might be using 10 servings, that could be 5 G of carbs. For some, myself included, that would make my blood sugar go up.
The reason why your product says Agave on the label but has 0 calories is probably that they dilute the syrup enough to get the carb count down. Look at the ingredients, what’s the first product listed? I’ll bet you it’s water.
So to summarize, try it out, and if you’re happy with the result and the taste continue using it
Hi everyone. I am a type 2 diabetic and am interested in artificial sweeteners too. Anyone remember Tab soft drink from the 60’s? That’s how long I’ve been using artificial sweeteners. I came across a great site several years ago. It was an elderly doctor’s site who was a type one diabetic. He said that with artificial sweeteners, the Equal and Sweet N Low in packets shouldn’t be used. They contain dextrose that raises insulin levels. He recommended using the tablet form that contained pure saccharin or aspartame. I haven’t seen the tablets in years but the powdered forms without dextrose, can be purchased on the internet. Unfortunately, I don’t remember his website and haven’t been able to locate it and I don’t remember his name. Also, for those that hate the taste of some artificial sweeteners or even Stevia, try mixing several together in a container and use a spoon, scoop, measuring spoon, etc. to use. I have mixed Equal, Sweet N Low and Stevia together and stored it in a plastic container to sweeten my coffee. Some companies sell their own blends.
Thank you for sharing Terri
Wow! Having read this article and then the comments, there’s so much information here. Thank you all so much for contributing and helping me make definite choices.
I have a question though. I read somewhere stevia is 250 times sweeter than sugar. That being the case, my reckoning tells me I should use 1/250th of a tsp of stevia per 1 tsp of sugar. Yet, I also read stevia can be used cup-for-cup instead of sugar. Can you please clarify this.
Thank you.
So glad you found this useful! And it’s a great clarifying question.
The Stevia extract is much sweeter, and to some, a little bitter, so use a very small amount compared to sugar.
Stevia mixes (the powdered versions you most often can find in the supermarket) are cup-for-cup with sugar.
Hope that makes sense
In baking cookies, is Truvia better to use instead of Stevia?
Have family members that are diabetic and would like to make cookies without using granulated white sugar.
Truvia is a Stevia brand. It’s not an extract, which makes it easier to bake with, so not a bad choice.
If you are a diabetic and have to inject unsulin beware stevia can interere with the uptake of the insulin.
What about molasses as a healthy sugar substitute?
Molasses, like agave, is a type of sugar, so it will impact blood sugars and I would not recommend it as a substitute.
I understand that the studies say this and that about equal but I’m just concerned that you say it doesn’t raise insulin right
Hi Angel, I don’t personally see an impact but as I write in the post:”it might have a minimal/neglectable impact on blood sugars”
How does stevia affect blood insulin Levels?
Stevia in itself doesn’t affect blood sugar levels, but some Stevia products contain small amounts of sugar or other sweeteners that may have an impact. Check the label on any Stevia product you use to see what’s in it.
Hi. Stevia in the Raw contains maltodextrin which is actually worse than sugar! The hard part about finding the perfect Stevia sweetener is that numerous brands add dextrose and maltodextrin and actually cause a rise in blood glucose and insulin. Truvia is the much better choice or The Sweetleaf drops
Appreciate the article, but for Obesity / Diabetes the latest research (The Obesity Code – Jason Fung MD) states that Blood sugar is not the reaction we should be looking at and that it’s Insulin reaction and not increased blood sugar even though they are related. He states that its Insulin that causes fat storage and the constant release of Insulin causes Insulin Resitance. He says even stevia causes an Insulin release. Instead of the Glycemic index, we should be looking at the Insulin Index. Please research this further and hopefully we can find a natural sweetener that doesn’t cause an Insulin release. Literal food for thought!
Every study I have ever read says that pure stevia does not cause an insulin response. It actually improves insulin sensitivity.
Thank you for this article Christel! The sweetener world is confusing to navigate, and your article puts things in good perspective: natural is better! I do use Truvia sweetener (erythritol) because it closely mimics the “crunch” of sugar in baked items. Swerve is another brand, though I find it to have a bizarre aftertaste. On the other hand, too much erythritol beyond a very moderate amount will clean my clock! To avoid this, I am slowly converting to Stevia in the Raw. Cooking with this a bit challenging because it seems to me to be far sweeter than Truvia. It’s a matter of finding that good “sweet” balance. I’m wondering if you simply use it cup for cup in most recipes, or do you cut it back?
I love you and your hard work! Thank you!!!
I’m glad you liked it. I have a VERY sweet tooth so I often do a little more than cup for cup, but according to the manufacturer cup for cup should do it.
My husband is Type 2 diabetic but has a real sweet tooth craves deserts especially ice cream is there any ice cream that is suitable for him I have bought sugar free but under nutrition facts it still shows sugar 1g. I use trivia for baking, Ingredients: Erthritol,Stevia Leaf Extract. Don’t think I am helping his cause What is my best choice ?
You can’t get ice cream completely without sugars since the ice cream base will always contain some form of carbohydrate even if no sugar is added for sweetness. Trivia is one of those products that FDA sees as not impacting blood sugars even though it will have traces of carbohydrates (aka sugar). My perspective is that if you keep it within reason (not ice cream every night or cups of Truvia a day) you’ll be fine. He is most likely instructed (by his medical team) to reduce carbohydrates, not eliminate them completely
Tescos value range has less sugar content than diabetic ice cream
Google “Keto ice cream” and you will find a pretty good ice cream recipe that is easy to make using coconut milk, whipping cream, vanilla, xylitol, a pinch of salt and a little xanthum gum. It might contain a little MCT oil as well. High fat, low carb.
I use raw honey to make raw chocolate and find that it doesn’t impact my blood sugar greatly but I only eat small amounts – it is filling (I add home made nut butter) and not addictive like table sugar plus made with raw cacao powder, raw cacao butter and coconut oil, it is packed full of nutrients. Mood and Mind do a great stevia extract.
Glad you found an option that works for you (and that does sound pretty yummy)
One size does not fit all. What you may have another may not have we are all different after all.
I agree completely, but knowing the basics can help us make informed choices
Thank you so much! It’s nice to get a diabetics perspective on this! People have very decided opionions on what’s “healthy” or not. It’s frustrating when people kindly give me advice like “use honey or agave syrup” instead of sugar and I try and explain to them that I still need to take insulin for these things and that they count against my limited calorie or carbohydrate counts. :/ I personally do not like the taste of any sweeteners natural or otherwise, but do love Sweet-n-Low in my one glass of unsweet tea I occasionally allow myself. It fulfills cravings for me and is a treat. Everyone’s taste buds are different. I live by ‘everything in moderation.’
Thank you for that comment, Kate. I’m with you, find what works for you!
I use SweetLeaf stevia because so many other brands have additives SweetLeaf does not.
I was under the impression that Splenda contained maltodextrin and could then have an effect on your blood sugar. Is this incorrect?
The Splenda brand includes quite a few sweeteners (now also a Stevia product). The main sweeteners according to the manufacturer is sucralose, and it should not impact blood sugars. For more indebt knowledge on Splenda specifically, Hope Warshaw (dietitian and diabetes educator) has written quite a bit about it (LINK HERE).
I read the article.
Are you saying I should be able to find a Splenda product that is just sucralose and does not contain maltodextrin?
The Splenda brand has several products (I don’t use them but found them on their website), including a Stevia product.
The original Splenda sweetener looks to all have Maltodextrin, but in so low amounts that the company (and FDA) sees it as a non-blood sugar impact sweetener. So I was referring back to their (and FDA’s) statements that Splenda won’t impact blood sugars.
However, my personal perspective is still that Stevia is a better option, so if I had to choose I’d choose the Splenda Naturals product line that only contains Stevia and Erythritol. If you don’t want anything but Stevia I suggest the NOW Stevia extract I’m linking to in the post
Thank you for the input.
Wow…I thought I was doing good by using stevia! Didn’t even think about them adding things in… 🙁 Thanks for the info!
I really like this post! I was very interested the honey/agave thing because honestly, I don’t see where it’s any better calorie wise either. I tend to use stevia when I can find it, otherwise, I keep splenda around because hubby is diabetic. Loving your site so far! I’m really anxious to try some of your recipes. 🙂
Thank you Shelby. Yeah, honey/agave is pretty much sugar with good branding :-). They do contain some healthy elements, but they definitely aren’t health foods.
Thank you! I’m will research Now Better Stevia. I am always looking for ways to lower my a1c and live my heathiest life!
Thanks mama. As mentioned it’s a little pricey but a lbs will last you a REALLY long time.
Great article !
Thanks, glad you found it informative
Great article! I remember in high school trying a chocolate bar that was sweetened with maltitol. I found out quickly how badly my stomach reacted to sugar alcohols, and that was the last time I tried them!