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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I use Swerve. Is that on the same level as trivia? I like it and Swerve has brown sugar and powdered sugar as well. It meets all my needs.
I’ve used Swerve as well and really like it. I don’t find that it impacts my blood sugar. I haven’t tried their brown sugar, only the confectioner and granular just might have to it though
Hi Christel,
First I just want to say thank you!! I am trying to learn and understand how to live with and improve my numbers and health as well. Your site has been a blessing. You mentioned agave nectar in your post, is blue agave the same ? It doesn’t say nectar on the bottle I bought, just want to know before I use it.
I don’t know the product but googled it and it looks like agave syrup. What that means is that it will impact your blood sugar, so just use it in moderation
Thank you!!
Any thoughts on the artificial sweeteners driving blood sugars down? Is it possible that even though being Type One the pancreas is still releasing insulin? When I drink diet sodas or ‘sugar free’ drinks and even some s.f. coffee creamers, that are artificially sweetened, my sugar drops and I am running for a can of real coke! I have read other articles saying that these sweeteners have no effect on blood sugar. I’d appreciate any insights or thoughts on this.
It’s an interesting question. You believe you can ask to have your insulin production tested at your endos office. Generally as someone living with type 1 diabetes, we don’t produce insulin, however, I found a study stating that some have “Residual insulin production can last for more than four decades”. You can read the study paper HERE.
The study is from 2004, so older. I wonder, had they done it today, would they have discussed the option of some of these test subjects actually being LADA (late onset) and not actually having Type 1
I am also reading that erythritol doesn’t affect blood sugar because it’s not absorbed by the body and simply passes out unchanged in the urine. Not sure what to believe. One source said it does not affect blood sugar in “healthy people”. Other sources say it doesn’t affect blood sugar at all. One source said the problem isn’t that the product affects blood sugar, but that it is made with GMOs. I have reactive hypoglycemia and have to pay close attention. My body is super sensitive to sugars. Can you help?
I’d suggest just trying a small amount at a time where your blood sugars are fairly stable. Measure your blood sugar before you try it and 20 min after. If you see a significant increase, the brand or erythritol in itself does not work for you. I see no blood sugar impact from the brand I currently use (Swerve) but some brand will have other things added
It’s ok in moderation but could upset the stomach bacteria balance over time.
Based on your recommendation I was going to buy some Sweet Leaf drops. The link in your article goes to the Water Drops which contain vegetable glycerin. Are you suggesting to use the Water Drops or the Sweet Leaf liquid stevia drops?
Thank you for the information.
Hi Janis, the Water Drops I link to (which are also made by the Sweetleaf Stevia Brand) are the ones that have different flavors. I like those in my water and they don’t affect my blood sugar. The regular Liquid Stevia drops are only sweet (no added flavor). I mostly use those for baking or in my tea. Does that answer your question?
Does truvia raise your sugar level and is it a safe alternative for Keto
Truvia is just a branded Stevia blend. It has a minimal amount of Erythritol as well so it could potentially have a small impact on blood sugar. I consider such insignificant and use Stevia blends all the time. If you do find that it increases your blood sugar you can try a different brand
Why would it matter if Monkfruit was mixed with Erythritol or Stevia if they are both the same types of sweeteners and don’t raise your blood sugar?
My only comment about Monkfruit is that is can have; quote: “Erythritol or even sugar and molasses” added. Those additions can/will have an impact on blood sugar.
Have you heard of Sukrin before? It’s quite expensive, but personally I like the way it tastes the most (which would be honely-like).
I haven’t, but I looked it up and it looks promising
Thank you for giving us a true look at how different sweeteners can affect our wellbeing, I now have been using truvia, agave, and stevia in the raw for different recipes , I started using the Keto diet to improve my health., I am a sugar freak so I didn’t want to have to give up my cravings and deprive myself of what I enjoy in order to maintain a healthier life style. I post what I make on Facebook as I go so my friends who are having the same issues with food choices can see that you can enjoy what you eat and not feel deprived and they seem to like what I am doing and want to be my neighbor,hee,hee. thanks again
Glad you liked it and have found something that works for you (and your neighbor 🙂 )
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 went on Keto diet. My A1C went from 9.4 to 6.4 in 3 months. I did not lose much weight, maybe 10 pounds in that time, but it was Fantastic for my A1C 🙂 I also didn’t add any exercise, which means doing none lol. I had Metformin but rarely took it, less than once a week.
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