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I am often asked about what the best sweeteners are for people with diabetes 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.
Table of Contents
What are natural & artificial sweeteners?
The 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 quickly 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 a 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
I think that the corporate marketing machine has been very clever when declaring agave nectar is 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 blood sugar-friendly 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
New natural low-calorie and low-carb sweeteners have come to market in recent years, which is exciting if you’re looking to reduce your carb intake but still enjoy something sweet.
Here we’ll talk about 3 different natural sweeteners that will have little to no impact on your blood sugar
Stevia
I’m often asked if Stevia is 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 sugar levels. It’s actually my sweetener of choice.
So, what is Stevia? Stevia is 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 flavored drops.
In its purest processed form, Stevia is about 300 times sweeter than regular table sugar but the products available on the market have varying degrees of sweetness so it’s important to know the sweetness of the product you use.
Stevia powder: I used to buy the standard supermarket brand Stevia powder until I realized that they mix it with fillers (primarily dextrose) 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, many people really like monk fruit.
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. I recommend the brand Monk Fruit in the Raw.
Allulose
Allulose is a simple sugar (monosaccharide) and should not affect blood sugars as it’s not metabolized by the body.
It’s a naturally occurring sweetener and can be found in small quantities in different foods such as maple syrup, brown sugar, wheat, and fruits (e.g., raisins, dried figs). However, whereas those foods will impact blood sugars and add calories to what you eat or drink, allulose won’t and is nearly calorie-free.
Allulose is 70% as sweet as regular sugar so you need to use slightly more if you are replacing regular sugar in a recipe or if you’re just sweetening your tea or coffee.
The FDA has reviewed allulose and determined that it’s a very low-calorie sweetener (i.e., no more than 0.4 kcal/g). The carbs in allulose are included on the nutrition label of foods that contain allulose (in contrast to many other low-carb sweeteners where the carbs aren’t included) but that is only because the FDA determines carb counts based on chemical markup rather than blood sugar impact.
What’s exciting about allulose, and what sets it apart from other natural sweeteners, is that clinical studies have shown that it can potentially help with blood sugar management. The studies were very small, but they showed that when people not living with diabetes as well as people living with pre-diabetes ate allulose together with carbohydrates, the blood sugar impact wasn’t as big as when allulose wasn’t included.
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 in this post, 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 the American Society for Nutrition: “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, monk fruit, or allulose. They are all 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 when 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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Bree
I recently learned maltodextrin definitely impacts my blood sugar. The problem is, I wasn’t looking for the ingredient on nutrition bars and drinks labeled “low carb”. 1 g net carb etc. Are there also other names for this particular sweetner we need to look for on labels? I was diagnosed as a 1.5 adult onset diabetic, with my body gradually becoming completely insulin dependent. Thanks for the article!
Christel Oerum
Glad you figured that one out.
I’d suggest you look for any sweetener ending in “ols”. That’s the sugar alcohols I mention in the article and the ones that are most likely to impact your blood sugar
Pramit Debbarma
Hi I’m Pramit, and I personally feels that stevia is the best non-nutritive sweetener as compared to monk fruit. Even though both the sweetener are non-nutritive, people mostly prefers the taste of stevia. Stevia has almost no calories, and not only helps to control blood sugar but also helps in loosing weight. Thanks for providing such a great information.
Ganesan Doraisami
I find Splenda raises my blood sugar. Normally use three packets to make a mug of tea. Measured blood sugar before and after drinking black tea (no other food or dairy) . The blood sugar increased by 57mg/dL May try stelvia extract to see if it makes a difference.
Toni
Easier said than done when you’re a sugar addict.
Toni
Hi Christel, I think this is a great article! I am Type 2 and am trying to cut back on sugars and carbs. I use about 2-3 packs of Sweet’N Low daily and wondered do you think this a little overboard for artificial sweeteners or what? I welcome your thoughts.
Christel Oerum
That should be fine.
The FDA has set the acceptable daily intake (ADI) of saccharin at 2.3 mg/lb (5 mg/kg) of body weight.
This means if you weigh 154 lbs (70 kgs), you can consume 350 mg every day of your life without going over the limit.
To further put this into perspective, you could consume 3.7 cans of 12-ounce diet soda daily — nearly 10 servings of saccharin.
You can find more details on Healthline
Josie
Hello, I went to a diabetes education class at my hospital and they told us that stevia is not good for diabetics?
Christel Oerum
I don’t know why they would say that. Did they give you any explanation?
Jean
Hi Crystal – thank you. I am prediabetic so I’m looking at prevention right now. I’ve been using Stevia in the Raw and the ingredients show it as stevia extract and maltodextrin. Maltodextrin is not recommended for diabetics, so I’m a little confused. Thank you.
Christel Oerum
The amount of Maltodextrin is generally considered negligible. I personally don’t see a blood sugar impact with Stevia in the Raw, but if you have a blood sugar meter I suggest you try it out yourself. Add some sweetener to water or tea, measure your blood sugar before you drink it and again ~an hour after.
Dorothy A.
Some Stevia contains erythritol and some contain inulin. Which would you recommend?
Christel Oerum
Unfortunately, I don’t have a good answer to this question. What I would do is to try out small amounts and see how your body reacts before committing to one brand. And please let me know how it goes
Len
Here’s what confuses me: I keep reading that Stevia, coconut sugar, monkfruit sugar, and other table sugar substitutes have “no effect whatsoever” on blood sugar, yet when I read the labels of products like Erythritol and coconut sugar that are often touted for diabetics, it states that they each contain 5 grams of carbohydrate per teaspoon …. identical to carb content of table sugar!
So, WHAT, if anything, makes them a better choice for diabetics?
PS: I ask because artificial products like Stevia and sucralose, both of which trigger violent gastrointestinal reactions for me.
Christel Oerum
If a Stevia product lists calories it’s because it has other ingredients listed. The difference is between “low-calorie” and “no-calorie” products. As mentioned in the article some “non-calorie” products (such as stevia extract) will add taste or consistency fillers transforming it into a “low-calorie” product. Generally, per FDA it can be listed as “zero” calories if it has negligible calorie count, which should not translate to more than less than a gram of carbs. But most importantly, if you can’t digest it, I’d stay away and just choose natural sweeteners with care
Reenie
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.
Christel Oerum
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
Monica Black
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.
Christel Oerum
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
Monica Black
Thank you!!
Scott
I use Whey Low. Curious if you would take a look at and give me you opinion. It seems to cook really well so I have been using it for everything needing sugar.
Thank you,
Scott
Christel Oerum
I had to look that one up. Looking at the nutrition values (turn the package around and you’ll see what’s in the product) 1 tsp has 4 g of sugar, so 4 g of carbohydrates. How they get that to 1 carb, I don’t know. It’s a reduced sugar/calorie product, but it still looks to have carbs.
Anyway, that means that even 1 tsp potentially will impact your blood sugar. If you take insulin I’d definitely suggest you consider bolusing for it, and if you don’t try consuming 1 tsp and measure your blood sugar before and 30-60 min after to see if there’s an impact.
MIKE MYERS
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.
Christel Oerum
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