If you have diabetes, you know that managing the disease takes a lot of diligence in terms of monitoring the medication(s) you take, how you exercise, and (perhaps most importantly) how you eat. 

This includes being extra aware of how much sugar (especially added sugar!) is in your diet. 

While there have been many popular sugar substitutes over the years, including Splenda (sucralose) and Equal (aspartame), one of the most popular recently is stevia, made from the plant of the same name. 

But what is stevia, and is it a healthy sugar alternative for people with diabetes? What are the benefits and what are the risks? 

This article will explore everything you need to know about this popular sugar alternative and how (and if!) you should incorporate it into your diet. 

Five different Stevia products on a table

What is stevia? 

Stevia is a zero-calorie sweetener with no nutritional value, made of steviol glycosides extracted from the leaves of the Stevia Rebaudiana plant. 

The plant is primarily grown in Brazil, Paraguay, Japan, and China. China is currently the biggest exporter of stevia. 

Stevia is about 200-300 times sweeter than traditional table sugar and has been used for centuries as a sweetener and herbal remedy. 

The FDA considers both rebaudioside A and other steviol glycosides such as stevioside as “generally recognized as safe” (GRAS).

Most commercially available stevia sweeteners are a blend of stevia with low to no-calorie sweeteners like erythritol, but some are also blended with dextrose, so it’s important to read the nutrition label.

People, especially people with diabetes, use stevia in things like coffee, tea, oatmeal, and on top of fruit as an extra sweet dessert. 

Is stevia safe to eat? 

According to the FDA, safe, daily consumption for humans is 4 milligrams (mg) per kilogram (kg) of body weight. When used to sweeten food, it is safe for humans to consume. 

While some studies have found potential side effects in laboratory animals (mostly mice) when huge amounts of the extract are consumed, most of that research has since been disproven. 

Negative side effects of eating stevia

However, you may experience several side effects if you eat stevia. Some side effects may include the following:

Gastrointestinal (GI) problems

People who use stevia excessively (and are sensitive to sugar alcohol) may experience issues such as bloating, nausea, indigestion, diarrhea, cramping, and vomiting. 

If you experience these symptoms, you may need to stop eating stevia or talk with your doctor about the symptoms you’re experiencing. 

Low blood pressure 

Stevia acts as a vasodilator, which causes the blood vessels to widen and lower blood pressure

While this is normally seen as a benefit, long-term use of stevia (especially if you currently have lower blood pressure or are on blood pressure lowering medications) should be discussed with your doctor. 

If you currently struggle with high blood pressure, this may actually be a benefit if you start to consume stevia regularly. 

Endocrine disruption 

Steviol glycosides, a type of steroid, can interfere with the hormones of the endocrine system. 

A study in 2016 found that when human sperm cells were exposed to steviol glycosides, they experienced an increase in progesterone production, which may be harmful to human health. 

Talk with your doctor if you have these concerns. Common side effects of increased progesterone production include anxiety, agitation, breast swelling and tenderness, depression, fatigue, and weight gain. 

What are the benefits of stevia? 

For people with diabetes, however, eating stevia may have many benefits. The following are the benefits of eating this extract, especially if it’s replacing traditional table sugar:

Better blood sugars 

Research has shown that stevia does not contribute any calories or carbohydrates to the human diet, and it has no effect on either blood sugar levels or insulin response, which is a huge win for people with diabetes. 

You can sweeten something up (like oatmeal, for instance), without adding any additional carbohydrates, which can make not only blood sugars better, but diabetes management easier overall, which is a huge win! 

Aid in weight loss

Replacing all of the added sugar in your diet with stevia may help you lose weight. Sugar has 4 calories per gram (as opposed to 0 calories per gram of stevia), which can add up quickly. 

If you replace all of those carbohydrates and calories with a sugar-free alternative, you can lose weight. 

If, however, you feel like you’re “earning” an unhealthy food item by eating something “healthier” with stevia added instead of sugar, eating stevia for weight loss may not be effective. 

Overall, it’s best to just be mindful of the amount of added sugar and calories you’re eating, and replace all sugar-sweetened foods and beverages with either unsweetened versions or sugar replacements (like stevia) if you’re looking to lose some weight. 

While stevia in particular has not yet been studied, studies show that aspartame can help people lose weight when replacing sugar in their diet with it. 

Improved dental health

Replacing sugar with stevia can help you have healthier teeth and gums, too! Sugar is damaging to oral and dental health; it causes unnecessary cavities and premature tooth decay, and may even contribute to gingivitis. 

Stevia has been found to reduce bacterial formation in the mouth, helping to prevent both cavities and gum disease. In fact, it’s often added as a safe sweetener to mouthwashes and toothpaste! 

May help improve skin health 

Stevia’s antibacterial properties can also help skin health, helping to treat conditions such as eczema and dermatitis. 

Topical application of stevia stops the spread of surface-level bacteria and acts as a steroid to bring relief to many people who suffer from these conditions. 

Conclusions 

Stevia, a plant extract derived from the plant of the same name, has been used medicinally around the world as a natural sweetener, tonic, and salve in herbal medicine for centuries. 

It does not contain any sugar, carbohydrate, calories, or artificial ingredients.

It is between 200-300 times sweeter than sugar and is a great sugar substitute for people with diabetes, or for people who are looking to lose weight, eat healthier, or take better care of their dental health. 

People typically add stevia to beverages like coffee and tea, foods like oatmeal and cereals, put it on fruit, or in homemade desserts, to make them less carbohydrate-heavy and calorie-dense. 

However, some people may experience negative side effects, such as gastrointestinal problems and lower blood pressure (which can be an issue if you already have low blood pressure or are on blood pressure lowering medications), and stevia may act as an endocrine disruptor. 

Talk with your doctor if you have concerns about incorporating stevia into your diet.