How Sweet They Are: The Real Skinny on Eight Common Sugar Substitutes and Diabetes

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honey dripping off honey spoon into bowl

There are so many sugar substitutes available today it can be hard to keep them all straight.  Making the healthiest choice possible is especially important for the millions of people who live with diabetes.

In general, sugar substitutes sweeten food and drinks with fewer calories and carbs than table sugar. People with diabetes need to limit the carbs in their diet to keep their blood sugar (glucose) levels under control.

Here’s the real skinny on eight of today’s artificial sweeteners and how they affect your blood sugar levels and sweet tooth.

Stevia

What it is: Derived from the South American stevia plant, this sugar substitute is also known as Rebaudioside A, Reb-A, or rebiana. Brand names include PureVia, Truvia and SweetLeaf Sweetener. According to the US Food and Drug Administration (FDA), Stevia is a Generally Regarded As Safe (GRAS) ingredient. This ruling does not pertain to whole-leaf stevia or [other] non Reb-A  extracts.

Where it is: Stevia can be found in drinks, desserts, gum, baked goods, candy, yogurt, and in packets for use in beverages. Stevia can also be used when baking at home.

How sweet it is: Up to 300 times sweeter than sugar

OK for diabetes? Yes. Stevia does not affect blood sugar levels.

Agave Nectar

What it is: Agave comes from the same Southwestern U.S plant that is used to make tequila. It has more calories than table sugar, 60 calories versus 30 calories respectively, which is rare for a sugar substitute. Some brand names may include Wholesome Sweeteners, Madhava, and Volcanic Nectar.

Where it is: Agave is a concentrated sugar syrup that looks and feels like honey. (Yes, it is that sticky!) It can be used to sweeten beverages and baked goods. Agave dissolves easily in cold drinks.

How sweet is: 1.5 times sweeter than table sugar

OK for diabetes? In moderation. It’s better than refined sugar, but the American Diabetes Association lists Agave as “a sweetener to limit.”

Aspartame

What it is:  Aspartame is produced by linking aspartic acid and phenylalanine, two amino acids (building blocks of proteins). Brand names are Equal and Nutrasweet.

Where it is: Aspartame can be found in soft drinks, yogurt and dairy, candy, fruit spreads and other foods. It is also available in packets to be added to coffee and tea according to taste.

How sweet it is: Up to 200 times sweeter than sugar

OK for diabetes? Yes. Aspartamehas no effect on blood glucose levels.

Sucralose (Splenda)

What it is: Sucralose or Splenda is a no-calorie sugar substitute.

Where it is:  Splenda is found in many processed foods, and is available as a tabletop and general purpose sweetener. Splenda can be found in small yellow packets wherever coffee and tea are served. It is considered the most heat-stable of all the sugar substitutes, which makes it ideal for your baking needs.

How sweet it is: As much as 600 times as sweet as sugar

OK for diabetes?  Maybe not, research suggests. Splenda contains about 1 gram of carbs per teaspoon, which means it could affect blood sugar if it’s not consumed in moderation.

Saccharin

What it is: Discovered in 1879, saccharin is an artificial sweetener. Brand names include Sweet and Low®, Sweet Twin®, Sweet'N Low®, and Necta Sweet.

Where it is: Saccharin may be found in drinks, and other food bases or mixes if it’s prepared in accordance with directions and stringent guidelines. It is also used as a sweetener for coffee and teas. 

How sweet it is: From 300 to 500 times as sweet as sugar

OK for diabetes? Yes. Saccharin has no discernable effect on blood glucose levels.

Acesulfame K (acesulfame potassium)

What it is: Acesulfame K or acesulfame potassium is an artificial sweetener. Brand names include Sunett or Sweet One.

Where it is:  This sweetener may be found alone or in combination in baked goods, candy, dairy products, soft drinks as well as some medicines. Acesulfame K can also be used as a tabletop sweetener and when baking.

How sweet it is: Up to 300 times as sweet as sugar

OK for diabetes? Yes. Acesulfame K has no effect on blood glucose levels.

Sugar Alcohols

What they are:  Sugar alcohols are natural sugar substitutes. They are not sugars and they are not alcohols either. Sugar alcohols provide about half of the calories of sugar.

Where they are: Sugar-free products including energy bars. Chemical names may include erythritol, lactitol, maltitol, mannitol, sorbitol and xylitol (Note: all sugar alcohols end with “tol"). Some may cause stomach upset.

How sweet they are: Less sweet than sugar

OK for diabetes? Sugar alcohols do have an effect on blood glucose levels, but it is not as dramatic as straight sugar. Some math is required. The body does not absorb half the carbs in sugar alcohols. This means that you should subtract half the sugar alcohol grams from the total carb grams when carb counting.

Coconut Oil

What it is: Derived from the flower of the coconut palm, coconut oil is also called palm sugar. Unlike other non-sugar sweeteners, coconut oil is rich in vitamins and nutrients.

Where it is: Health food stores.

How sweet it is: Not as sweet as sugar. Coconut oil has a caramel taste.

OK for diabetes?  Yes. It has a low glycemic index, which is the number given to foods based on how quickly they can spike blood sugar. Lower is better for people with diabetes.

Honey

What it is: Made by bees, honey is thick, gold, sticky and sweet.

Where it is: Some baked goods and cereals are sweetened with honey. It can also be purchased and used on its own.

How sweet it is: Not as sweet as sugar

OK for diabetes? Neutral. There is no advantage to using honey instead of sugar. Honey has slightly more carbohydrates and more calories per teaspoon than sugar.

It’s always a good idea to talk to your doctor, nutritionist or a certified diabetes educator if you have any questions or concerns about how a sweetener may affect your blood sugar levels.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 2

  1. American Academy of Family Physicians. Acesulfame K: What You Need To Know. http://familydoctor.org/familydoctor/en/prevention-wellness/food-nutrition/sugar-and-substitutes/sug...

  2. American Academy of Family Physicians. Stevia Sweeteners. http://familydoctor.org/familydoctor/en/prevention-wellness/food-nutrition/sugar-and-substitutes/sug...

  3. American Academy of Family Physicians. Sugar Alcohols. http://familydoctor.org/familydoctor/en/prevention-wellness/food-nutrition/sugar-and-substitutes/sug...

  4. American Diabetes Association. Low Calorie Sweeteners. http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-carbohydrates/artificial-...

  5. American Diabetes Association. Size Up Your Sweetener Options. http://www.diabetesforecast.org/2009/jul/size-up-your-sweetener-options.html

  6. Food and Drug Administration. Saccharin. http://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/ucm397725.htm#Sacchari...

  7. Pepino ML, et al. Sucralose affects glycemic and hormonal responses to an oral glucose load. Diabetes Care. 2013 Sep;36(9):2530-5. http://www.ncbi.nlm.nih.gov/m/pubmed/23633524/

  8. National Institutes of Health. Sweeteners-Sugars. http://www.nlm.nih.gov/medlineplus/ency/article/002444.htm

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