Can I use artificial sweeteners if I have diabetes?
Answer From M. Regina Castro, M.D.
You can use most sugar substitutes if you have diabetes, including:
- Saccharin (Sweet'N Low)
- Aspartame (NutraSweet)
- Acesulfame potassium (Sunett)
- Neotame (Newtame)
- Sucralose (Splenda)
- Stevia (Pure Via, Truvia)
Artificial sweeteners are also called sugar substitutes, low-calorie sweeteners or nonnutritive sweeteners. They offer the sweetness of sugar without the calories. Artificial sweeteners are many times sweeter than sugar. Because of this, it takes only a small amount of artificial sweeteners to sweeten foods. This is why foods made with artificial sweeteners may have fewer calories than those made with sugar.
Sugar substitutes don't affect your blood sugar level. In fact, most artificial sweeteners are considered "free foods." Free foods contain less than 20 calories and 5 grams or less of carbohydrates, and they don't count as calories or carbohydrates on a diabetes exchange. But remember that other ingredients in foods that have artificial sweeteners can still affect your blood sugar level.
Some studies have found that substituting sugar-sweetened food and beverages with those that have been artificially sweetened may not be as beneficial as once thought. This may be especially true when artificial sweeteners are consumed in large amounts. But more research is needed.
Also, be cautious with sugar alcohols — including mannitol, sorbitol and xylitol. Sugar alcohols can increase your blood sugar level. And for some people, sugar alcohols may cause diarrhea.
M. Regina Castro, M.D.
April 07, 2021
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See more Expert Answers
- Get to know carbs. American Diabetes Association. https://www.diabetes.org/healthy-living/recipes-nutrition/understanding-carbs/get-to-know-carbs. Accessed Jan. 20, 2021.
- American Diabetes Association. Facilitating behavior change and well-being to improve health outcomes: Standards of Medical Care in Diabetes—2021. 2021; doi:10.2337/dc21-S005.
- Additional information about high-intensity sweeteners permitted for use in food in the United States. U.S. Food & Drug Administration. https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states. Accessed Jan. 21, 2021.
- Rother KI, et al. How non-nutritive sweeteners influence hormones and health. Trends in Endocrinology & Metabolism. 2018; doi:10.1016/j.tem.2018.04.010.
- Nichol AD, et al. Glycemic impact of non-nutritive sweeteners: A systematic review and meta-analysis of randomized controlled trials. European Journal of Clinical Nutrition. 2018; doi:10.1038/s41430-018-0170-6.
- Sylvetzky AC, et al. Nonnutritive sweeteners in weight management and chronic disease: A review. Obesity. 2018; doi:10.1002/oby.22139.
- Azad MB, et al. Nonnutritive sweeteners and cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ: Canadian Medical Association Journal. 2017; doi:10.1503/cmaj.161390.