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You can use most sugar substitutes if you have diabetes, including:
Artificial sweeteners, also called sugar substitutes, offer the sweetness of sugar without the calories. Artificial sweeteners are many times sweeter than sugar, so it takes a smaller amount 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" — foods containing less than 20 calories and 5 grams or less of carbohydrates — because they don't count as calories or carbohydrates on a diabetes exchange. Remember, however, other ingredients in foods containing artificial sweeteners can still affect your blood sugar level.
More research is needed, but studies are increasingly finding that the benefits of substituting sugar-sweetened food and beverages with those that have been sweetened artificially may not be as clear as once thought, particularly when consumed in large amounts. One reason may be a "rebound" effect, where some people end up consuming more of an unhealthy type of food because of the misperception that because it's sugar-free it's healthy.
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.
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