Here are nine low- or no-calorie sugar substitutes to consider when you have type 2 diabetes:
1. Sucralose (Splenda), the Most Popular Sugar Substitute2. Saccharin (Sweet’N Low), the Oldest Artificial Sweetener3. Aspartame, a Low-Calorie Sweetener That’s Not Okay for People With PKU4. Stevia (Truvia or Pure Via), a Natural Sweetener Option5. Sugar Alcohols, a Low-Calorie Option for Sweetening Your Fare6. Erythritol, a Sugar Alcohol With Fewer Side Effects Than Other Options7. Monk Fruit Sweetener, Another Natural Option for Sweetening Your Foods8. Acesulfame Potassium, a Popular Sugar Substitute in Diet Soda9. Allulose (Dolcia Prima), a New Artificial Sweetener That’s No Longer Considered an Added SugarOne Last Thing About Using Sugar Substitutes When Managing Type 2 DiabetesThe Takeaway
1. Sucralose (Splenda), the Most Popular Sugar Substitute
This sweetener is excellent for people with type 2 diabetes. Splenda is about 600 times sweeter than sugar, but it doesn’t affect your blood sugar levels, says Keri Glassman, RD, CDN, of Nutritious Life, a nutrition practice based in New York City. (Sucralose also happens to be the most popular sweetener on the market.)
That’s not to say you can eat an infinite amount, though: The U.S. Food and Drug Administration (FDA), which has approved sucralose, sets the recommended limit for sucralose at 23 packets per day.
2. Saccharin (Sweet’N Low), the Oldest Artificial Sweetener
Saccharin, the sweetener sold in pink packets under the brand name Sweet’N Low, is calorie-free and about 200 to 700 times sweeter than sugar. While it’s only been used as a food additive since 1977, it was first discovered in 1879.
If you’ve been using artificial sweeteners since the 1970s, you may remember a previous warning label about saccharin increasing the risk of bladder cancer. But rest assured, it’s safe. The research that prompted the label was done on animals, and further studies by the National Toxicology Program of the National Institutes of Health concluded that saccharin shouldn’t be on the list of potential carcinogens.
Saccharin is FDA-approved.
The FDA sets the recommended limit for saccharin at 45 packets per day.
3. Aspartame, a Low-Calorie Sweetener That’s Not Okay for People With PKU
Aspartame, sold in blue packets under the brand names Equal and NutraSweet, is a nonnutritive artificial sweetener that is about 200 times sweeter than sugar, according to the FDA. While not zero-calorie like some other artificial sweeteners, aspartame is still very low in calories.
While the FDA has reviewed the scientific research and determined that aspartame is safe to eat, Glassman notes that there have been some conflicting study results regarding this sweetener’s safety. The International Agency for Research on Cancer, for example, labeled aspartame as “possibly carcinogenic to humans,” but other scientific agencies, such as Health Canada and the European Food Safety Authority consider it to be safe when consumed at the advised levels.
Nevertheless, people with phenylketonuria (PKU), a rare condition in which they are unable to metabolize phenylalanine (a key component of aspartame), should not consume this sugar substitute.
If you don’t have PKU, aspartame is safe to consume in moderation.
The FDA sets the recommended limit for aspartame at 75 packets per day.
4. Stevia (Truvia or Pure Via), a Natural Sweetener Option
Steviol glycosides are sweeteners derived from the leaf of the stevia plant, which is native to South America. Truvia and Pure Via, both brands of stevia-based sweetener, are calorie-free, and stevia is often used as a sweetener in foods and beverages.
Like other nonnutritive sweeteners, stevia has little to no impact on blood sugar.
The FDA has approved the use of certain stevia extracts, which it has generally recognized as safe (a term that is applied to food additives that qualified experts deem as safe, which are therefore not subject to the usual premarket review and approval process).
People have reported side effects, including gastrointestinal symptoms, after eating high amounts of stevia. But to date, there is no solid scientific research to prove these claims.
The FDA recommends limiting your stevia intake to 27 packets per day.
5. Sugar Alcohols, a Low-Calorie Option for Sweetening Your Fare
Sugar alcohols, or polyols, are derived from the natural fibers in fruits and vegetables.
Commonly used sugar alcohol sweeteners in many so-called “sugar-free” desserts, candies, and gums include:
- Xylitol
- Sorbitol
- Mannitol
- Isomalt
- Lactitol
Though sugar alcohols are relatively low in calories and more blood sugar–friendly than carbohydrates, they may have a laxative effect and cause indigestion, bloating, and diarrhea in some people.
Products containing sorbitol and mannitol must bear a label warning that excess consumption can have a laxative effect.
The gastrointestinal symptoms arise because sugar alcohols are not completely absorbed in the digestive tract, says Lynn Grieger, RDN, CDCES, a medical reviewer for Everyday Health who’s based in Prescott, Arizona. She explains that unabsorbed carbohydrates from these sweeteners pass into the large intestine, where they are fermented by gut bacteria to produce gas. See how you respond to a small amount before incorporating them into your daily diet.
Also, keep in mind that sugar alcohols do contain some carbohydrates and are nutritive sweeteners, so they can affect blood sugar levels.
“It’s important for people with diabetes to read the nutrition facts label for total carbohydrate content and plan accordingly,” says Grieger. “Remember that the information in a nutrition facts label is based on one serving, and it’s easy to eat more than one serving of foods that contain sugar alcohols, which can increase the total carbohydrate consumed.”
6. Erythritol, a Sugar Alcohol With Fewer Side Effects Than Other Options
Erythritol is also a sugar alcohol, but unlike some of the other options, it contains almost no calories and doesn’t seem to affect blood sugar or insulin levels.
It’s an ingredient in the stevia-derived sweetener Truvia, and it’s marketed under the brand name Swerve.
If other sugar alcohol sweeteners give you tummy trouble, this may be a better option for you. It is less likely to produce the gas, bloating, and diarrhea that happen from fermentation by gut bacteria, since only a small amount of the erythritol you consume enters the colon.
There’s no recommended limit for erythritol, but the FDA hasn’t questioned notices submitted by erythritol makers that the sweetener is “generally recognized as safe.” However, use caution when consuming erythritol. Recent studies have found an increased risk of heart attack and stroke. The research states that long-term studies are necessary.
7. Monk Fruit Sweetener, Another Natural Option for Sweetening Your Foods
Monk fruit extract is a natural, zero-calorie sweetener derived from the fruit of the plant Siraitia grosvenorii, which is native to southern China.
It is 150 to 200 times sweeter than sugar.
Popular brands include Monk Fruit in the Raw and Lakanto. The FDA has not questioned notices submitted by monk fruit sweetener makers that the extract is “generally recognized as safe.” The agency doesn’t specify a recommended limit for monk fruit sweetener.
8. Acesulfame Potassium, a Popular Sugar Substitute in Diet Soda
Also known as Ace-K, this nonnutritive sweetener is an FDA-approved sweetener that’s about 200 times sweeter than sugar. Often, manufacturers combine it with other sweeteners, though it is also sold for tabletop use under the brand name Sweet One. You will also find it in popular diet soft drinks.
Some research involving mice has suggested possible issues with Ace-K, including one study that concluded that consumption of Ace-K led to an imbalance of flora in the gut microbiome.
Another study — this one focused on humans — theorized that large quantities in pregnant women may lead to early delivery.
The FDA recommends limiting your use of acesulfame potassium to 23 packets a day.
9. Allulose (Dolcia Prima), a New Artificial Sweetener That’s No Longer Considered an Added Sugar
Allulose (also known as D-allulose or D-psicose) is a low-calorie sweetener that occurs naturally in small amounts in wheat and fruits and is marketed under the brand name Dolcia Prima.
It has 90 percent fewer calories than sucrose but is about 70 percent as sweet. Plus, it doesn’t affect your blood sugar or insulin levels.
While allulose isn’t on the list of FDA-approved sweeteners, the agency hasn’t questioned notices submitted by manufacturers that the sweetener is “generally recognized as safe.” It isn’t approved for use, though, in Canada or Europe.
One Last Thing About Using Sugar Substitutes When Managing Type 2 Diabetes
Even if you do choose a calorie-free sweetener, you should still enjoy sugar substitutes in moderation. It’s thought that sugar sweeteners may trick our bodies into craving more sweets later on, which could lead to weight gain.
Moreover, some research has found that sugar substitutes have been linked to higher rates of heart disease and suggests that the best idea is to try to lower our consumption of all sugars, including sugar substitutes.
Remember: Water is still the healthiest drink. “A major goal should be to reduce all types of sweeteners in your diet, including sugar substitutes, so that you become accustomed to the naturally sweet taste of food,” says Grieger. Then trust your body to tell you when enough is enough.
The Takeaway
- Sugar alternatives can satisfy your craving for something sweet without destabilizing your blood sugar levels.
- Sugar substitutes include nutritive (caloric) and nonnutritive (noncaloric) sweeteners.
- Some popular sugar substitutes include aspartame, saccharin, sucralose, and stevia.
Additional reporting by Margaret O’Malley.
