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, Equal)
  • Acesulfame potassium (Sunett)
  • Sucralose (Splenda)
  • Stevia (Pure Via, Truvia)

Artificial sweeteners, also called sugar substitutes, low-calorie sweeteners or nonnutritive sweeteners, 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, that other ingredients in foods containing artificial sweeteners can still affect your blood sugar level.

More research is needed, but some studies have found 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. This may be especially true when artificial sweeteners are consumed in large amounts. One reason may be a "rebound" effect, in which some people end up consuming more of an unhealthy type of food because of the misperception that it's healthy because it's sugar-free.

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.

With

M. Regina Castro, M.D.

Feb. 12, 2019 See more Expert Answers

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