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Diabetic Diet, Symptoms
Glycemic Index

Diabetes Diet  


Sugar Substitutes for Diabetics

Years ago, having diabetes meant that you had to avoid sweetness in your meals. Luckily, today, there are low glycemic index sugar substitutes that taste as good as sugar and have very few calories.

The American Diabetes Association diet used to suggest avoiding table sugar and using sugar substitutes instead.  The assumption was that the human body more quickly digests and absorbs regular sugar into the blood than starches.  The sugar was thought to cause a more significant rise in blood glucose.

Today, this is considered inaccurate.  Over a dozen studies have pointed out that there isn’t much difference in the increase in blood glucose between table sugar and refined starches (such as white flour and white rice).  The American Diabetes Association has changed its recommendations here on sugar substitutes for people with either type 1 or type 2 diabetes. 

Even though the former restrictions as to exact amounts of table sugar have been eased, the American Diabetes Association still suggests this: Work sugar amounts and frequencies into your dietician recommended food plan.  Of course, you can mix regular sugar along with low glycemic index sugar substitutes into your meals. 

Sugar is Now Considered Just Another Carbohydrate for Diabetics

Since table sugar counts as a carbohydrate it needs to be substituted as such.  Your dietician will give you ideas as to what constitutes “sugary” foods.  Be aware that sugary foods have empty calories and offer little nutrition.  Sometimes they are high in fat.  Greater risk of heart and blood vessel disease can result. 

Since individuals have different responses to foods, it's a good idea to check your blood sugar level with a glucose meter right after consuming a sugary food.  There could be a small change in blood glucose levels or a much greater change (then you would need to use more caution when eating foods with significant sugar content).  For your own information, you might also want to check your blood sugar after consuming a sugar substitute to see the difference between regular sugar and sugar substitutes.

In nature, there are many kinds of sugars.  Besides sucrose or table sugar, there are maltose, fructose, and dextrose, as well as sugar alcohols like mannitol, sorbitol, and xylitol.

Natural Sugar Substitutes, Stevia and Xylitol

Here are two naturally derived sugar substitutes that have been used safely for many years.

  • Stevia is a naturally derived sugar substitute from a South American plant.  It is very sweet and a tiny amount produces an extremely sweet but slightly bitter taste.  It is generally only available in health food stores because the FDA has approved it as a food additive/supplement not as a sweetener, even though it is quite safe to consume.  The reason for this is that it cannot be patented and therefore, no organization has been willing to do the expensive work of getting it approved by the FDA. Newer versions of this sweetener do not have the slightly bitter aftertaste.
  • Xylitol is derived from food sources and contains 10 calories per teaspoon.  It is an excellent FDA approved sweetener for the diabetic.  It tastes more like sugar than some of the other products mentioned above but when taken in very large doses, it can cause diarrhea (simply reduce or discontinue use).  Even though it tastes more like sugar than any other sugar substitute, it is mostly found in health food stores and on the Internet.

Here are 3 Artificial Sugar Substitutes

Regarding many low calorie sweeteners, the American Diabetes Association generally follows the FDA’s conclusion.  The following three artificially created sweeteners do have FDA approval.  We do not recommend that you use these sweeteners in large quantities, as the long-term effects on humans have not been thoroughly studied.   These sweeteners are not naturally derived and some studies have shown possible problems with them.

  • Saccharin—even though very significant amounts of saccharin have caused cancer in laboratory rats, there is evidence also that this sweetener doesn’t cause cancer in people.  Saccharin has a slightly bitter aftertaste.
  • Aspartame or NutraSweet, available at grocery stores, is an alternative sweetener for the diabetic except for those people with phenylketonuria or PKU.  Aspartame has been known to cause many unpleasant side effects so we recommend that you use this sweetener with care.
  • Sucralose or SPLENDA can be purchased in your local grocery store.  It can be used in place of sugar such as in baked goods and processed foods.  Sucralose is created from regular table sugar (sucrose), where three chlorine atoms have been substituted artificially for other groups found in sucrose.  Even though the FDA approves it, since this is a newly developed sweetener, the long-term safety of sucralose is unknown

Avoid Corn Syrup

A commonly found sweetener in many processed foods is corn syrup.  We recommend that you do not eat or drink foods that have this highly processed sweetener as a major ingredient as it can actually cause an excessive rise in blood glucose.  No matter how you look at it, excess amounts of refined carbohydrates are not good for your blood glucose levels.

Important suggestions for diabetics in relation to using sugars and sugar substitutes:

  • Take advice from a registered dietician regarding a meal plan, when including sugar and low-calorie sweeteners.
  • Excessive use of any sweetener (artificial or natural) may not be healthy for diabetics.  Use them judiciously and in moderation.
  • Cut down on saturated fats and refined carbohydrates (anything made with white flour) which often are found with sugar in sweet foods.
  • Make sure you go through Food Labels to find out about the quantities of carbohydrates, fats, and proteins you are getting.
  • Eat healthy foods like beans, low glycemic vegetables, fruits, and non-fat dairy products daily.

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