10 best sugar substitutes for diabetics

What are the best sugar substitutes for diabetics?

Are you worried about having diabetics and cannot eat your favourite dessert or food?

Don’t worry, here is the solution.

There are plenty of sugar substitutes for diabetics, but which are safe.

In this article, we will dive into the 10 best sugar substitutes for diabetics.

What are sugar substitutes?

Sugar substitutes or artificial sweeteners came into usage during World War  I & II. Due to the fall of sugar production from the agricultural crisis, people used to try alternatives for sugar.

They have other names such as non-nutritive sugars or low-calorie sweeteners. These are sweeter than normal sugars. Therefore we need to add a very little amount of sweetener. That is why it is called low-calorie sugar. The final food has only very limited calories than foods that have normal sugars.

10 best sugar substitutes for diabetics

1.  Saccharin

Saccharin is the most common among the best sugar substitutes for diabetics and others as well. It is 100 to 500 times sweeter than normal sugar.

Saccharin is available in brand names such as Sweet Twin, Sweet’N Low, and Necta Sweet. The FDA has approved Saccharin as a safe sugar substitute. Although previous studies using mice have shown some negative impacts of saccharin and bladder cancer, various human studies confirmed this is safe for human use and has no connection with cancer.

But studies have shown that large amounts of saccharin consumption cause hyperinsulinemia. In other words, this reduces the resistance of insulin and causes improved blood sugar control in mice compared to controls.

Saccharin is a man-made artificial sugar substitute. It is made by the oxidation of o-toluene sulfonamide or phthalic anhydride. It presents as insoluble saccharin and its various salts.

The FDA, World Health Organization (WHO), and the European Food Safety Authority (EFSA) now identified Saccharin as safe for human use. According to the FDA, the total daily consumption of Saccharin is 15mg per kilogram of body weight.

2.   Sucralose

Sucralose is an artificial sugar made from sucrose. This is also one of the best sugar substitutes for diabetics. It is 600 times more sweetener than normal sugar. In contrast, it has fewer calories.

This is widely used in daily intake and baking and hot cooking. Unlike most sugar substitutes, Sucralose is heat stable. So it is good for baking and preparing hot drinks.

Several studies have already shown the safety of Sucralose for human consumption. There were studies to evaluate the effect of Sucralose daily consumption to control glycemic index in type 2 diabetic patients. Those studies have identified that there was no significant difference in HbA1C, fasting blood glucose, or fasting serum C-peptide in base level between the study group and the controls.

Furthermore, recent studies using mice have indicated that male mice who use Sucralose have a high tendency to develop malignant cancer. However, this needs more studies to confirm the finding.

According to the FDA, the daily consumption/ acceptable daily intake (ADI) of Sucralose is 5mg per kilogram.

Diabetic patients can use Sucralose in their daily beverages and foods.

What are the bad effects of Sucralose?

  • Some studies have identified Sucralose increases blood glucose and insulin levels. Moreover, it reduces insulin sensitivity. This may negatively affect diabetic patients who use Sucralose as a sugar substitute.
  • Sucralose has effects on intestinal bacteria flora. This gut flora is essential for the body’s normal functions such as the production of vitamin K. These bacteria play a key role in maintaining a healthy immune system.

3.   Aspartame

Aspartame is another popular artificial sweetener. It has the chemical name L-aspartyl-L-phenylalanyl-methyl ester. This is one of the best sugar substitutes for diabetics which is 200 times sweeter than normal table sugar. It has zero glycemic index and has no calories.

The US FDA has approved Aspartame as a safe sweetener by 1981. The FDA has approved using Aspartame in tabletop sweeteners, chewing gums, cold breakfast cereals, beverages like tea, coffee, and desserts like pudding, toppings, and dairy products also. Hence if you are a diabetic patient, you don’t have to worry about not getting a sweet taste to your daily meals. The daily intake of this sugar substitute is 50 milligrams per kilogram body weight.

Aspartame comes into the market in different brand names. You can purchase these online also. There were hundreds of experiments undergone for evaluating the safety of Aspartame. Scientists have done many studies on Aspartame. The FDA scientists have indicated, considering those studies, Aspartame is safe for the normal population.

However, the bad thing about aspartame is, it is unsuitable for patients with phenylketonuria. The reason is, those patients cannot metabolize a component of Aspartame called Phenylalanine.

Unlike Sucralose, Aspartame is not suitable for baking. Because it is not heat-stable.

What are the bad effects of Aspartame?

  • If affects body weight

Aspartame increases body weight. Several studies have shown that although it has low calories it causes weight gain. Studies using rodents have shown that when compared with other sweeteners such as Saccharin, Aspartame has a high tendency to gain weight.

  • Metabolism

Aspartame has bad effects on normal metabolism. Since it breaks down into phenylalanine (IAP). IAP prevents the occurrence of metabolic syndrome. Inhibition of this enzyme leads to alterations of metabolism. In other words, IAPs protective mechanism is blocked by phenylalanine which is a metabolite of Aspartame.

  • Appetite

Aspartame increases appetite ultimately causes weight gain. Among studies, Aspartame increases hunger when compared to glucose or water.

  • Dizziness

Although there is some evidence that Aspartame causes vertigo and dizziness, still there is no systematic study. However, Aspartame can increase the permeability of the blood-brain barrier.

  • Seizure

According to a study published in Epilepsia, March 1995, finding the Aspartame and seizure susceptibility, there were no seizures or other clinical experiences after Aspartame ingestion. However, mean plasma Phenylalanine concentration was increased after Aspartame ingestion significantly with the placebo.

In contrast, some studies show that Aspartame can cause neurologic effects. As you already know, Aspartame can increase phenylalanine levels in your blood. With that in mind, Anecdotal reports indicate that some people who take Aspartame have shown behavioural and neurologic reactions. Since phenylalanine is neurotoxic and it has effects on the synthesis of monoamine neurotransmitters, it has neurologic effects.

  • Headache

According to the publication in HEADACHE – the Journal of Head and the Face Pain, 2008, some susceptible individuals have increased attacks of migraine headache after taking aspartame-containing foods and beverages.

Anecdotal reports and observational studies also indicate that Aspartame is a potential migraine trigger.

  • Alzheimer’s disease

In the body, Aspartame’s methyl ester part is metabolized into methanol and then into formaldehyde. This has some connection with Alzheimer’s disease. Alzheimer’s is a type of dementia.

  • Cancer

Aspartame is a common sugar substitute in the world and is used for many purposes. Some studies have found that Aspartame has carcinogenic effects in rodents. According to the three lifespan studies conducted at the Cesare Maltoni Cancer Research Center of the Ramazzini Institute, rodents who got the substance have shown carcinogenic results.

In 2012, Harvard researchers found that taking Aspartame can increase the risk of non-Hodgkin lymphoma and multiple myeloma in men. Moreover, Aspartame can increase the risk of leukemia in both men and women. They published these findings in the American Journal of Clinical Nutrition.

  • Congenital disorders

If you are a woman who lacks enzymes to metabolize phenylalanine which is a component of Aspartame, they will have large amounts of phenylalanine in their blood. This may cause birth defects.

However, Aspartame is considered a safe sugar substitute in pregnancy but in moderate amounts. In healthy pregnant women, Aspartame is safe and does not cause any birth defects.

4.   Acesulfame potassium

Acesulfame potassium or Ace-K is one of the best sugar substitutes for diabetics. It has a slightly bitter after-taste so, often other artificial sweeteners like sucralose and aspartame are mixed with Ace-K.

This is 200 times sweeter than normal sugar and is present in various food products. For instance,

  • Soft drinks
  • Frozen desserts
  • Protein shakes
  • Tabletop sweeteners
  • Candy
  • Gums
  • Drink mixes, etc.

Ace-K is a non-nutritive artificial sweetener approved by the US FDA. It has approved a daily intake (ADI) of 15 mg or less per kilogram of body weight.

There are about 90 studies supporting Acesulfame potassium as a safe artificial sweetener. However, some evidence says the opposite and indicates Ace-K has some significant health risks.

Unlike other non-nutritive sweeteners, Ace-K is a calorie and carbohydrate-free sugar substitute. Hence, it is safe for persons having diabetes.

5.   Neotame

Among the best sugar substitutes for diabetics, Neotame is another good option. It is 7000-13000 times sweeter than normal table sugar. The best thing is Neotame is resistant to heat and it is useful in baked foods and other heated foods.

The US FDA has approved Neotame as a safe sugar substitute. The daily intake of Neotame is 0.3mg/kg. The FDA approved Neotame for the use of general purposes as a sweetener, flavour enhancer in foods and beverages.

6.   Stevia

Stevia is a natural sugar substitute and one of the best sugar substitutes for diabetics which is about 300 times sweeter than normal sugar. The origin of stevia is Stevia rebaudiana, which is a plant of the Asteraceae family. This also has a common name, sweet leaf.

Manufacturers use the leaves and extract the steviol glycosides.

Stevia also has a slightly bitter after-taste which makes it unpleasant. So, some manufacturers mix other sugar substitutes to balance the sweet taste. However, this may reduce the natural nutritious value of pure stevia.

Some studies indicate Stevia is useful in reducing blood cholesterol as well, unlike consuming normal table sugar.

The safe daily intake of Stevia as approved by the US FDA is 4 mg per kilogram body weight.

Is stevia safe for diabetics?

As stevia doesn’t contain any calories it does not increase blood sugar levels. Hence, it is safe and one of the best sugar substitutes for diabetics. It has a low glycemic index. Moreover, Stevia usually does not gain weight. In the market, Stevia is available in different forms such as powders, liquid, and granules.

What are the bad effects of Stevia?

Although Stevia is usually a safe sugar substitute, some people exhibit unwanted side effects. Stevia and the gut flora connection allows these bad effects. Stevia can change the concentrations of gut bacteria.

A group of scientists in Israel found that Stevia does not kill the gut bacteria. But instead, it interrupts the communication within gut bacteria. This ultimately reduces the ability of gut bacteria to maintain the body’s normal functions.

Studies showed that gut flora is essential for vital functions of the body including immunity, weight, the health of the heart and vascular system, nervous system, and so on. Hence maintaining healthy gut bacterial flora is essential to a healthy life.

Stevia has the chemical compounds, rebaudioside, and stevioside.

Some people who take this Stevia and Stevioside may experience certain side effects. For instance,

  • Bloating
  • Nausea
  • Muscle pain
  • Dizziness
  • Numbness

The occurrence of these side effects depends on the individual.

7.    Advantame

Advantame is a sugar substitute that is a combination of Aspartame and vanillin. This is also an artificial version of vanilla extract. This is also one of the best sugar substitutes for diabetics.

Advantame is sweeter than table sugar. It is about 20000 times sweeter than sugar. Moreover it is 100 times sweeter than aspartame. The US FDA has approved Advantame as a safe sugar substitute for diabetics. Around 37 animal and human studies support this decision. These studies focused on the possible side effects on reproductive, neuropathy, and cancer-leading processes.

The safe daily intake (ADI) of Advantame as approved by the FDA is 32.8mg per kilogram body weight. This is one of the best sugar substitutes for diabetics when used in foods and beverages.

8.   Tagatose

Tagatose is another common sugar substitute. It is a fructose-type sugar substitute. It is 90 times sweeter than sugar. Tagatose is a low-calorie natural sugar substitute.

The US FDA has approved Tagatose as a safe sweetener for food and beverages. For instance,

  • Cereals
  • Soft drinks
  • Fat-free ice cream
  • Desserts
  • Diet soft confectionary
  • Icings
  • Chewing gums
  • Hard candy, etc.

However, Tagatose is a somewhat expensive sugar substitute than other common artificial sweeteners.

What is the specialty of Tagatose?

Other than acting as a sugar substitute, anti-obesity, anti-diabetic drug. Moreover, Tagatose has many other health benefits.

  • Treatment for diabetes
  • Hyperglycemia
  • Anemia
  • Hemophilia
  • Improvement of fetal development.

Several new studies are showing Tagatose is a promising agent for hyperglycemia. It has a potent hypoglycemic effect. According to a publication, published by Hindawi BioMed Research International in 2018, Tagatose is a safe and promising agent for hyperglycemia, control of diabetes, weight loss, and high-density lipoprotein in the blood. However, currently, there is no treatment for diabetes using Tagatose.

What are the side effects of Tagatose?

  • Gastric upsets usually occur but only with large consumption of Tagatose. This can be due to the osmotic effect of Tagatose when it goes through the intestine.
  • Also, due to its blood sugar-lowering activity, Tagatose can interfere with other hypoglycemic drugs. Ultimately this leads to lower blood glucose levels.
  • Tagatose can increase uric acid in the blood. This can harm such patients who had kidney stones in the past.

9.     Luo Han Guo fruit extracts (Monk Fruits)

Luo Han Guo fruit extract or extract of monk fruit is a natural sweetener. This is one of the best sugar substitutes for diabetics. The sweetener is coming from the extractions of the dried fruit.

This is about 150-200 times sweeter than table sugar. It does not elevate blood sugar hence is safe for diabetic patients.

The US FDA has approved Monk fruit as a sugar substitute for all including pregnant women and children.

Monk fruits get their sweet taste from natural sweetening compounds called mogrosides. Generally, this sugar substitute is safe for diabetic patients. Because it does not contain calories and does not increase blood sugar.

However, some Luo Han Guo fruit extracts may contain blends of other sugar substitutes. Therefore not all the market available monk fruit extracts are free from calories. You need to carefully read what the other components, monk sweeteners contain.

What are the other benefits of Monk extracts?

  • Reduce body weight

Since monk fruit extracts do not contain calories, carbs, or fats, this will be an ideal option if you are trying to promote weight loss. You can substitute monk fruit extract sugar substitutes for your normal daily consumption. But be careful when you choose foods and other products. Make sure to buy Monk fruit sweetener that does not contain any artificially added sugars.

  • Anti-inflammatory activity

Monk fruit extract has been used for decades in China for the removal of phlegm and sore throat. The specific compounds in the monk fruit including mogroside exhibit anti-inflammatory properties.

10. Erythritol

Erythritol is a sugar alcohol. It is popular as a sugar substitute and a food additive. This is an artificial sweetener. Erythritol is present in low-sugar and sugar-free food products. This sugar substitute naturally presents in fruits like peaches, grapes, and mushrooms. In addition, it artificially occurs when certain products are produced. For instance, wine, beer, and cheese fermentation.

Among the sugar alcohols, Erythritol is the safest sugar alcohol. It does not raise blood sugar levels and hence a good choice for diabetic patients.

Erythritol is a calorie-free artificial sweetener and one of the best sugar substitutes for diabetics. Moreover, Erythritol has fewer side effects. It does not cause gastric upsets like other sugar alcohols. This is due to its chemical structure. Our body can’t digest Erythritol and pass it in its unchanged form through our digestive tract.

Among all the other sugar alcohols like xylitol, mannitol, Erythritol is the newest sugar substitute in the market. There are several studies on humans and animals supporting Erythritol as a safe sugar substitute. The WHO approved Erythritol in 1999 and the FDA did it in 2001.

What are the side effects of Erythritol?

  • Gastric upsets

You will absorb most of the Erythritol amount into the bloodstream. Other remaining portion will travel unchanged to the colon. However, like other sugar substitutes, colon bacteria cannot ferment Erythritol.

Several studies have shown based on this activity of Erythritol, likely to cause gastric upsets. Unless you have taken massive amounts of Erythritol at one time you cannot get gastrointestinal problems.

  • Affect on blood sugar levels

As a sugar substitute, when you get Erythritol you cannot digest it. Because you do not have enzymes to digest them, all the absorbed Erythritol passes through the digestive tract and excrete by urine unchanged.

For people who have diabetes or obesity, Erythritol acts as an excellent alternative to normal sugar. It does not elevate blood sugar levels, change insulin levels, cholesterol, triglycerides, or any other biomarker. Even in healthy people, Erythritol is a good choice for sugar.

  • Prevents heart diseases

According to the studies using diabetic rats, Erythritol can reduce the risk of heart diseases. Since it acts as an antioxidant, perhaps it can fight against blood vessel damage and protect them. Important to mention, Erythritol may help to improve blood vessel function in type 2 diabetic patients.

However, this is still doubtful. Because some studies have identified consumption of large amounts of Erythritol can increase fat in the body.

Are these sugar substitutes good for diabetics?

Sugar substitutes, most of the time artificial sweeteners are good for diabetics. They contain no calories hence do not raise blood sugar levels. There are two types of sugar substitutes namely, nutritive and non-nutritive artificial sweeteners. Among them, there are the best sugar substitutes for diabetics.

These sugar substitutes can produce a sweet taste in very little amounts. Because they are sweeter than normal table sugar many times. Hence you need to take a very little amount of these sugar substitutes as recommended.

Since these sugar substitutes do not affect your blood glucose levels, they are “free foods”. Free foods have calories less than 20 and 5grams of carbohydrates. So these are not considered foods containing calories or carbohydrates. However, during the production, these foods also may contain sugars. So be careful when choosing your food if you are a person having diabetes.

Also, sugar alcohols may cause diarrhea in some patients. Since these sugar alcohols such as xylitol, mannitol, and sorbitol can elevate your blood glucose levels.

What are the best natural sugar substitutes for diabetics?

Among the available natural sweeteners, not all of them are not safe for diabetes. You have to be careful when selecting such natural sweeteners as well.

For example, even some natural sweeteners do not increase your blood glucose level, they contain high calories. Sometimes more than normal granulated sugar. This causes less production of insulin. Ultimately, this increases the workload of the liver to break down the sugars.

For instance, Agave is such a natural sweetener.

What are the best natural sugar substitutes for diabetics?

  • Monk fruit extract
  • Erythritol
  • Fresh fruits
  • Stevia

Are sugar-free products good for diabetics?

Actually, sugar-free products are a good option for diabetes patients. Since sugars can affect the blood glucose levels which can be harmful to controlling diabetics.

However, always taking sugar-free products does not help you to control your blood sugar level. Although these foods or beverages do not contain any sugars in their direct form, several carbohydrates and starches may include. These compounds also add glucose after digest.

So, you need to carefully select your daily meals.

What are the pros and cons of sugar substitutes for diabetics?

Generally safe for diabetic patientsSome of the sugar substitutes produce unwanted effects
Do not elevate blood glucose levels significantlySome artificial sweeteners may increase the blood sugar level
Help to reduce calorie and carbohydrate intakeSome sugar-free foods may contain carbohydrates, calories, and fat.
Have normal foods without having difficultiesSugar alcohols can produce digestive problems.
Taste your favorite foods and beverages.Some sugar substitutes cannot be used for baking or cooking due to heat sensitivity.

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