Sweeteners and Diabetes

The best and worst sweeteners for diabetes.

There is a lot of conflicting information about sugar and sweeteners for people with diabetes. Most medical experts and researchers agree that people with diabetes should avoid sugar. However, what about when it comes to other sweeteners, both natural and artificial?

Some sweeteners have little to no effect on blood sugar levels, but are they safe for people with diabetes? 

In this article, we will take a closer look at how sugar and sweeteners affect your body. We’ll show you our top 3 list of natural sweeteners that you should be able to use without affecting your blood sugar. We will also show you which sweeteners you should completely avoid and what to watch for on nutrition labels.

However, beware that consuming anything sweet, whether regular white sugar or a zero-carb sweetener, has the same effect in triggering sugar cravings. For some people, this can be a slippery slope and can lead to potentially unhealthy eating choices. For this reason, we recommend cutting back on desserts and sweet treats and saving them only for special occasions.

Sugar and Sugar Substitutes


Two wooden bowls filled with white sugar and brown sugar, also sugar cubes.While sugar comes in many different forms, all sugar negatively impacts blood sugar, weight, and inulin response. Sugar is made up of 50% glucose and 50% fructose and is 100% carbohydrate. Common forms of sugar include:

  • Regular white table sugar
  • Brown sugar
  • Powdered sugar/confectioners sugar
  • Coconut sugar
  • Date sugar
  • Maple syrup

Sugar should be avoided by anyone with diabetes or prediabetes, as sugar raises blood sugar, increases insulin production, and leads to weight gain. You can learn more about how sugar affects your body and the relationship between sugar and diabetes here.


Clear thick high fructose corn syrup on a spoon and dripping off the front.What about honey, molasses, corn syrup, and agave nectar? These sweeteners, although natural, are generally considered to be worse for your overall health than regular sugar. This is because they contain higher fructose content than sugar. Fructose is considered worse than pure sugar, especially for people with diabetes.

Many researchers believe that consuming fructose can cause many metabolic disorders, including type 2 diabetes and obesity. Fructose can only be metabolized by your liver, and when you consume excessive fructose, your liver starts turning fructose into fat. Some of the other side effects of too much fructose include:

It is important to note that fructose causes a slower rise in blood sugar levels than regular sugar. For this reason, agave nectar is often marketed as a ‘healthy’ natural alternative to sugar. However, agave nectar has the highest amount of fructose in actuality, making it perhaps the least healthy option out there.

It’s safe to say that you should avoid eating anything with high fructose sweeteners, especially if you have diabetes.

The side effects of fructose DO NOT apply to eating whole fruit, only to consuming excess fructose added into food as sugar.

Can I Use Sweeteners if I Have Diabetes

Yes and no.

Yes, using certain sweeteners can allow you to have a dessert or sweet treat without worrying about your blood sugar or insulin production rising. There are some clear-cut winners and some sweeteners that you should avoid.

No, it is still possible to develop a “sweet tooth” using sweeteners. For this reason, Total Diabetes Wellness recommends saving the sweets for special occasions, such as a birthday, family gathering, or other important events.

Why does your website include recipes for desserts if you recommend avoiding them? We want to provide you with a database of recipes to choose from when you have a special occasion, so you don’t have to guess. Our website’s dessert and sweet recipes follow the same low-carb, high-fat (LCHF) format as our other recipes and should not raise your blood sugar.

If you’re going to make a cheesecake or apple cobbler, use our recipes. Our dessert recipes are delicious, and your friends and family won’t be able to tell they’re low-carb.

Caution for Using Sweeteners

There are three main concerns of using sweeteners for people with diabetes:

  1. The danger of developing a sweet tooth
  2. Side effects such as nausea, diarrhea, and upset stomach
  3. Misleading and deceptive marketing

Sweet Tooth Concerns for Sweeteners

You will soon learn which sweeteners are better options. However, it is still essential to understand the effects that sweeteners have on the body. There are two main concerns with using sweeteners too often.

  1. Relapse for unhealthy sweets. Even if they don’t harm blood sugar or weight, eating desserts and sweet foods can lead to giving into sugar cravings (sweet tooth) and addictions later. This is because the tongue receptors trigger a brain response that keeps those sugar cravings around for much too long. Many people don’t realize that even ‘healthy’ sweeteners with zero carbs or calories have the same effect on your sweet tooth as pure white sugar. Research has shown that “both caloric and non-caloric sweeteners appear to act on brain reward mechanisms in ways that likely perpetuate their intake.” In addition, if you are pregnant, these zero-calorie sweeteners could potentially put your baby at risk for long-term metabolic health. For this reason, sweets should only be considered for special occasions.
  2. Very little research has been done on the long-lasting implications of sweeteners. The best advice here is moderation. Again, only treat yourself to a “healthier” dessert for special occasions.

Side Effects of Sweeteners

Closeup of woman holding her stomach in pain from gas and bloatingSide effects include nausea, bloating, diarrhea, and an upset stomach. Many sweeteners, even natural ones, can cause uncomfortable side effects. Some sweeteners are more likely to induce these side effects than others. Since everyone’s body responds differently, it is impossible to tell which sweeteners may have a negative impact on your body without trial and error.

Misleading and Deceptive Marketing for Sweeteners

Zero-calorie sweeteners can actually contain almost 100% carbohydrates. Keep in mind that to eliminate one negative label, often another negative label takes its place. The trick is for companies to focus on the removal (zero calories) of one while ignoring another (replaced with carbohydrates). Zero-calorie sweeteners can be highly processed and potentially cause long-term metabolic health issues. Soda, even diet soda, can cause weight and health problems due to the sweeteners used.

The Best Natural Sweeteners That Won’t Affect Blood Sugar

Here are the best natural sweeteners that shouldn’t affect your blood sugar. Keep in mind that each person’s body responds differently. Testing your blood sugar before and after trying something new is the only way to determine how each sweetener affects your body. Our top three picks, in order, are:

1. Monk Fruit

Close up view of monk fruit (whole fruit), and a bowl of granulated monk fruit sweetener.Monk fruit, sometimes called monk fruit extract, is extracted from monk fruit, grown most commonly in Southeast Asia. A natural sweetener, monk fruit has been around for centuries. Monk fruit is 100-250 times sweeter than regular table sugar, so a little goes a long way! For this reason, some manufacturers mix monk fruit with another sweetener (often erythritol) to lessen the sweetness and make it more of a 1:1 ratio. We’ll discuss erythritol in more detail below. Some people can tolerate erythritol, while it causes digestive upset for others. We strongly recommend choosing monk fruit that is pure without anything else added.

Monk fruit does not affect your blood sugar and also has zero calories.

The best part about monk fruit is the taste. In our opinion, monk fruit has the best taste of all sweeteners and is the closest to white sugar with a slightly fruity aftertaste. Monk fruit can also be used for baking, or anywhere else you’d use regular sugar.


  • Natural 
  • Does not raise blood sugar
  • Zero calories
  • Tastes the closest to white sugar out of all the sweeteners
  • A little goes a long way (100-250 times sweeter than table sugar)
  • Can be used for baking
  • No evidence to date of negative side effects


  • Expensive
  • Somewhat hard to find
  • Can be mixed with other sweeteners or fillers; read labels carefully

2. Allulose

Allulose is a newer sweetener to the market and naturally occurs in foods such as dried fruit (raisins and figs), maple syrup, and brown sugar. The body cannot metabolize allulose, which means it passes through without affecting blood sugar or calories.

It is about 70% as sweet as regular table sugar. If you’re baking or using allulose as a sweetener, you’ll need to use more to account for the slightly less sweet taste. Most people enjoy the taste of allulose and find it tastes similar to table sugar.

Allulose does not affect blood sugar and is low in calories.

Allulose is much more difficult to find, especially at local grocery stores. Most likely, your best bet is to purchase allulose online if you decide to try this sweetener. Because it isn’t widely available, allulose can be expensive.

Most people using allulose don’t experience any negative side effects. However, one study found negative digestive side effects when consuming larger amounts of allulose. Side effects included gas, bloating, abdominal pain, and diarrhea.


  • Natural
  • Does not raise blood sugar
  • Tastes similar to regular table sugar
  • Can be used for baking


  • Expensive
  • Because it is a newer sweetener, not as much research has been done on allulose
  • Hard to find
  • Possible negative digestive side effects

3. Stevia

Stevia plant next to powdered stevia on a wooden spoonStevia comes from the plant Stevia rebaudiana Bertoni. Classified by the FDA as a non-nutritive sweetener, which means stevia has almost no calories. Like monk fruit, a little goes a long way as stevia is 200-300 times sweeter than regular table sugar. In addition, stevia does not affect blood sugar, making it a good choice for people with diabetes.

Make sure to read the ingredients label when purchasing stevia carefully. It is often mixed with other sweeteners (erythritol), fillers (maltodextrin), or sometimes other vague “natural flavors.” We recommend choosing a stevia product that is 100% stevia and nothing else.

The biggest downside to stevia is that it doesn’t taste like table sugar. Stevia has a licorice flavor, and some people find it has a bitter aftertaste. The taste and aftertaste make stevia challenging to cook and especially bake with as it can alter the recipe’s taste. Since taste is highly individualized, we suggest trying stevia and see how you like it. Some people like the taste quite a bit and find they prefer stevia to monk fruit because it’s usually cheaper and easier to find.


  • Natural
  • Does not raise blood sugar
  • Zero calories
  • Widely available, many grocery stores carry stevia products


  • Can be mixed with other sweeteners or fillers (“natural flavors”); read labels carefully
  • Some people don’t like the bitter aftertaste
  • Can be difficult to cook and bake with

Sugar Alcohols and Their Effect on Blood Sugar

Most sugar alcohols look and taste like sugar, and many can be used in a 1:1 ratio when cooking, making them a top choice for some people.

White bottle of erythritol artificial sweetener, sugar alcohol What are sugar alcohols? Sugar alcohols are a sweet carbohydrate. At first glance, this description sounds exactly what people with diabetes should avoid. However, sugar alcohols behave similarly to fiber during digestion, meaning they’re only partially digested. Some sugar alcohols are found naturally in fruits and vegetables, and others are chemically processed from other sugars.

Many people with diabetes find that sugar alcohols either do not affect their blood sugar or the effect is minimal. However, since everyone responds differently to different foods, there’s no easy way to know exactly how your body will respond without consuming and testing your blood sugar.

Sugar alcohols are not calorie-free; however, they typically have fewer calories than regular table sugar.

The biggest drawback to sugar alcohols is their negative digestive side effects that occur for many people. This is why we don’t include any sugar alcohols on our Top 3 Best Natural Sweeteners list. The most common side effects are gas, bloating, upset stomach, and diarrhea.

Here are the most common sugar alcohols:


The most widely available sugar alcohol, erythritol is often mixed with other sweeteners such as monk fruit and stevia. Erythritol is relatively easy to find compared to other sweeteners. Although most people enjoy the taste, some people report a cooling aftertaste. Erythritol is easy to use for cooking and baking.


This sweetener can be fatal to pets, especially dogs. For this reason, we recommend avoiding xylitol altogether. In addition, xylitol has more reported negative digestive side effects than other sugar alcohols and has more carbs than other sweeteners.


Maltitol is commonly used in pre-made “low sugar” or “sugar-free” desserts and low-carb or keto products. However, maltitol has been shown to raise blood sugar, making it a bad option for people with diabetes. Maltitol can also act as a laxative and cause diarrhea for some people.


Sorbitol has minimal effect on blood sugar; however, it has been shown to cause digestive upset.


Other less common sugar alcohols include mannitol, isomalt, lactitol, and hydrogenated starch hydrolysates.

Artificial Sweeteners

Artificial sweeteners, as the name implies, are synthetic sweeteners created in a lab. We recommend avoiding all artificial sweeteners. Most artificial sweeteners have negative side effects, and research is mixed on the long-term health effects. With several good natural sweeteners to choose from, why bother with artificial sweeteners?

The following are artificial sweeteners approved for use in the United States and/or European Union. 

  1. Acesulfame potassium, also known as acesulfame K and Ace-K (Sweet One and Sunett, Swiss Sweet) 
  2. Aspartame (Equal and NutraSweet)
  3. Saccharin (Sweet‘n Low and Sugar Twin, Necta Sweet)
  4. Sucralose (Splenda)
  5. Advantame
  6. Neotame (Newtame)
  7. Aspartame-acesulfame salt (Twinsweet)
  8. Cyclamate
  9. Neohesperidin

Diet Soda and Diabetes

Rows and rows of red and blue cans of diet sodaAlmost all diet soda is sweetened with artificial sweeteners. For this reason, we recommend people with diabetes avoid diet soda.

Some research has shown drinking diet soda can make it harder to lose weight. However, since many diet sodas are marketed as zero-calorie and zero-carb, it’s unclear exactly how or why they inhibit weight loss. 

As we mentioned earlier, consuming anything sweet acts the same way on your taste receptors and triggers a ‘sweet tooth’ response in your brain. Diet soda behaves the same way, and some researchers believe drinking sweet drinks throughout the day may increase your overall sugar cravings and lead to unhealthy eating choices.

If you have diabetes, water is the very best thing you can drink for your overall health.

The Bottom Line

People with diabetes should avoid regular sugar in any of its forms. White table sugar spikes blood sugar and increases insulin production, making diabetes harder to manage. Other natural sweeteners such as honey, agave, corn syrup, and molasses have a higher fructose content than regular sugar, which may make your blood sugar rise slower. However, fructose has been shown to have several dangerous side effects, so people with diabetes should avoid eating anything that has added fructose.

We recommend using monk fruit, allulose, or stevia, as all of these natural sweeteners won’t raise your blood sugar or affect insulin production. You may be able to tolerate other natural sweeteners, such as sugar alcohols. However, you’ll need to test how your blood sugar reacts and watch for negative digestive side effects with these before beginning use.

Avoid all artificial sweeteners. There are many better natural sweetener options, and some artificial sweeteners have side effects dangerous to your health.

All sweets can potentially trigger the same ‘sweet tooth’ cravings, regardless of if they’re healthy natural sweeteners versus regular table sugar. For this reason, we strongly suggest saving desserts and sweet treats for special occasions. Many people find once they step back from eating sweetened food, their taste palate changes, and they enjoy nature’s sweetness in fruits, berries, nuts, and spices.