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Artificial Sweeteners—Good or Bad for Diabetics?

Shay Morrigan | April 29th, 2013

Diabetic Diet GuidelinesDo diabetic diet guidelines allow the use of artificial sweeteners? Most health experts say, “yes,” because on the whole, artificial sweeteners don’t raise blood glucose levels. There are some concerns, however, that they can potentially contribute to weight gain. Some studies have indicated that diet sodas, for example, can actually increase risk of getting type 2 diabetes in the first place.

As Dr. Michael Kaplan, Chief Medical Officer of The Center for Medical Weight Loss, one of the largest networks of weight loss physicians in the country, explains, “Many of our patients can use artificial sweeteners in moderation and find that it helps them manage their cravings. But because artificial sweeteners can taste even sweeter than sugar, some patients find themselves craving sweeter and sweeter foods.” So long as diabetes patients are able to keep their blood sugar levels as well as their sweet tooth in check, these products are generally safe.

 What are artificial sweeteners?

Also called “low-calorie” or “sugar substitutes,” artificial sweeteners are food additives that mimic the taste of sugar, but with fewer calories and a reduced effect on blood sugar. The main ones in use today include:

  • Aspartame (NutraSweet, Equal): synthesized in the lab from natural amino acids
  • Acesulfame potassium (Nutrinova, Sunett): an organic potassium salt
  • Neotame (also NutraSweet): derived from aspartame
  • Saccharin (Sweet’N Low): a synthetic chemical, benzoic sulphimide
  • Sucralose (Splenda): chemically manufactured from sugar
  • Stevia (Pure Via, Truvia): sweetener extracted from the leaves of the stevia plant

Because these sweeteners are many times sweeter than natural sugar, they add few, if any, calories. Manufacturers can use much less to get the same level of sweetness, and diabetics can use many of them with little effect on their blood sugar levels.

Sugar substitutes for diabetics: the pros

There are several advantages to sugar substitutes for diabetics. The FDA has stated they are safe for general consumption, and the Mayo Clinic states they are safe for diabetics. “Sugar substitutes don’t affect your blood sugar level,” the Clinic reports. They caution that diabetic diet guidelines should warn about sugar alcohols like xylitol, mannitol, and sorbitol, as these actually can affect blood glucose.

According to the American Diabetes Association, artificial sweeteners can also help curb cravings, and allow diabetics to enjoy a sweet taste in their foods when they want it. The American Heart Association and the American Diabetes Association stated in 2012 that using non-nutritive sweeteners could cut down on added sugars, and therefore lead to beneficial effects, like weight loss.

“Smart use of non-nutritive sweeteners could help you reduce added sugars in your diet, therefore lowering the number of calories you eat,” said Christopher Gardner of Stanford University in Palo Alto, California, lead author of a study published in Circulation on the issue.

Sugar substitutes for diabetics: the cons

Researchers have also noted, however, that the beneficial effects of artificial sweeteners can be undone if people “compensate” for the reduced calories by eating more high-calorie foods. If a patient drinks a diet soda, but then eats more later, he may be defeating his long-term weight loss goals, and sabotaging control of his blood sugar.

A study published in Preventive Medicine (Volume 15, Issue 2) found that women between the ages of 50 and 69 who used artificial sweeteners were more likely than nonusers to gain weight, regardless of their initial weight at the beginning of the study. Another study published in the American Journal of Clinical Nutrition in 2013 indicated that consuming “light” and diet sodas was associated with an increased risk of type 2 diabetes.

Sugar substitutes best in moderation

As the experts have demonstrated, diabetic diet guidelines are not always simple to follow. Every person faces his or her own challenges in the quest to lower blood sugar, lose weight, and get healthy. Understanding your own response to sweets is the first step in deciding whether to incorporate artificial sweeteners in your diet.

If you want to learn more about moderate consumption of sugar substitutes or have other questions about managing your diabetes with diet, you may consider consulting a weight loss specialist at The Center for Medical Weight Loss. With over 450 locations nationwide, there might be a Center in your area. Visit their website at