When you think of diabetes and sugar, the first thing that probably comes to mind is blood sugar levels. But this post is on another type of sugar, alternative sugar for diabetics. I will break down the sugars by artificial sweeteners, sugar alcohols, and sugars found in nature.
Artificial Sweeteners
Artificial sweeteners are in everything from baked goods to beverages. They are also called non-nutritive sweeteners because they contain few calories or nutrients. Artificial sweeteners include:
- Aspartame (Equal, NutraSweet)
- Saccharin (Sweet’N Low, Sugar Twin)
- Sucralose (Splenda)
- Acesulfame potassium/acesulfame K (Sunett, Sweet One)
Most diet/no-sugar soft drinks contain Aspartame or Sucralose. Although they are FDA approved, my post, 14 Healthier Substitutes for Diet Soda (https://backtonaturediabetic.com/14-healthier-substitutes-for-diet-soda/) cites research showing that artificial sweeteners may stimulate appetite, cause weight gain, and increase the risk of strokes and heart attacks. They also increase the risk of colorectal cancer in women under 50.
Sugar Alcohols (also known as polyols)
Sugar alcohols are in some fruits and vegetables but are often artificially made. They are used to sweeten diet foods, sugar-free candies, and chewing gums. Sugar alcohols include:
- Erythritol
- Xylitol
- Sorbitol
- Lactitol
- Isomalt
- Mannitol
Your body cannot digest most sugar alcohol, which is good and bad. Because your body partially digests them, they don’t affect blood sugar levels like regular sugar (sucrose). They travel to the large intestine, where gut bacteria break them down. However, as a result, they can produce side effects such as gas, bloating, and diarrhea, especially if you eat a large amount. If you’ve ever eaten sugar-free candy, you might have noticed the warning on the back of the package, “excessive consumption may have a laxative effect.” This is due to the sugar alcohols used to replace sucrose.
Research shows that sugar alcohol can be just as bad as artificial sweeteners because they may increase the risk of cardiovascular disease. A recent study revealed that xylitol in processed food can increase the risk of heart attack and stroke.
“Our studies show that elevated blood levels of xylitol contribute to heightened platelet reactivity and are associated with an enhanced risk for cardiovascular events, like heart attacks and stroke,” says physician-scientist Stanley Hazen, MD, PhD (https://health.clevelandclinic.org/dangers-of-xylitol). He also stated that “The very people who are most at risk for clotting events like heart attack and stroke — people with diabetes — are the very same people who are most likely to be ingesting xylitol in high levels and further increasing that risk without knowing it.”
The findings are similar to those of Dr. Hazen and his team in studies of erythritol, another sugar alcohol.
Sugars Found in Nature
Honey
Honey contains sugars (approximately 40% fructose and 30% glucose). While honey is slightly better than sugar because it contains nutrients, it has more calories than sugar and can still raise blood sugar.
Blackstrap Molasses
Boiling molasses three times creates blackstrap molasses. It’s more nutritious than molasses because boiling concentrates nutrients. Like honey, blackstrap molasses contains calcium, magnesium, and potassium.
“Molasses contain nutrients that are lacking in traditional sugar. Molasses also has more flavor than sugar, making it easier to use less for sweetening. However, blackstrap molasses has a flavor that may not appeal to some people and may not be preferred in all cases where sugar is needed,” says Joy Ashby Cornthwaite, certified diabetic care educator at the University of Texas Health Science Center at Houston.
“A person with diabetes should weigh the options on blackstrap molasses,” she adds. (https://www.livestrong.com/article/205509-black-strap-molasses-diabetes/)
Agave Nectar
Agave syrup is made from a group of succulent plants that grow in the southwest. It has a low glycemic index, meaning it won’t significantly affect blood sugar levels. However, Agave contains more fructose than table sugar and most other sweeteners.
“Excess fructose is converted into fat by your liver. This can raise triglyceride levels and may promote non-alcoholic fatty liver disease,” says Alexandra Caspero, a plant-based dietician. “There are also studies showing that diets high in fructose consumption are associated with higher levels of LDL cholesterol and increased belly fat. For comparison, regular table sugar is about 50 percent glucose and 50 percent fructose. Agave syrup is [about] 85 percent fructose.” (Agave Nectar May Lead to Fatty Liver Disease – Woman’s World (womansworld.com))
Coconut Palm Sugar
Coconut palm sugar comes from the sap of the coconut palm tree. Like agave, it has a low glycemic index but contains fructose.
Are Natural Sugars Better Than Artificial Ones?
You may assume these four sweeteners are better than artificial sweeteners because they come from nature. On the one hand, they contain nutrients and do not cause the adverse effects of artificial sweeteners. However, they contain calories. While fructose is natural and found in fruit, excess consumption can lead to insulin resistance and non-alcoholic fatty liver disease. They are sweeter than sugar, so you can use a smaller amount, but fructose can raise blood sugar levels. Therefore, use them in moderation.
Allulose– The New Kid on the Block
Allulose is a lower-calorie sugar that came out in 2015 and comes from fruits like figs and raisins. It’s also commercially produced from corn or fructose. Allulose is 70% as sweet as sugar but with 90% fewer calories. Despite not being a sugar alcohol, we still metabolize it similarly. It’s absorbed in the small intestine, so it doesn’t get absorbed in the body, meaning it doesn’t affect blood sugars significantly. However, like sugar alcohol, you may get gastrointestinal discomfort.
In addition, exciting new research shows that it may lower after-dinner blood sugar and reduce body fat. Read more here:
My Two Picks for Alternative Sugar for Diabetics
Monk Fruit
With a name like monk fruit, you’d expect sugar from this fruit to come from fructose. However, unlike most fruits, the sweetness in monk fruit comes from antioxidants called mogrosides, which the body processes differently than sucrose and fructose.
Processing separates mogrosides from fresh juice, removing fructose and glucose (https://www.healthline.com/nutrition/monk-fruit-sweetener#what-it-is).
Stevia
Stevia comes from the stevia plant leaves and is 100-300 times sweeter than table sugar.
Unlike artificial sweeteners, stevia and monk fruit have not been linked to health risks. Contrary to natural sweeteners like honey, they do not contain calories, fructose, or glucose, so they don’t raise blood sugar levels. And they do not cause the stomach issues that sugar alcohols can.
But be sure to read the product labels to ensure no other sweeteners are added.
Conclusion
There are many sugar substitutes for diabetics, including those found in nature. However, some can cause health problems, stomach discomfort, and even raise blood sugar. My top picks are monk fruit and stevia, which are considered safe and do not raise blood sugar. They are becoming more mainstream, found in many soft drinks, and sold as packets. You can even bake with them because both are heat-stable.
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Disclaimer
Please remember this is not medical advice or intended to replace the advice of your doctor. This is my experience with the natural supplements that have helped me manage my diabetes. They are not intended to cure any disease. Please do not self-diagnose. Always check with your health care provider before trying new treatments.
Also, natural does not mean safe. Many natural remedies have side effects and can interact with medication and supplements. It should be noted that the FDA does not regulate dietary supplements but treats them like foods and not medication. Unlike drug manufacturers, supplement makers do not have to show their products are safe or effective.
I ask you to please keep an open mind; be a diabetic detective and do your own research; work with your healthcare team; see what works best for you, and monitor your blood sugars.