5 Best Sweeteners for People With Diabetes

People with diabetes looking for a sweetener that won't raise their blood sugar levels frequently turn to sugar substitutes.

There are several sugar alternatives that are considered safe and may be preferable to sugar if you have diabetes, as these options tend to have less of an effect on blood sugar and insulin levels compared to traditional sugar.

This article looks at five of the best sugar substitutes for people with diabetes.

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Use in Cooking and Baking

Be aware of these issues when cooking and baking with alternative sweeteners:

  • Your baked goods may be lighter in color as natural sugar browns more deeply when baked and artificial sweeteners don't brown as nicely.
  • Cooking time may need to be adjusted.
  • There may be a texture or aftertaste you're not used to.
  • The volume of cakes or cookies may be slightly decreased as you're using much less sweetener.

Xylitol

Xylitol is extracted from the natural fiber in birch trees or from plant fiber known as xylan. It is a sugar alcohol compound (but does not contain alcohol) that is similar in sweetness to sugar. Xylitol is FDA-approved and contains 40% fewer calories than sugar at 2.4 calories per gram. It has negligible effects on blood sugar and insulin (when used in moderation).

Despite its relatively low impact on blood glucose, xylitol may have a laxative effect if overused. An acceptable daily intake (ADI) hasn't been established for xylitol, but a 2016 review found that adults can safely tolerate between 10 grams and 30 grams of xylitol per day. After the body adapts to xylitol, adults can consume up to 70 grams per day without side effects.

Xylitol works well in baking because of its similarities to sugar.

Xylitol is less commonly found in grocery stores but can be found in major drugstores and health food retailers. Look for brands such as Xlear and Xyla on the market.

Erythritol

Also a sugar alcohol, erythritol has been praised for its sweetness while having little to no calories. Erythritol occurs naturally in a variety of fruits, vegetables, and fermented foods and is also commercially produced from fermented wheat or starch and contains 70% of the sweetness of sugar and just 6% of the calories, at 0.24 calories per gram.

Erythritol is FDA-approved and very safe to use but still may cause some digestive upset if consumed in large quantities (as with any sugar alcohol). Because humans don't have the necessary enzymes to digest erythritol, most of it is absorbed into the bloodstream and is then excreted into the urine unchanged, meaning it won't raise blood sugar levels.

An ADI hasn't been established for erythritol, but erythritol is considered to be well-tolerated up to 1 gram per kilogram of body weight per day, which would be up to 68 grams (about 2.5 ounces) of erythritol per day for someone weighing 150 pounds. 

Erythritol is a preferred sugar substitute in baking and is used in many commercially prepared baked goods and products promoting sugar and carbohydrate reduction.

Monk Fruit Extract

Popular in Traditional Chinese Medicine (TCM), monk fruit, or Luo Han Guo, is a diabetes-safe sugar alternative that is extracted from a dried melon. Monk fruit extract contains zero calories, zero carbs, and is about 150 times sweeter than table sugar. It doesn't raise blood glucose levels, making it a useful choice for people with diabetes.

Monk fruit is FDA-approved as GRAS (generally recognized as safe)—the FDA recognizes monk fruit as safe for all people, with no side effects. An ADI has not been specified for monk fruit and may not be necessary because there is evidence of the ingredient's safety at levels well above the amounts needed as a sweetener in food.

While it has been used in TCM for thousands of years as an anti-inflammatory agent and to combat sore throat, there have been no long-term scientific studies currently on its usage for this purpose.

You may see monk-fruit-sweetened products popping up on the shelves, such as Monk Fruit In the Raw or Lakanto Monkfruit Sweetener, both of which are powdered forms.

Monk fruit can be used in baking, but because it's 150 times sweeter than sugar, a smaller volume is needed which may affect cooking time as well as the texture and color of the baked product. It does have a slight aftertaste, but this drawback may be outweighed by the product's benefits.

Yacon Syrup

Harvested from the roots of the yacon plant, native to the Andes mountains in South America, yacon syrup is a fiber-rich sweetener that's full of fructooligosaccharides (FOS), a form of soluble fiber that serves as food for the bacteria in your microbiome (known as prebiotics).

Yacon syrup has been studied for weight loss, but its true benefit is in its high fiber content that helps balance glucose levels. It has a glycemic index of 1.

The FDA recognizes yacon syrup as GRAS. Although an ADI hasn't been established, a daily intake of 20 grams of FOS or less is generally considered safe.

Yacon syrup can be used just like honey, maple syrup, or molasses in all baking or cooking. It looks and tastes a bit like molasses, with a deep, caramel sweetness that lends itself well to baked goods, sauces, and desserts.

Stevia (Truvia, PureVia)

Stevia is a plant-based product extracted from the leaves of the Stevia rebaudiana plant.

It has 3 grams of carbs per packet and a glycemic index of 0. The FDA has approved only stevia leaf extract as GRAS—the whole-leaf stevia, does not have GRAS status and has not been permitted for use as a food additive.

Because all stevia extracts are metabolized into one common end product, steviol, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) has established a group ADI for stevia sweeteners of 4 milligrams per kilogram of body weight per day of steviol equivalents.

Stevia extract may be found in powder and liquid form. It doesn't offer quite the intensity of sweetness as most sugar substitutes but can be used in baking because it remains stable when heated. It has a characteristic aftertaste that is well-tolerated by most people but may be very noticeable to some.

Stevia in its powdered form is marketed under various brand names, including Truvia and PureVia. Although whole-leaf stevia isn't approved for commercial use, you can grow it indoors as a potted plant. You might want to try adding a single fresh leaf to a cup of tea for an unprocessed alternative to the powdered form.

Associated Conditions

People may choose to use these sweeteners instead of sugar for various reasons—including managing blood sugar, weight, and other health conditions—since these sweeteners contribute only a few or no calories to the diet and generally will not raise blood sugar levels.

That said, there is no set limit on sugar intake for people with diabetes or other health conditions, though the 2020-2025 Dietary Guidelines for Americans recommend limiting added sugars to less than 10% of your daily calories.

The most important thing for people with diabetes is to track your carbohydrate intake (including sugars) and account for them in your diabetes management plan. Work with your healthcare provider or registered dietitian to understand what is the right amount for you.

Summary

There are several sugar alternatives that are considered safe and may be preferable to sugar if you have diabetes or other health conditions that could benefit from lower sugar consumption. The FDA considers these five sweeteners safe and are generally well tolerated.

Several sweeteners work well as a substitute for sugar when baking and in other recipes. A healthcare provider or registered dietitian can provide more specific guidance if you are unsure which sweetener is best for you.

15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Stacey Hugues
Stacey Hugues, RD is a registered dietitian and nutrition coach who works as a neonatal dietitian at Beth Israel Deaconess Medical Center in Boston.