What kind of sugar can diabetics have? A Guide to Sweeteners

January 12, 2026 •

4 min read

According to the American Diabetes Association, reducing sugar intake is a cornerstone of diabetes management. This has prompted a widespread search for viable alternatives, but the options and their safety profiles are often confusing, leading many to ask: what kind of sugar can diabetics have?

Quick Summary

Exploring various sweeteners, including natural options like Stevia and monk fruit, artificial choices, and sugar alcohols. This guide outlines their effects on blood sugar, potential side effects, and best uses to inform healthier dietary decisions for managing diabetes.

Key Points

Natural, Zero-Calorie Sweeteners: Stevia, monk fruit, and allulose are derived from natural sources, have a low to zero glycemic index, and are safe for diabetics in their pure forms.
Artificial Sweeteners: FDA-approved artificial sweeteners like sucralose and aspartame do not raise blood sugar, but recent research suggests potential long-term metabolic effects and gut health impacts, so moderation is advised.
Sugar Alcohols: Erythritol is a low-calorie sugar alcohol that has a minimal effect on blood glucose and is generally well-tolerated. Other sugar alcohols like xylitol and sorbitol may cause digestive upset.
Focus on Whole Foods: Health authorities like the ADA emphasize that the best strategy for diabetes management is a balanced diet rich in whole foods, rather than solely relying on sweeteners.
Read Labels Carefully: Many processed "sugar-free" products contain a blend of sweeteners, bulking agents, and other carbohydrates that can affect blood sugar. Always read the nutrition facts label.

Navigating Sweeteners for Diabetes Management

For individuals with diabetes, controlling blood glucose levels is critical to managing their health. The type of sweetener consumed can have a significant impact, making it essential to understand the different options available. Sweeteners are broadly categorized into three groups: natural, artificial, and sugar alcohols. Each has a unique metabolic effect, with some being better choices than others, depending on individual health goals and tolerance.

The Rise of Natural, Zero-Calorie Sweeteners

Natural, non-nutritive sweeteners are derived from plants and typically have a glycemic index (GI) of zero, meaning they do not affect blood sugar levels.

Stevia: Extracted from the leaves of the Stevia rebaudiana plant, pure stevia has zero calories and is significantly sweeter than sugar. It does not increase blood glucose and may even offer antidiabetic properties, though processed versions can contain other additives. It is heat-stable and a good option for baking.
Monk Fruit Extract: Derived from a small melon, monk fruit is another zero-calorie, natural option with no effect on blood sugar. It contains antioxidants called mogrosides that provide its sweetness. Like stevia, it's a good alternative, but checking for added ingredients is important.
Allulose: A 'rare sugar' found in small amounts in some fruits, allulose has a low glycemic index and negligible calories. It tastes and behaves very similarly to sugar and doesn't impact blood glucose or insulin levels, making it a popular choice for baking and general use.

Understanding Artificial Sweeteners

Artificial sweeteners are synthetically produced and are often much sweeter than regular sugar. The U.S. Food and Drug Administration (FDA) has approved several for consumption.

Sucralose (Splenda): Though derived from sugar, sucralose is not metabolized by the body for energy and thus does not affect blood sugar. It's heat-stable and widely used.
Aspartame (Equal, NutraSweet): This low-calorie sweetener is about 200 times sweeter than sugar. It is generally considered safe but should be avoided by individuals with the rare genetic disorder phenylketonuria (PKU).
Saccharin (Sweet'N Low): One of the oldest artificial sweeteners, saccharin is calorie-free and can be used in both hot and cold foods.

Recent studies have raised some questions about the long-term metabolic effects of certain artificial sweeteners, including their potential impact on gut microbiota and insulin sensitivity. While these sweeteners can be useful for reducing calorie intake in the short term, health authorities recommend focusing on limiting added sugars from all sources as a primary strategy.

What About Sugar Alcohols?

Sugar alcohols, or polyols, are carbohydrates found naturally in some fruits and vegetables, though they are often manufactured. They have fewer calories and a lesser effect on blood sugar than table sugar because they are only partially absorbed.

Erythritol: A well-tolerated sugar alcohol with almost zero calories and no effect on blood sugar or insulin levels. It is used in many sugar-free products and is a component of some stevia brands. However, some studies have flagged a potential link to cardiovascular issues, and more research is needed.
Xylitol, Sorbitol, and Maltitol: These are common sugar alcohols, but they can cause gastrointestinal distress, such as bloating and gas, especially when consumed in large quantities. Their impact on blood sugar is more significant than erythritol, so portion control is important.

Sweeteners to Use with Caution

Some so-called 'natural' sweeteners can still significantly impact blood sugar. Honey, agave nectar, and maple syrup, while less processed than white sugar, still contain calories and carbohydrates that can raise glucose levels. Coconut palm sugar also contains a similar number of calories and carbs as regular sugar, and should be used with the same moderation. The American Diabetes Association emphasizes moderation for all added sugars, natural or not, and encourages prioritizing whole foods.

Making Informed Choices

Choosing the right sweetener is a personal decision that should be made in consultation with a healthcare provider or registered dietitian. Reading nutrition labels is paramount, especially for processed foods that may contain multiple types of sweeteners and other ingredients that affect blood sugar. Focusing on a diet rich in whole foods, like fruits, vegetables, and whole grains, remains the most effective strategy for managing blood sugar.

Comparison Table of Common Sweeteners for Diabetics


Sweetener	Type	Calories	Glycemic Index (GI)	Primary Uses	Potential Side Effects	Notes
Stevia	Natural (Plant-based)	Zero	Zero	Beverages, baking	Potential bitter aftertaste	Check labels for added fillers
Monk Fruit	Natural (Plant-based)	Zero	Zero	Beverages, baking	Minimal, generally well-tolerated	Often blended with other ingredients
Erythritol	Sugar Alcohol	Very low	Near Zero	Baking, cooking	Digestive issues in high amounts, some cardiovascular concerns	Tolerated better than other sugar alcohols
Sucralose (Splenda)	Artificial	Zero	Zero	All-purpose, baking	Minimal, debated long-term effects on gut health	Can be found in many processed foods
Allulose	Natural (Rare Sugar)	Very low	Very low	Baking, cooking	Digestive issues with large amounts	Tastes and browns like sugar
Xylitol	Sugar Alcohol	Low	Low (7-13)	Baking, gum	Significant digestive issues in some	Toxic to pets

Conclusion: Prioritize Overall Health

While there are many sweetening options available, the best approach for diabetics is not just swapping one type of sugar for another. Instead, it involves a comprehensive approach to diet that prioritizes whole, unprocessed foods. Zero-calorie options like pure stevia, monk fruit, and allulose offer excellent ways to satisfy a sweet craving without affecting blood sugar, but moderation is always key. Regular consultation with a healthcare professional can help tailor the best strategy for individual needs, ensuring long-term health and effective diabetes management.

For more guidance on diet and diabetes, the American Diabetes Association provides valuable resources on understanding carbohydrates and making informed food choices.(https://www.diabetes.org/food-nutrition/understanding-carbs)

Frequently Asked Questions

Yes, pure stevia extract is a safe and suitable sugar alternative for diabetics, as it has a glycemic index of zero and does not raise blood sugar levels. However, some processed stevia products contain additional ingredients, so it's important to check the label.

Sugar alcohols like erythritol are generally safe for diabetics, as they have fewer calories and a lesser impact on blood sugar than table sugar. Erythritol is often better tolerated than other sugar alcohols and has virtually no calories or effect on blood glucose. However, some recent studies have raised questions about a potential link to cardiovascular issues, and moderation is recommended.

For baking, heat-stable options like stevia and sucralose are effective substitutes. Allulose is also a popular choice as it behaves similarly to sugar in recipes, including browning. Some sugar alcohols, particularly erythritol, can also be used.

Artificial sweeteners like sucralose, aspartame, and saccharin are nonnutritive, meaning they have no calories and are not metabolized by the body in a way that raises blood sugar. However, some research suggests they may have longer-term effects on metabolism and gut health, so their use should be monitored.

No, honey is not a better option than sugar for diabetics. Although it has a slightly different nutritional profile, it still contains calories and carbohydrates that raise blood sugar levels. Diabetics should consume honey, like other added sugars, in strict moderation.

No, 'sugar-free' does not mean 'carb-free.' Sugar alcohols are still carbohydrates and can raise blood sugar, albeit less than regular sugar. It is essential to read the nutrition label and account for the carbohydrate content of foods containing sugar alcohols.

The 'safest' sweetener depends on individual needs and reactions. Many health professionals recommend focusing on natural, zero-calorie options like pure stevia or monk fruit extract. However, the best approach is to reduce your desire for intense sweetness overall by focusing on a diet of whole foods.