Diabetic Sugar Substitutes

A spoonful of sugar being added to a cup(BlackDoctor.org) — If you have diabetes and are trying to control your weight and blood sugar levels, you might rely on artificial sweeteners to make foods taste better without adding sugar or carbohydrates to your diet. That’s just fine, according to the American Diabetes Association.

Artificial sweeteners, also known as sugar substitutes, add sweetness without adding calories by being so much sweeter than sugar that only a tiny amount is needed to equal sugar’s taste. The body also does not fully absorb artificial sweeteners, so the few calories they contain do not affect blood sugar levels. These factors make artificial sweeteners ideal for use in a diabetes management plan.

Sweetening The Diabetic Diet

Artificial sweeteners that are approved by the U.S. Food and Drug Administration (FDA) include three that are widespread in the marketplace — saccharin, aspartame, and sucralose — as well as two that are used less often.

• Saccharin. This is the granddaddy of artificial sweeteners, first developed in 1879. It’s sold under the brand name Sweet’N Low and is 200 to 700 times sweeter than sugar. Many diet colas and other diet foods contain saccharin. It also is sold in packets for sweetening individual meals and in bulk for use in cooking.

Safety: A 1970 study associated saccharin with bladder tumor growth in rats, so an eat-at-your-own-risk warning was added to its packaging. But the National Cancer Institute and the FDA have since concluded that saccharin does not pose a risk for bladder cancer in humans, so it is considered a safe sugar substitute for type 1 and type 2 diabetes diets. However, experts still recommend that pregnant women avoid saccharin.

• Aspartame. This sweetener is sold under the brand names Equal and NutraSweet and is 180 to 200 times sweeter than sugar. It is sold in packet and bulk form, but is not considered as useful in cooking because high heat reduces its sweetness.

Safety: While many anecdotal reports have linked aspartame to health conditions ranging from depression and headache to cancer, researchers have not found that the sweetener poses any health risk to people. The American Medical Association, American Diabetes Association, and the FDA have all come down in support of aspartame’s safety, and it can be used by people with any of the three types of diabetes. However, people with a disorder called phenylketonuria (PKU) should avoid it.

• Sucralose. Sold under the brand name Splenda, this artificial sweetener is 600 times sweeter than sugar and is very useful in baking because granulated Splenda can be directly substituted for sugar in recipes.

Safety: Because sucralose is newer, there are fewer long-range studies available regarding its safety. That said, it has FDA approval and is accepted by the American Diabetes Association for use by all three types of diabetics.

• Acesulfame K (Sunett, Sweet One): This sweetener, which can be used for baking, can be found in many packaged goods and is 200 times sweeter than sugar.

Safety: More than 90 studies showed acesulfame to be safe.

• Neotame: This recently approved sweetener is about 8,000 times sweeter than sugar. It’s closely related to aspartame, but not yet widely used in the United States.

Safety: Although derived from aspartame, a chemical change makes this sweetener safe for those with PKU.

In addition, two natural alternative sweeteners are gaining in popularity:

• Stevia (Truvia, PureVia, SweetLeaf, Stevia in the Raw): The stevia plant is the basis of this sweetener, which is 250 to 300 times sweeter than sugar.

Safety: Until recently, the FDA had banned stevia because of concern that it might cause reproductive problems in lab animals. But late in 2008, the FDA approved the purified part of the stevia leaf, known as rebaudioside A, for use as an additive in American food products. This form of stevia also is reported to have less of an aftertaste.

• Agave nectar: This sweetener, produced from the agave plant, has just as many calories as sugar. But it is sweeter than sugar, so you use less, and it has much less direct impact on your blood sugar levels than either sugar or honey.

Safety: Agave nectar is as safe as sugar.

How To Substitute Your Sugar Naturally…

If you don’t want to use sugar but are worried about the safety of artificial sweeteners, there are ways to get by without them:

• Skip diet sodas in favor of flavored seltzer water.

• Use naturally sweet substitutes, such as blueberries instead of brown sugar on your morning oatmeal.

• Read the nutrition facts and ingredient labels on foods so that you can select the lowest-sugar alternative and avoid products with sugar substitutes.

If you’re following a diabetic diet, it’s smart to familiarize yourself with all of the sweetener options and choose the ones that best suit your taste and lifestyle. And, of course, talk to your doctor about any questions or concerns you have.