Sweeteners and diabetes
Artificial sweeteners that contain either saccharine, aspartame or acesulfame potassium (acesulfame K, Ace K) are suitable for use by people with diabetes as a replacement for sugar as they are very low in calories and do not affect blood glucose levels.
Examples of products which contain these sweeteners include Hermesetas, Flix, Natrena, Canderel, Sweetex, Sweet’N Low, and NutraSweet. These products are available in tablet and/or powder form. Add sweeteners after cooking as heat can change their taste.
Products Which Are Not Recommended For People With Diabetes
Some sweeteners contain sugar (e.g. Sucron, Half Spoon) and should not be used by people with diabetes as an alternative to sugar. Sugar substitutes (e.g. sorbitol, fructose) are high in calories and in large amounts can cause diarrhoea, and therefore these are also not recommended.
Foods containing sorbitol, xylitol, fructose or mannitol are not recommended for people with diabetes, in part because they are expensive, but also because they are often high in calories and can still cause a rise in blood glucose and blood fats.
Polyols, such as xylitol, sorbitol, maltitol and isomalt are usually used in significant quantities in manufactured foods. They have been used as a substitute for sucrose in products such as chocolates, confectionary, biscuits and chewing gum and most are labelled as sugar free. This can be perceived as being healthier and often consumers do not realise that these foods still contain significant amount of CHO, calories and fat. Hence they need to be accounted in the daily nutritional intake.
Polyols have a slightly lower glycaemic response than sucrose and provide less energy 2.4kcal /g compared with 3.75kcal/g of other sugars due to incomplete digestion and absorption. But most polyols are only half as sweet as sucrose, twice as much is needed to provide the same intensity of sweetness and thus negating any energy saving. Products containing polyols are safe to consume but should be eaten in moderation. Excessive consumption >30g /day can cause gastrointestinal side effects. Some individuals are particularly sensitive and vary in their tolerance and may experience stomach cramps, flatulence and osmotic diarrhoea at smaller quantity.
Polyols are less likely to cause dental decay than sucrose and have value as sugar substitute in some products. But other potential long term benefit still need to be established and current recommendation states that the use of polyols does not offer any special benefit to people with diabetes.