The Most Dangerous Sweeteners for Diabetes

by David Mendosa Patient Advocate

Sugar is the worst stuff that you eat or drink. It’s not good for anyone, but it’s especially dangerous for anyone who has diabetes. It raises our blood sugar and increases our weight without giving us any nutrients in return. Sugar is insidious too because it’s disguised under at least 56 different names.

Sugar bowl on the kitchen table.

Remove the table sugar from your table

What we call “table sugar” is one of the worst sugars, sucrose. It's actually comprised of two sugars: fructose and glucose. Fructose is the sugar that our liver metabolizes, which turns into fat when we eat more than the small amount in fruit. Eating excessive amounts of fructose can lead to fatty liver disease and then cirrhosis of the liver.

Corn stalk.

High-fructose corn syrup is even worse

Table sugar comes from sugarcane or sugar beets. High-fructose corn syrup, made from corn stalks by a secret chemical enzymatic process, has about the same ratio of fructose to glucose as table sugar does. Research suggests that overconsumption of simple sugars such as HFCS can increase serum triglyceride levels, which is a risk factor for cardiovascular disease.

Maple syrup bottles.

What about other natural sweeteners?

Besides honey, some of the most common natural sweeteners are maple syrup, molasses, and coconut palm sugar. Natural, of course, doesn’t necessarily mean healthful. Like honey, the main trouble with each of them is that they are about half fructose, according to the USDA’s National Nutrient Database.


Is agave nectar "good for diabetics?"

Sometimes the ads for agave nectar will say that it’s “good for diabetics.” When a doctor told me in 1994 that I have diabetes, that fooled me before I began to write about it in my first book What Makes My Blood Glucose Levels Go Up…and Down? Agave nectar, which is sometimes known as agave syrup, does have a low glycemic index because it is almost totally sugar.

Pink tablets.

Some sugars aren’t sweeteners

The names of typical natural sugars end with the suffix -ose. In addition to fructose and sucrose, the most common one is glucose (dextrose). While our bodies handle glucose with less trouble than fructose or sucrose, any glucose we eat is very fast acting, spiking our blood sugar. That’s why some people use glucose tabs when they go hypo. The other common natural sugar, lactose, comes from milk. But sucrose and fructose are the only sugars used as added sweeteners.

Artificial sweeteners in a cup.

If natural sugars are so bad, can artificial ones be better?

The U.S. FDA has approved 6 artificial sweeteners. The main ones are sucrose (Splenda), saccharin (Sweet ’n Low, etc.), and aspartame (NutraSweet, Equal, Sugar Twin). The others are acesulfame potassium, neotame, and advantame, each made chemically to be many times sweeter than sugar. They usually have a few calories from bulking agents. The FDA says that they are safe, but they remain highly controversial.

Sugar in a bowl.

Sugar alcohols can be good alternative sweeteners

Sugar alcohols aren’t sugar and they aren’t alcohol either. They are a type of carbohydrate known as polyols. Of the eight sugar alcohols that the FDA regulates, xylitol is the most common and is about as sweet as table sugar but has about 60 percent of its calories. Large amounts of xylitol can cause digestive problems, such as bloating, cramping, and gas. Erythritol is 60 to 80 percent as sweet as sugar, has the fewest calories, and doesn’t cause stomach distress.


A natural sweetener without calories

The best sweeteners are natural ones that don’t have any calories. They don’t therefore have any carbohydrates and their glycemic index is zero. It may sound too good to be true, but it’s for real. Stevia, extracted from the leaves of the stevia plant (Stevia rebaudiana), is readily available from many sources and can be found in either powdered or liquid form without any bulking agent. You can also buy organic stevia.

Monk fruit.

The alternative to stevia

Some people don’t like the taste of stevia. For them the best sweetener may be monk fruit or Luo Han Guo, which is an extract from the Siraitia grosvenorii fruit. But it’s considerably more expensive than stevia and is generally only available as Monk Fruit in the Raw, which uses maltodextrin as a bulking agent. I like stevia and monk fruit, but I use much less stevia to get equivalent sweetness.

David Mendosa
Meet Our Writer
David Mendosa

David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.