The 9 Best Sugar Substitutes for People With Type 2 Diabetes
When it comes to blood sugar and weight management, not all sugar substitutes are created equal. Find out which option is the best fit for your health goals.
Everyone likes a little something sweet and now and again. But if you have type 2 diabetes, you also need to keep tabs on how many carbohydrates, including sugar, you’re eating.
That’s where sugar substitutes come in. They offer that same sweet taste, but because they contain few to no calories, they don’t raise your blood sugar levels as quickly, if at all.
Sugar substitutes come in two varieties:
Nutritive (or caloric) sweeteners: These provide some calories and can raise your blood sugar.
Nonnutritive sweeteners (sugar substitutes or artificial sweeteners): These provide very few or no calories and will not raise your blood sugar. They are many times sweeter than sucrose (table sugar).
Safe Sugar Substitutes for People With Diabetes
Using artificial sweeteners is considered a safe way to help control blood sugar levels — and today, there are more choices than ever.
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Here are nine low- or no-calorie sugar substitutes to consider when you have type 2 diabetes:
1. Sucralose (Splenda), the Most Popular Sugar Substitute
This sweetener is excellent for people with type 2 diabetes. Splenda is about 600 times sweeter than sugar, but it doesn’t affect your blood sugar levels, says Keri Glassman, RD, CDN, of Nutritious Life, a nutrition practice based in New York City. (Sucralose also happens to be the most popular sweetener on the market.)
That’s not to say you can eat an infinite amount, though: The U.S. Food and Drug Administration (FDA), which has approved sucralose, sets the recommended limit for sucralose at 23 packets per day.
2. Saccharin (Sweet’N Low), the Oldest Artificial Sweetener
Saccharin, the sweetener sold in pink packets under the brand name Sweet’N Low, is calorie-free and about 200 to 700 times sweeter than sugar. While it’s only been used as a food additive since 1977, it was first discovered in 1879.
If you’ve been using artificial sweeteners since the 1970s, you may remember a previous warning label about saccharin increasing the risk of bladder cancer. But rest assured, it’s safe. The research that prompted the label was done on animals, and further studies by the National Toxicology Program of the National Institutes of Health concluded that saccharin shouldn’t be on the list of potential carcinogens. Saccharin is FDA-approved.
The FDA sets the recommended limit for saccharin at 45 packets per day.
3. Aspartame, a Low-Calorie Sweetener That’s Not Okay for People With PKU
Aspartame, sold in blue packets under the brand names Equal and NutraSweet, is a nonnutritive artificial sweetener that is about 200 times sweeter than sugar, according to the FDA. While not zero-calorie like some other artificial sweeteners, aspartame is still very low in calories.
While the FDA has reviewed the scientific research and determined that aspartame is safe to eat, Glassman notes that there have been some conflicting study results regarding this sweetener’s safety. The International Agency for Research on Cancer, for example, labeled aspartame as “possibly carcinogenic to humans,” but other scientific agencies, such as Health Canada and the European Food Safety Authority consider it to be safe when consumed at the advised levels.
Nevertheless, people with phenylketonuria (PKU), a rare condition in which they are unable to metabolize phenylalanine (a key component of aspartame), should not consume this sugar substitute. If you don’t have PKU, aspartame is safe to consume in moderation.
The FDA sets the recommended limit for aspartame at 75 packets per day.
4. Stevia (Truvia or Pure Via), a Natural Sweetener Option
Steviol glycosides are sweeteners derived from the leaf of the stevia plant, which is native to South America. Truvia and Pure Via, both brands of stevia-based sweetener, are calorie-free, and stevia is often used as a sweetener in foods and beverages.
Like other nonnutritive sweeteners, stevia has little to no impact on blood sugar. The FDA has approved the use of certain stevia extracts, which it has generally recognized as safe (a term that is applied to food additives that qualified experts deem as safe, which are therefore not subject to the usual premarket review and approval process).
People have reported side effects, including gastrointestinal symptoms, after eating high amounts of stevia. But to date, there is no solid scientific research to prove these claims.
The FDA recommends limiting your stevia intake to 27 packets per day.
5. Sugar Alcohols, a Low-Calorie Option for Sweetening Your Fare
Sugar alcohols, or polyols, are derived from the natural fibers in fruits and vegetables. Commonly used sugar alcohol sweeteners in many so-called “sugar-free” desserts, candies, and gums include:
Xylitol
Sorbitol
Mannitol
Isomalt
Lactitol
Though sugar alcohols are relatively low in calories and more blood sugar–friendly than carbohydrates, they may have a laxative effect and cause indigestion, bloating, and diarrhea in some people. Products containing sorbitol and mannitol must bear a label warning that excess consumption can have a laxative effect.
The gastrointestinal symptoms arise because sugar alcohols are not completely absorbed in the digestive tract, says Lynn Grieger, RDN, CDCES, a medical reviewer for Everyday Health who’s based in Prescott, Arizona. She explains that unabsorbed carbohydrates from these sweeteners pass into the large intestine, where they are fermented by gut bacteria to produce gas. See how you respond to a small amount before incorporating them into your daily diet.
Also, keep in mind that sugar alcohols do contain some carbohydrates and are nutritive sweeteners, so they can affect blood sugar levels.
“It’s important for people with diabetes to read the nutrition facts label for total carbohydrate content and plan accordingly,” says Grieger. “Remember that the information in a nutrition facts label is based on one serving, and it’s easy to eat more than one serving of foods that contain sugar alcohols, which can increase the total carbohydrate consumed.”
6. Erythritol, a Sugar Alcohol With Fewer Side Effects Than Other Options
Erythritol is also a sugar alcohol, but unlike some of the other options, it contains almost no calories and doesn’t seem to affect blood sugar or insulin levels. It’s an ingredient in the stevia-derived sweetener Truvia, and it’s marketed under the brand name Swerve.
If other sugar alcohol sweeteners give you tummy trouble, this may be a better option for you. It is less likely to produce the gas, bloating, and diarrhea that happen from fermentation by gut bacteria, since only a small amount of the erythritol you consume enters the colon.
There’s no recommended limit for erythritol, but the FDA hasn’t questioned notices submitted by erythritol makers that the sweetener is “generally recognized as safe.” However, use caution when consuming erythritol. Recent studies have found an increased risk of heart attack and stroke. The research states that long-term studies are necessary.
7. Monk Fruit Sweetener, Another Natural Option for Sweetening Your Foods
Monk fruit extract is a natural, zero-calorie sweetener derived from the fruit of the plant Siraitia grosvenorii, which is native to southern China. It is 150 to 200 times sweeter than sugar.
Popular brands include Monk Fruit in the Raw and Lakanto. The FDA has not questioned notices submitted by monk fruit sweetener makers that the extract is “generally recognized as safe.” The agency doesn’t specify a recommended limit for monk fruit sweetener.
8. Acesulfame Potassium, a Popular Sugar Substitute in Diet Soda
Also known as Ace-K, this nonnutritive sweetener is an FDA-approved sweetener that’s about 200 times sweeter than sugar. Often, manufacturers combine it with other sweeteners, though it is also sold for tabletop use under the brand name Sweet One. You will also find it in popular diet soft drinks.
Some research involving mice has suggested possible issues with Ace-K, including one study that concluded that consumption of Ace-K led to an imbalance of flora in the gut microbiome. Another study — this one focused on humans — theorized that large quantities in pregnant women may lead to early delivery.
The FDA recommends limiting your use of acesulfame potassium to 23 packets a day.
9. Allulose (Dolcia Prima), a New Artificial Sweetener That’s No Longer Considered an Added Sugar
Allulose (also known as D-allulose or D-psicose) is a low-calorie sweetener that occurs naturally in small amounts in wheat and fruits and is marketed under the brand name Dolcia Prima.
It has 90 percent fewer calories than sucrose but is about 70 percent as sweet. Plus, it doesn’t affect your blood sugar or insulin levels.
While allulose isn’t on the list of FDA-approved sweeteners, the agency hasn’t questioned notices submitted by manufacturers that the sweetener is “generally recognized as safe.” It isn’t approved for use, though, in Canada or Europe.
One Last Thing About Using Sugar Substitutes When Managing Type 2 Diabetes
Even if you do choose a calorie-free sweetener, you should still enjoy sugar substitutes in moderation. It’s thought that sugar sweeteners may trick our bodies into craving more sweets later on, which could lead to weight gain. Moreover, some research has found that sugar substitutes have been linked to higher rates of heart disease and suggests that the best idea is to try to lower our consumption of all sugars, including sugar substitutes.
“A major goal should be to reduce all types of sweeteners in your diet, including sugar substitutes, so that you become accustomed to the naturally sweet taste of food,” says Grieger. Then trust your body to tell you when enough is enough.
The Takeaway
Sugar alternatives can satisfy your craving for something sweet without destabilizing your blood sugar levels.
Sugar substitutes include nutritive (caloric) and nonnutritive (noncaloric) sweeteners.
Some popular sugar substitutes include aspartame, saccharin, sucralose, and stevia.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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Witkowski M et al. The Artificial Sweetener Erythritol and Cardiovascular Event Risk. Nature Medicine. March 29, 2023.
Yeung AWK. Bibliometric Analysis on the Literature of Monk Fruit Extract and Mogrosides as Sweeteners. Frontiers in Nutrition. August 20, 2023.
Hanawa Y et al. Acesulfame Potassium Induces Dysbiosis and Intestinal Injury With Enhanced Lymphocyte Migration to Intestinal Mucosa. Journal of Gastroenterology and Hepatology. August 8, 2021.
Chiang Y-F et al. Consumption of Artificial Sweetener Acesulfame Potassium Increases Preterm Risk and Uterine Contraction With Calcium Influx Increased via Myosin Light Chain Kinase–Myosin Light Chain 20 Related Signaling Pathway. Molecular Nutrition & Food Research. August 20, 2022.
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Reyna Franco, RDN, is a New York City–based dietitian-nutritionist, certified specialist in sports dietetics, and certified personal trainer. She is a diplomate of the American College of Lifestyle Medicine and has a master's degree in nutrition and exercise physiology from Columbia University.
In her private practice, she provides medical nutrition therapy for weight management, sports nutrition, diabetes, cardiac disease, renal disease, gastrointestinal disorders, cancer, food allergies, eating disorders, and childhood nutrition. To serve her diverse patients, she demonstrates cultural sensitivity and knowledge of customary food practices. She applies the tenets of lifestyle medicine to reduce the risk of chronic disease and improve health outcomes for her patients.
Franco is also a corporate wellness consultant who conducts wellness counseling and seminars for organizations of every size. She taught sports nutrition to medical students at the Albert Einstein College of Medicine, taught life cycle nutrition and nutrition counseling to undergraduate students at LaGuardia Community College, and precepts nutrition students and interns. She created the sports nutrition rotation for the New York Distance Dietetic Internship program.
She is the chair of the American College of Lifestyle Medicine's Registered Dietitian-Nutritionist Member Interest Group. She is also the treasurer and secretary of the New York State Academy of Nutrition and Dietetics, having previously served in many other leadership roles for the organization, including as past president, awards committee chair, and grant committee chair, among others. She is active in the local Greater New York Dietetic Association and Long Island Academy of Nutrition and Dietetics, too.
Sheryl Huggins Salomon has spent her career equipping people with information to help improve their well-being and prospects in life. She is a veteran journalist and editor who has covered topics as varied as health, politics, business, history, genealogy, lifestyle, and justice. In addition to writing for Everyday Health, she has written and edited for publications such as The Root, NewsOne.com, and AOL Black Voices. She was co-editor of The Nia Guide series of self-help books, including Choosing Health and Wellness and other titles about work-life balance and career success.
At Columbia Journalism School, Huggins Salomon received the Cowan Award for Excellence in the study of publishing. She is also a communicator in the field of poverty policy and research. Aside from journalism, her passions include running, fitness, and healthy living.
