Department of Nutrition and Dietetics Diabetes: Sweeteners

Patient Information

Sweeteners can be used as an alternative to sugar in drinks, on cereals, in desserts and baking. They are also used in the manufacturing of sugar-free products such as sweets, diabetic products, diet and sugar-free drinks, light/diet yoghurts and sugar-free squashes. Many sweeteners are available, and some are better for blood glucose levels than others.

Sweeteners that don’t increase blood glucose can be used as part of a healthy diet for diabetes These are calorie free and will not affect blood glucose levels. They are available in different forms including tablets, powders and granules. The granulated types are designed to replace sugar spoon for spoon, but they weigh much less than the corresponding amount of sugar.

Examples of brands of artificial (low calorie) sweeteners include:

 Supermarket own brands  Canderel

 Sweetex  Stevia

 Sweet n Low  Silver Spoon

 Hermesetas  Splenda

 Truvia  Saccharin

These sweeteners contain saccharin, aspartame, sucralose, acesulphame K, cyclamate and steviol as their main ingredients.

Sugars and sweeteners which increase blood glucose levels are best limited, even if they are labelled ‘suitable for diabetics’

Patient Information

Sugars are all types of carbohydrate that can affect blood glucose levels. They can also affect weight and blood fats if eaten to excess. There is no advantage for people with diabetes in using one type of sugar over another.

Examples of sugars include:

 All types of white and brown sugar  Honey

 Invert sugar  Corn, maple and golden syrup

 Treacle and molasses  Fructose

 Barley malt  Rice syrup

 Maltose  Lactose

 Glucose, glucose syrup and  Agave nectar glucose-fructose syrup

Sugar blends are a mixture of sugar and artificial sweeteners. Because they do contain some sugar, they contain calories and will affect blood glucose levels to some extent.

Examples of sugar blends/sugar substitutes include:

 Silver Spoon Half Spoon  Tate & Lyle Light at Heart

 Silver Spoon Truvia Baking Blend  Splenda Sugar Blend

 Sucron

Sugar alcohols (polyols) are often used in foods labelled as ‘suitable for diabetics’. These sweeteners generally contain calories and some carbohydrate, so will still affect blood glucose, though to a lesser extent than sugar.

Consuming large amounts of polyols can have a laxative effect, causing bloating, flatulence and diarrhoea. Foods marketed as “diabetic” or “suitable for diabetics” can also be high in fat, so we do not recommend these products.

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Examples of polyols include:

 Lactitol  Maltitol

 Mannitol  Sorbitol

 Xylitol  Polydextrose

 Isomalt  Palatinite

 Erythritol* (contained in Truvia in  Polyol syrup UK)

 Hydrogenated starch hydrolysates (HSH)

*Erythritol has virtually no calories and may be less likely to cause stomach upset compared to the other polyols.

It’s not clear how the polyols should be counted by people who are adjusting their insulin dose according to the carbohydrate they consume, as not all of the carbohydrate from polyols is absorbed.

Cooking and baking with sweeteners  You could follow a traditional recipe, but try adapting your recipe to cut calories, fat and sugar. Although there is a certain amount of trial and error involved, many baking recipes work even when the amount of sugar in the recipe is reduced by half.  Recipes such as fruit cake, scones or tea breads can be made without sugar as they do not need sugar for bulk like sponge cakes do. Dried fruit will add some sweetness.  Satisfactory baking results can be achieved using some of the intense sweeteners if the manufacturer’s instructions are followed. See below for details.  Foods such as porridge, custard, milk puddings and stewed fruit can be sweetened with granulated sweeteners. Non-heat resistant sweeteners should be added after cooking as they can turn bitter or lose their sweetness during cooking.  Remember that most puddings and cakes are usually high in fat and calories as well as sugar, and should be limited as part of a healthy diet.

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Sweeteners such as Hermesetas, Splenda, Sweet n Low and Truvia can be used for baking and have guidance on their websites: www.splenda.co.uk www.hermesetas.com www.sweetnlow.com www.truvia.com

Safety All sweeteners on sale in the UK have been thoroughly tested for safety up to a level well beyond a reasonable daily intake. Further information on the safety of sweeteners is available from Diabetes UK (www.diabetes.org.uk, or Tel: 0345 123 2399)

People who have the metabolic disorder phenylketonuria (PKU) should avoid aspartame.

Further Information The information has been produced by Coventry and Rugby Dietitians, University Hospitals Coventry & Warwickshire NHS Trust. If you would like further information, you can contact the team on: 024 7696 6161.

The Trust has access to interpreting and translation services. If you need this information in another language or format please contact 024 7696 6161 and we will do our best to meet your needs.

The Trust operates a smoke free policy

Document History Department: Dietetics Contact: 024 7696 6161 Updated: September 2019 Review: September 2021 Version: 8 Reference: HIC/LFT/254/06

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