Sweeteners and Diabetes: Natural vs. Artificial Sweeteners for Diabetes 

Introduction

Diabetes is a condition characterized by high blood sugar levels, making it important to carefully monitor sugar and carbohydrate intake. Therefore, managing diabetes is a lot about making smart food choices. Though it is suggested that individuals with diabetes avoid all forms of sweet and sugary foods, that may not always be possible. So, we look for ways to enjoy them in moderation as part of a balanced diet and choose healthy alternatives.  

One such alternative is using sweeteners for diabetics. These are typically used as substitutes for sugar to satisfy a sweet tooth! There’s a large variety of sweeteners available in the market, ranging from natural ones to artificial, often making it confusing to choose the right option. Factors like taste, how quickly a sweetener raises blood sugar, and its overall impact on health play a significant role in selecting the most suitable option. Moreover, as sugar alternatives are becoming popular, it’s important to know which sweeteners are safest for diabetics.  

In this blog, we’ll have a detailed look at these sugar substitutes and their impact on diabetes, compare the natural and artificial ones, and help you choose the best option for managing blood sugar effectively.  

Understanding Sugar Alternatives for Diabetes

Sugar, whether refined or natural, is a type of simple carbohydrate that provides quick energy to the body. It is naturally found in foods like fruits (fructose) and milk (lactose) but is also added to processed foods and drinks as refined sugar.  

Natural sugars like honey contain fructose and glucose, along with beneficial nutrients like fibre, antioxidants, and vitamins. While these are healthier than refined sugars when consumed in moderation, it’s essential to remember that they still contribute to calorie intake. Refined sugar, found in products like table sugar, are often referred to as “empty calories,” because they provide energy without any additional nutrients¹.  

When it comes to individuals with diabetes, it becomes important to watch sugar and carbohydrate intake. For this reason, many turn to artificially produced sugar alternatives or sweeteners used in place of regular sugar. These are generally sweeter than regular sugar, so they are needed only in small amounts to sweeten up your food or drinks. You’ll often find them in products labelled “sugar-free” or “no added sugar.” include sugar alcohols like sorbitol, xylitol, and mannitol and other approved sugar alternatives like aspartame, saccharin, and sucralose. These are used in many products like food, drinks, medicines, and vitamins. 

Using sweeteners for diabetes in your diet may be a good way to manage your health without giving up sweetness, although you must be aware of their pros and cons. 

Understanding Sweeteners

Sweeteners are substances added to food and drinks to make them taste sweet and are often used as substitutes for sugar. These alternatives generally don’t cause a spike in blood sugar levels, which makes them helpful for people with diabetes. They are also low in calories, which might help with weight control². 

Sweeteners can be divided into two main types: natural sweeteners for diabetics, which come from plant sources, and artificial sweeteners, which are generally man-made. 

Natural Sweeteners for diabetics 

Natural sweeteners come from plants and are not made using chemicals or heavy processing. They are found in plants like vegetables, seeds, nuts, roots, and fruits. Common examples are stevia (from the stevia plant), coconut sugar, date sugar, honey, maple syrup, and molasses³. Although better than refined sugar, yet eating too much of natural sugars like honey or maple syrup can increase the risk of type 2 diabetes, health problems, and weight gain³. 

A natural sweetener called Stevia, derived from a South American shrub Stevia rebaudiana, is a popular choice for people with diabetes because it doesn’t have many calories like other natural sweeteners. In fact, stevia tops the list as one of the safest sweeteners for diabetics because it’s natural, has little effect on blood sugar and other potential health benefits too^4,5.   

Artificial Sweeteners for diabetes 

Artificial sweeteners (also called sugar substitutes) are commonly used sweeteners for diabetics. They are generally man-made, though some come from natural ingredients. These sweeteners are much sweeter than regular sugar, some can be up to 13,000 times sweeter, so only a very small amount is needed to sweeten food or drinks. Common examples include aspartame, saccharin, sucralose, acesulfame potassium, and neotame³. 

Artificial sweeteners for diabetes are available in two main types: 

• Nutritive sweeteners like xylitol and sorbitol, which contain some calories. 
• Non-nutritive sweeteners (NNS), which have little to no calories and are often used in sugar-free or “diet” foods and drinks. 

These sweeteners for diabetics are often chosen by people who want to manage their weight, reduce sugar intake, or control blood sugar levels. They don’t cause a big rise in blood sugar and are approved for use as food additives. While artificial sweeteners for diabetes are generally safe when used in moderation, some studies suggest that long-term use of certain non-nutritive sweeteners might affect gut health and how the body responds to sugar³. 

Both types of sweeteners can be useful, but it’s important to pick the one that suits your individual health needs.  

Impact of Sweeteners on Diabetes

Replacing regular sugar with artificial sweeteners or natural ones like stevia, can help reduce overall sugar and calorie intake, as these alternatives provide a sweet taste without adding extra calories. Some of the benefits of using sweeteners for diabetics include: 

1. Blood Sugar Control in Diabetes

When it comes to natural sweeteners like honey, maple syrup, and agave, they may taste sweet, but they also raise blood sugar levels, which may not be ideal for people with diabetes. Stevia, on the other hand, doesn’t spike blood sugar and may even help improve insulin sensitivity, making it a good option for managing blood sugar. Now, artificial sweeteners like aspartame and sucralose don’t raise blood sugar either, since they aren’t real sugars, but some studies hint they may alter insulin levels over time, which could affect long-term blood sugar control³. 

2. Weight Management

Artificial sweeteners² and natural ones like stevia contain little to no calories⁴. For example, a can of soda usually contains around 10 teaspoons of sugar, while an artificially sweetened version has much lesser calories. This can help with weight control while still satiating one’s sweet tooth. And this is an important component when it comes to diabetes management. 

3. Other Potential Health Benefits

Some sweeteners may have other health benefits that are important for diabetes management. For e.g., Stevia, a natural sweetener, is one of the safest sweeteners for diabetics. It doesn’t raise blood sugar levels much and may even help improve insulin sensitivity and lower high blood pressure^4,5. 

Remember, while these sugar alternatives may help control blood sugar levels, it’s important to use them in moderation. 

Comparing Natural and Artificial Sweeteners

Both natural sweeteners for diabetics and artificial sweeteners for diabetes offer alternatives to regular sugar, but they differ in taste, how they affect blood sugar, and their health impact. 

1. Taste 

Natural sweeteners like honey and monk fruit are often preferred for their pleasant taste and lack of aftertaste. Although stevia, which is up to 300 times sweeter than sugar and has a slower onset and longer duration of sweetness, may not appeal everyone’s taste⁴.  

Artificial sweeteners for diabetes like aspartame, saccharin, and sucralose are also much sweeter than sugar, but they may leave a bitter aftertaste that some people find unpleasant⁶. 

2. Glycaemic Response 

Natural sweeteners like honey, agave, and maple syrup, though often considered healthier, still raise blood sugar levels to some extent. In contrast, stevia, which is also a natural sweetener for diabetics, has little to no impact on blood sugar and helps avoid sugar spikes, making it ideal for people with diabetes. In fact, stevia is found to help improve glucose metabolism by promoting insulin secretion, enhancing insulin sensitivity and increasing glucose uptake by muscles^2,5.  

While artificial sweeteners also have a low glycaemic impact, some studies suggest they may affect glucose absorption or insulin secretion in the long run, potentially influencing blood sugar control³. 

3. Health Effects 

Natural sweeteners for diabetics have calories and while they act as a good energy source, they may not have weight loss benefits. Stevia, although a natural extract, not only provides sweetness without calories but also contains beneficial compounds such as antioxidants that can help improve insulin sensitivity and overall health. Stevia is considered one of the safest sweeteners for diabetics due to its beneficial effect on blood sugar levels and obesity. However, impure stevia extracts have been found to cause allergic reactions^4,5. It is therefore crucial to choose high quality products with clear labels and list of ingredients to avoid any such side effects. 

Artificial sweeteners for diabetes, although effective at reducing calorie intake, have been linked to potential changes in gut microbiota and may not support metabolic health as effectively as natural options. Long-term use of some artificial sweeteners might increase the risk of cardiovascular disease and other health issues like cerebrovascular events or cancer⁷. 

How to Choose the Best Sweetener for Managing Diabetes

Choosing the right sweetener, whether natural or artificial, depends on individual needs like taste preferences, glycaemic response, and specific health goals such as maintaining healthy digestion or managing weight. 

Here are five practical tips to help you make your choice: 

• Blood Sugar Response: Sweeteners like stevia are great choices for managing diabetes, as they don’t raise blood sugar levels⁴. On the other hand, artificial sweeteners like aspartame and acesulfame potassium may affect blood sugar control in the long run³. 
• Weight Loss Benefits: For people looking to manage their weight, non-nutritive sweeteners, like sucralose, can be helpful⁸. Stevia is also a zero-calorie sweetener that doesn’t add calories to your diet, which helps reduce overall caloric intake⁴. 
• Digestive Health: Some sugar alcohols like xylitol, sorbitol, and erythritol are commonly found in sugar-free products. While they are lower in calories, they can cause digestive issues like bloating or loose motion if consumed in large amounts⁶. Stevia and other natural sugar are less likely to cause digestive problems, making them a good option if you have a sensitive stomach⁹. 
• Taste Preferences: Sweeteners vary widely in taste. Natural sugars like monk fruit or honey often preferred for their sugar-like sweetness without a bitter aftertaste. Sucralose is another option with a sweetness profile closer to sugar, and fewer aftertaste issues⁶. 
• Safety Concerns: When choosing a sweetener, it’s important to consider personal health conditions. For instance, people with phenylketonuria (PKU) should avoid aspartame¹¹. Additionally, those who want to minimize chemical exposure and are apprehensive of the long-term health effects of artificial sweeteners may prefer natural sweeteners like stevia or monk fruit extract. Sucralose and stevia are typically considered safe for most people when used in moderation^3,4. 

Keep these tips in mind when selecting a sweetener and always talk to your doctor for more personalized advice.  

Conclusion

If you have diabetes, selecting the right sweetener involves balancing factors like glycaemic response, taste preferences, and long-term health benefits. Most sweeteners for diabetes contain calories but they are usually needed in very small amounts. Natural options like stevia are often considered the safest sweeteners for diabetics. Stevia may offer additional benefits, such as being packed with nutrients and phytochemicals while also supporting insulin sensitivity. While both natural and artificial sweeteners can help manage blood sugar levels, its best to use any sweetener in moderation. Always consult a healthcare professional to understand the right choice and amount tailored to your personal health needs. 

Frequently Asked Questions (FAQs)

References

1. Arshad S, Rehman T, Saif S, et al. Replacement of refined sugar by natural sweeteners: focus on potential health benefits. Heliyon. 2022 Sep 20;8(9):e10711. doi: 10.1016/j.heliyon.2022.e10711. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9519493/  

2. American Diabetes Association. Nutrition for Life: Sugar Substitutes [Internet]. 2023 Dec [cited 2025 Apr 14]. Available from: https://professional.diabetes.org/sites/dpro/files/2023-12/sugar_substitutes.pdf 

3. Matcha A, Choudhary AK, Devi R, Kumar A, Kumar S, Kumar V. Artificial sweeteners and their implications in diabetes: a review. Front Nutr. 2024;11:1411560. Available from: https://www.frontiersin.org/articles/10.3389/fnut.2024.1411560/full 

4. Stevia AM. Stevia, nature’s zero-calorie sustainable sweetener: a new player in the fight against obesity. Nutr Today. 2015 May;50(3):129-34. doi: 10.1097/NT.0000000000000094. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4890837/  

5. Peteliuk V, Rybchuk L, Bayliak M, Storey KB, Lushchak O. Natural sweetener Stevia rebaudiana: Functionalities, health benefits and potential risks. EXCLI J. 2021 Sep 22;20:1412-1430. Available from: https://pubmed.ncbi.nlm.nih.gov/34803554/

6. Mooradian AD, Smith M, Tokuda M. The role of artificial and natural sweeteners in reducing the consumption of table sugar: a narrative review. Clin Nutr ESPEN. 2017 Apr;18:1-8. Available from: https://pubmed.ncbi.nlm.nih.gov/29132732/ 

7. Iizuka K. Is the use of artificial sweeteners beneficial for patients with diabetes mellitus? The advantages and disadvantages of artificial sweeteners. Nutrients. 2022 Oct 22;14(21):4446. doi:10.3390/nu14214446. Available from: https://pubmed.ncbi.nlm.nih.gov/36364710/ 

8. Fitch C, Keim KS; Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and Dietetics: use of nutritive and nonnutritive sweeteners. J Acad Nutr Diet. 2012 May;112(5):739-58. doi:10.1016/j.jand.2012.03.009. Available from: https://pubmed.ncbi.nlm.nih.gov/22709780/ 

9. Jiang G. Natural sweetener stevia makes a gutsy comeback [Internet]. Tellus. U.S. Department of Agriculture; [cited 2025 Apr 16]. Available from: https://tellus.ars.usda.gov/stories/articles/natural-sweetener-stevia-makes-a-gutsy-comeback 

10. Newbould E, Pinto A, Evans S, et al. Accidental consumption of aspartame in phenylketonuria: patient experiences. Nutrients. 2021 Feb 23;13(2):707. doi:10.3390/nu13020707. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7926728/  

11. National Cancer Institute. Artificial sweeteners and cancer. [Internet]. Bethesda (MD): National Cancer Institute; [updated 2023 Jun 27; cited 2025 Apr 14]. Available from: https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/artificial-sweeteners-fact-sheet  

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

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