Sugar Substitutes for Diabetes: The Options and Their Safety

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In an effort to reduce blood glucose levels, many diabetics turn to sugar substitutes. Several artificial sweeteners, along with some natural sweeteners, can be a safe sugar substitute for diabetes. Alternative sweeteners generally have little to no affect on glucose levels, are low calorie and much sweeter than an equal amount of sugar. Less of the substitute needs used to have the same level of sweetness.

Types of Sugar Alternatives

The Food and Drug Administration has approved six sugar substitutes for use in the United States: aspartame, saccharin, sucralose, ace K (acesulfame potassium), neotame, and Reb-A, a purified product made from the herb, stevia.


Aspartame was FDA approved in 1981, and is commonly sold under the brand names NutraSweet and Equal. Aspartame can be a safe part of a diabetics diet, as it is 200 times sweeter than sugar. Aspartame loses sweetness in heat and during storage, making it less viable as a baking or cooking alternative. People with phenylketonuria, or PKU, cannot metabolize aspartame and should avoid foods containing it.


Saccharin is the oldest of the FDA-approved artificial sweeteners, receiving its approval before 1958. It is commonly sold under the brand name Sweet’N Low. This sugar substitute does not convert to glucose and is up to 700 times sweeter than sugar. It is considered safe for diabetics. The heat stable sweetener can be used in baking and cooking. Those on a low sodium diet may want to avoid sodium forms of saccharin. Safety for use in children and pregnant women has little research.


The FDA approved sucralose in 1998 for use as an artificial sweetener. Sucralose is sold as Splenda and ranks 600 times sweeter than sugar. It can be used in cooking and baking. Sucralose doesn’t affect glucose levels, making it safe for diabetics. The FDA approved sucralose for use for anyone.


Receiving approval in 1988, ace-K is sold as the artificial sweetener Sweet One, DiabetiSweet and Sunett. Diabetics can safely use ace-K and it is heat stable for cooking and baking. The sweetener has 200 times the sweetness of sugar. Like the other sugar substitutes, ace-K is considered safe for use in moderation.


While neotame received approval in 2002, it is only currently available in processed foods. The sweetest of the artificial sugars, neotame is 7,000 to 13,000 times sweeter than sugar. Like the other sweeteners, it doesn’t affect glucose levels and is considered safe for diabetics.

Reb-A or Stevia

Reb-A was approved for use in 2008. The sweetener is derived from the stevia plant, which has a history of use as a supplement and sweetener. Commonly sold as Truvia, SweetLeaf and PureVia, reb-A can be used in cooking and baking. Reb-A is considered safe for diabetics.


While sugar substitutes for diabetes are considered safe, other concerns over the use of artificial sweeteners exist. Studies show that in the recommended doses the sweeteners are safe and non-carcinogenic. Long-term use has not been studied on the newer types of sweeteners and diabetics should speak to their health care provider or nutritionist about using them.

References Sugar Substitutes: What You Need to Know

AgriLIFE Extension: Sugar Substitutes

Joslin Diabetes Centers: Artificial Sweeteners