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- Sugar substitutes add sweetness with little effect on blood sugar, helping manage blood sugar levels.
- Natural options like stevia, monk fruit and allulose are low-calorie and gentle on blood sugar.
- Artificial sweeteners like sucralose and aspartame can be safe in moderation but may affect gut health.
Blood sugar is a hot topic in the nutrition world—and for good reason. About 100 million Americans have prediabetes, which means they have elevated blood sugar levels that are not quite high enough to be classified as diabetes. Another 38 million people in the U.S. are living with diabetes. Whether you’re managing a diagnosis or aiming to prevent one, stabilizing blood sugar is key to feeling your best. Eating too many carbohydrates at once—especially quick-digesting ones like added sugars—can cause sharp spikes and crashes in blood sugar. If you’re looking to cut down on your added sugar intake but still enjoy the occasional sweet bite, you may want to learn more about sugar substitutes.
How Sugar Substitutes Affect Blood Sugar
“Regular sugar is a carbohydrate which can cause blood sugars to go up, which is a normal part of carbohydrate digestion,” adds Sheila Patterson, RD, CDCES, registered dietitian and certified diabetes educator. Janelle Bober, M.S., RDN adds, “Sugar substitutes provide the sensation of sweetness without digestible carbohydrates, so they minimally impact glucose and often don’t have any calories or carbohydrates associated with them.”
Sugar substitutes are often used in place of regular sugar to cut down on calories and carbohydrates. Popular options like stevia and aspartame can offer a sweet taste without the same impact on blood sugar. In this article, we break down the latest research on popular sugar substitutes and share what you need to know to make informed choices for better blood sugar management.
Natural Sugar Substitutes
Natural sugar substitutes refer to those that come from plants. They are generally very low in calories and do not raise blood glucose the same way that consuming sugar does. “Allulose stands out slightly ahead of other natural sugar substitutes in terms of blood sugar levels,” Patterson notes. They’re all considered fairly neutral, potentially even beneficial for blood sugar, adds Bober. That said, their flavor can differ from traditional sugar, and some people may experience digestive symptoms from consuming them, so picking one that you like and using it in moderation is key.
Stevia
Stevia is a natural sweetener that’s derived from a stevia plant, and it is about 200 to 400 times sweeter than sugar. Patterson notes, “since it has a higher level of sweetness, the portion you use may need to be adjusted or reduced compared to regular sugar.” A recent meta-analysis looked at stevia’s impact on blood glucose found that it was associated with significantly lower blood glucose levels, especially for people with diabetes, high blood pressure or a higher body-mass index (BMI). Patterson says, “stevia can be used as a sugar substitute with drinks like coffee or hot or iced tea along with using it was a baking substitute.”
Monk fruit
Monk fruit is another natural sweetener named after the plant it’s derived from, and it’s another option that’s significantly sweeter than regular sugar. This means you can use much less because it’s so naturally sweet. Monk fruit extract may even have some anti-inflammatory and antioxidant properties. Additionally, researchers have found that monk fruit does not raise blood glucose and stimulate insulin the way that table sugar does, and has a very minimal impact on blood sugar levels.
Allulose
“Allulose is a sugar found naturally in foods like figs, raisins and maple syrup. It’s absorbed in the small intestine, but most of it is typically excreted through our urine,” notes Bober. Researchers have found that in both rats and humans allulose leaves the body when we pee and poop, meaning we don’t digest it and absorb calories.
Allulose may also help slow down the digestion and absorption of glucose. Consuming allulose with a meal may help lower blood sugar levels after that meal, compared to just the meal without allulose.
Erythritol
Erythritol is a sugar alcohol which is made from a commercial fermentation process. It’s also mostly excreted in urine, so does not contribute meaningful calories or sugar to the diet. Research has consistently found that erythritol has minimal impact on blood sugar levels in humans. In animal studies, rats that were given erythritol alongside glucose had slower increases in blood sugar and a more favorable insulin response compared to those given glucose alone. While similar effects haven’t been shown in human studies, erythritol remains a low-impact sweetener when it comes to blood sugar. Replacing added sugar with erythritol may help support better blood sugar management, though more research is needed to fully understand its health impacts.
Artificial Sugar Substitutes
Sugar substitutes like sucralose, aspartame and saccharin are those yellow, blue and pink packets that you’ll typically see at coffee shops and diner tables. “None of the artificial sweeteners raise blood glucose, so from a diabetes management standpoint, I think all of them are safe options,” states Bober. Patterson notes that these sweeteners can help you cut down on your added sugar intake and, “the best artificial sweetener is one that you can use in moderation to provide a sweet taste.” Here’s what the research says on how these sugar subs impact blood sugar.
Sucralose
The research on sucralose and blood sugar is a little bit mixed. Overall, Patterson points out, “studies reflect that sucralose, first approved by the FDA in 1998, is not well absorbed and does not impact post-meal blood sugar levels.” A randomized-controlled trial that gave people sucralose or a placebo for 30 days found that the sucralose led to a significant decrease in insulin sensitivity. Researchers think it might be that sucralose inflames the gut which may affect insulin signals in your body. Other studies have found no impact on blood glucose or insulin for those consuming sucralose over two weeks. More research is needed to clarify these findings.
Aspartame
Aspartame is a chemical sweetener that’s been used since the 1970s, and is one of the most studied food additives. When people were given aspartame for two weeks, researchers noticed no impact on glucose metabolism or insulin sensitivity. A more recent review that looked at aspartame’s impact on blood sugar and insulin response found that it had little to no effect on glucose metabolism in the body. These findings suggest it could be a helpful option for those trying to reduce their added sugar intake and better manage their blood sugar levels.
Saccharin
“Saccharine hasn’t really been proven to have an impact on blood sugar in healthy adults, though some studies indicate it can impact fasting blood glucose,” notes Bober. While some research shows no effect, one recent randomized controlled trial did find a glycemic response to saccharin, possibly due to changes in the gut microbiome. “The main impact we see is that it can alter gut bacteria, which may indirectly lead to glucose intolerance and increased blood sugar levels over time,” adds Bober. Experts believe that certain individuals may be more sensitive to non-nutritive sweeteners like saccharin, depending on how their gut microbiome responds.
Other Tips for Healthy Blood Sugar Levels
- Increase your fiber intake: Fiber is found in foods like whole grains, fruits, vegetables, legumes, nuts and seeds. It is digested slowly, which helps blunt the blood sugar response in your body.
- Eat protein with your carbs: Protein has minimal impact on your blood sugar, and it is also digested more slowly like fiber, which can help it balance out the carbohydrates you eat. Pair rice with chicken, pasta with pork, quinoa with tofu and add some vegetables for a complete meal.
- Get enough sleep: Sleep deprivation is lined with poor glucose control and reduced insulin sensitivity. On the flip slide, getting enough sleep may improve blood glucose levels for both people with or without diabetes.
- Walk after meals: Those after-dinner walkers are onto something. Moderate exercise after eating helps lower your blood sugar. Try a 15 minute walk about 15 minutes after eating.
Our Expert Take
Managing blood sugar is an important part of overall health, especially for people with diabetes. Sugar substitutes can be an effective way to cut down on your added sugar intake while still enjoying something sweet. Beyond alternative sweeteners, balance your eating pattern with fiber and protein, move your body and aim for a good night of sleep for better blood sugar management.
Patterson adds, “If someone prefers to use small amounts of regular sugar, it is still possible to have healthy blood sugar levels.” If you do use sugar substitutes, even though they are calorie free and sugar-free, you still want to use them judiciously. “Try to mitigate your preference for sweet foods by lowering consumption of them overall,” notes Bober. She emphasizes eating a balanced diet featuring vegetables, fruits and whole grains over relying on ultra-processed foods.
