Sugar-based sweeteners like glucose, fructose, sucrose, maltose, molasses, honey, and jaggery should be avoided. Natural fill-ins for refined sugar like brown sugar and maple syrup are better than refined sugar, but they too spike sugar levels and are still unsafe for diabetics. Non-nutritive natural sweeteners like stevia are the best bet. They don’t add calories or heighten sugar levels.
If you have diabetes, you are naturally concerned about the optimal management of blood glucose. Doing away with sugar can be an uphill task. After all, everything you eat ultimately converts and breaks down into sugar! But for a person with diabetes, avoiding or limiting additional sugar intake through foods is vital in managing the condition. Should the intake of refined sugar be avoided completely? What is the best and safest sweetener? Let’s try and answer these questions.
Sweeteners are substances added to foods or beverages to enhance sweetness. These can be grouped into sugar or sugar substitutes and natural or artificial sweeteners
These contain carbohydrates and add to your calorific intake. Glucose, fructose, sucrose, maltose, honey, and molasses or jaggery fall into this category. Doctors usually do not recommend these type of sugars for people with diabetes as it instantly raises blood glucose levels. Glucose especially spikes the blood glucose level in a very short time.
Fructose is a natural sugar found in fruits and people with diabetes are asked to consume these in limited quantities. You may be allowed 1–2 small bananas a day or 1 orange and 1 apple, or a serving of papaya. Fruits that contain high levels of fructose include mango, jackfruit, litchi, figs, and grapes. As a diabetic, you must be careful while consuming these fruits.1 Maltose is usually found in alcoholic drinks like beer and whiskey. This is why doctors recommend that people with diabetes consume alcohol in small, moderate quantities.
Honey is one of the sweetest substances and contains a high percentage of sugar. Diabetics are generally asked to avoid honey altogether. Molasses or jaggery are excellent natural sugars but not recommended for people with diabetes since these are derived from sugar and spike blood glucose levels. Of all the sugars in this group, fructose is safe in moderate quantities.
A Sugar By Any Other Name…
Alternatives to refined sugar (sucrose) include brown sugar, demerara sugar, maple syrup, date syrup and sugar, coconut palm sugar, and agave nectar. While these are natural and definitely better than refined sugar, remember that they can still be unsafe for you. These sugars contain carbohydrates and calories and lead to an instant spike in blood glucose levels.
These are grouped into two types.
- Nutritive sweeteners which add carbohydrates and calories
- Non-nutritive sweeteners which reduce carbohydrates and calories
Nutritive sweeteners include a group called polyols (sugar alcohols) that comprise maltitol, xylitol, sorbitol, and mannitol. You’ll find them in sugar-free chewing gums, diet sodas, and sugar-free cookies and chocolates. These polyols have a laxative effect and also add some amount of carbohydrates and calories. So, while these sweeteners do not cause blood glucose spikes, they must still be consumed in moderation.2
Non-nutritive artificial sweeteners include aspartame, saccharin, sucralose, acesulfame K, and cyclamate. These are approved by the Food and Drug Administration for use as food additives. The American Diabetes Association also maintains that they can be safely used by diabetics in appropriate quantities.3 Non-nutritive artificial sweeteners contain little or no carbohydrates and calories and hence do not affect blood glucose levels. Aspartame and sucralose are safe for cooking as these do not lose their sweetness under the effect of heat. However, remember these are derived from chemical substances, and it is better to control your usage.4
Stevia, The Wonder Plant?
One sweetener which falls into the natural non-nutritive group is derived from the stevia plant and is sweeter than refined sugar and sucralose.5 Stevia can be used for cooking and as a table-top sweetener and is currently considered the safest natural non-nutritive sweetener.6
If you are a person with diabetes, make sure you consult your diabetologist and dietitian to work out your optimal daily intake of sweeteners. This is especially important if you also have an associated kidney or liver condition.
Take heart in the fact that you don’t have to avoid sweet foods completely. An occasional slice of pie or cake is fine! Just remember to balance it out by cutting back on other foods, managing the insulin dosage, and getting some extra exercise.
References [ + ]
|1.||↑||Johnson, Richard J., Mark S. Segal, Yuri Sautin, Takahiko Nakagawa, Daniel I. Feig, Duk-Hee Kang, Michael S. Gersch, Steven Benner, and Laura G. Sánchez-Lozada. “Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease.” The American journal of clinical nutrition 86, no. 4 (2007): 899-906.|
|2.||↑||Wolever, Thomas MS, A. Piekarz, Marjorie Hollands, and Katherine Younker. “Sugar alcohols and diabetes: a review.” Can J Diabetes 26, no. 4 (2002): 356-362.|
|3.||↑||American Heart Association/American Diabetes Association Scientific Statement: Non-nutritive sweeteners, American Diabetes Association.|
|4.||↑||Shankar, Padmini, Suman Ahuja, and Krishnan Sriram. “Non-nutritive sweeteners: review and update.” Nutrition 29, no. 11 (2013): 1293-1299.|
|5.||↑||Goyal, S. K., and R. K. Goyal. “Stevia (Stevia rebaudiana) a bio-sweetener: a review.” International Journal of Food Sciences and Nutrition (2010).|
|6.||↑||Mogra, Renu, and Versha Dashora. “Exploring the Use of Stevia rebaudiana as a Sweetener in Comparison with Other Sweeteners.” Journal of Human Ecology 25, no. 2 (2009): 117-120.|