Artificial Sweeteners, Is it Good For People with Diabetes?

What is Artificial sweetener? 

Artificial sweeteners, also known as non-nutritive sweeteners (NNS), are used as an alternative to sugar for people with diabetes or who want to control weight. These sugar alternatives are marketed as “low-calories”, and “zero sugar” and do not affect blood sugar. They are used in many products, including soft drinks, baked food, and confectionery. However, the safety and benefits of artificial sweeteners are still subject to debate among experts. 

Types of artificial sweeteners

  1. Aspartame

It is a NNS that is around 220 times sweeter than sugar. It is used in diet drinks, sugar-free desserts, gum and candy. People with a condition called Phenylketonuria should avoid aspartame as their bodies are unable to process phenylalanine, which is one of the ingredients of Aspartame. 

  1. Sucralose
    Sucralose is 600 times sweeter than sugar. Due to its stable structure, sucralose is used in a wide range of food and beverage products, from frozen desserts to baked food that require a high temperature. 
  2. Saccharin
    Saccharin is a low-calorie sweetener that is around 300-500 times sweeter than sugar. It has a slightly bitter, unpleasant aftertaste, thus it is often mixed with other non-nutritive sweeteners. 
  3. Sorbitol
    Unlike other NNS, sorbitol falls under a category called “Polytol”, which is a nutritive sweetener. It contains about ⅓ fewer calories than sugar and is used to make sugar-free chewing gums and other food products.
  4. Stevia
    The sweetener is extracted from the stevia leaf and is 300 times sweeter than sugar. It is used in low-calorie beverages and several tabletop sweeteners. However, some people cannot accept it as it has a bitter aftertaste. 
  5. Luo Han Guo extract (Monk fruit extract)
    The monk fruit extract is another sweetener extracted from natural food and is 100 times sweeter than sugar. It is used as a tabletop sweetener, but some people are not a fan of its fruity taste. 

The uses of artificial sweeteners 

  1. To reduce calorie intake and help in weight management
    Normal sugar has 4 kcal per gram, which can contribute to a certain amount of energy intake if consumed every day. Extra energy intake can cause weight gain easily.
    Non-nutritive sweeteners provide a sweet taste without adding many calories due to their high sweetness intensity. This means that people can use them to enjoy sweet food and drink and not worry about the added calories that can contribute to weight gain. 
  2. To reduce the impact of sugar on blood glucose 


Sugar is the nutrient that impacts insulin and affects blood sugar. While sugar substitutes, due to their properties, people only need a little sugar substitute to taste the same sweetness as ordinary sugar. Thus, people with diabetes can still enjoy sweet food without bringing their blood glucose at risk. 

Controversies towards sugar alternative 

Artificial sweeteners and blood glucose

Sugar substitutes are like a savior for people with diabetes and a sweet tooth. The Academy of Nutrition and Dietetics concluded that artificial sweetener does not affect glycemic response in people with diabetes. 

On the contrary, there are also studies reporting the consumption of artificial sweeteners was associated with increased type 2 diabetes risk. This is thought to be due to the way artificial sweeteners interfere with the gut microbiome and affect appetite regulation.

The impact of nonnutritive sweeteners on insulin and blood glucose can be complex and depends on many other factors. They can help people with diabetes to cut down their sugar intake, but regular monitoring may be necessary to avoid potential adverse effects. 

Artificial sweeteners and weight 

By replacing high-calorie sugar with nearly zero-calorie sugar substitutes, we are supposed to lose weight. However, some studies show people’s weight is not reducing but gaining. 

This might be due to the reward system of the body. When we consume natural sugar, a signal will be sent to our brain, which gives us rewards and satisfaction. However, artificial sweeteners do not activate the reward pathway in the same way as natural sugars. The lack of satisfaction may cause people to look for more food. 

Artificial sweeteners and gut health

The gut microbiome is the key factor determining the health of a person.  Artificial sweeteners will not be digested in the human body and will be excreted after consumption. Thus, it is believed that these sweeteners will do no harm to us. However, some claim consumption of non-nutritive sweeteners alters the gut microbiota composition, which affects health. 

Chi et al. demonstrated an experiment on mice and found that feeding neotame to mice, did alter the diversity of gut bacteria in those mice. A human study by Suez et al. also shows healthy adults developed glucose intolerance after consumption of saccharin.

However, another study in Canada showed a different result. They found artificial sweeteners(aspartame and sucralose) did not affect the microbiota of participants. 

More studies are needed to confirm the effect of artificial sugar on gut health. 

Are Artificial sweeteners safe?

People doubted the safety of nonnutritive sweeteners. The US Food and Drug Administration (FDA) has approved 6 NNS – Saccharine, Aspartame, Sucralose, Neotame, Acesulfame-K and Stevia and categorized them under the generally recognized as safe (GRAS) category. 

There is a saying that artificial sweeteners are causing cancers. However, since then, many studies show that sugar substitutes have no link to developing cancers. 

However, certain high-risk populations are not recommended to consume artificial sweeteners. These populations include pregnant and lactating women, migraine, epilepsy patients and children. People with Phenylketonuria (PKU) should avoid aspartame.

The safe practice is, as long as consumed within the acceptable daily intake limit, artificial sweeteners are safe to be consumed. 

Can artificial sweeteners replace sugar? 

Non-nutritive sweeteners are so useful, they are sugar-free, low in calories and cost-effective, choosing them is like a no-brainer. However, artificial sweeteners are not sugar replacements in all cases. Even though they both taste sweet, there is a big difference in the structure. 

For example, natural sugar contributes to caramelization (browning effects on food). They also affect the structure of baked goods, helping to retain moisture and tenderization. Besides, natural sugar can be fermented by yeast, which is an important process in the production of fermented food and drinks, such as bread, beer and wine. Artificial sweeteners do not have all these properties and functions of sugar. 

Guideline for including artificial sweeteners in daily meals

  1. Use in moderation: Artificial sweeteners are considered safe when used in moderation. Excessive consumption might cause unwanted side effects or health problems. 
  2. Do not have the compensation mindset: Do not consume extra calories by having the mindset that “you have saved the calories from using sugar replacement so you have a quota to eat more”
  3. Establish a holistic dietary pattern to maintain weight control, instead of solely relying on low-calorie sweeteners
  4. Read food labels: zero-sugar does not guarantee the quality of the food, always check the food label before buying it 
  5. Consult a healthcare professional: If you have a medical condition or taking medication, it is important to speak with your healthcare provider before using artificial sweeteners as a regular part of your meal. 

It is important to note that while artificial sweeteners can be beneficial, they are not magic solutions. A balanced diet and regular physical activity are still a crucial part in order to manage weight and control blood glucose. 

If you need help, please contact our dietitian in Diet Ideas.

Talk to a dietician
Hello 👋
We have helped over 1000 people improve their health with specialized diets. We hope to help you too! Message us now!