The world of sugar substitutes and type 1 diabetes can be confusing. There is a lot of conflicting information out there due to the lack of long-term human research. Whether you use them or avoid them, this guide on sugar substitutes in the UK will explore them in more detail and explain how they work with blood glucose levels.
Sugar substitutes, sweeteners, sugar replacements, sugar alternatives or whatever you like to call them can be a confusing area. There is a lot of conflicting information out there. And like with a lot of health and diet-related products sometimes the headlines can unconsciously sway our opinions.
Naturally, when you are diagnosed with diabetes, sugar takes on a whole new significance in your life, from how you consume it, to using it as a treatment. I started exploring the world of sugar substitutes not long after my daughter was diagnosed with type 1 diabetes. I realised that they had the potential to help support her diabetes management but I didn’t understand if they were safe or could potentially cause other dietary problems. So I needed to explore further.
I delved into the research and information available from reputable websites (which I have shared in the resources at the end of this post). I looked at the sugar substitutes that are available in the UK, their safety, taste profile and what they are like to bake and cook with. But I guess most importantly of all I wanted to understand their individual impacts on blood sugar levels.
In this post, I share the things I have learnt about sugar substitutes available in the UK and diabetes management. What are they and how do sugar substitutes relate to blood glucose levels, rather than looking at this from a health, weight or diet perspective.
What is a Sugar Substitute?
A sugar substitute is a food additive that can either be chemical or plant-based but ultimately has been manufactured to replicate sugar in taste.
These substitutes vary in their nutritive content but ultimately have been used in the food industry to lower the carbohydrate and calorific content of ultra-processed foods. Interestingly a lot of the artificial sweeteners were discovered by mistake by scientists working on fossil fuels! (Spector. T, Food for Life).
Unfortunately, sugar substitutes tend to be lumped into one category and news stories create the narrative of them as either being good or bad for us which can be misleading. Each sugar substitute is totally unique and needs to be considered. These different properties range from how they are made, their intensity of sweetness, and their calorific content to their taste profile and how you use them in cooking and baking.
Artificial Sweeteners – Synthetic Sugar Substitutes
Artificial sweeteners are chemical sugar substitutes that you are probably most familiar with, particularly as they are widely used in ultra-processed food and fizzy diet drinks. The most common and widely available in the UK are Saccharine, Sucralose, Aspartame, and Acesulfame K (AceK).
These sweeteners are generally very low in (or have no) calories due to the very small quantities needed to sweeten food as they are incredibly sweet. so bear in mind that they shouldn’t be used as a 1:1 sugar replacement.
These artificial sweeteners also don’t have a carbohydrate content either so they will not raise blood glucose levels.
Each artificial sweetener in the table below has its own unique taste profile. They will alter the flavours in your food along with changing the aftertaste. Therefore it really just comes down to our individual palettes and preferences as to the ones we favour.
The table below highlights the different profiles and some of the brands you will typically find in the UK.
| Synthetic Sugar Substitute | Carbohydrate per 100g | Potency (x sweeter than sugar) | Available | Brands |
| Acesulfame K (AceK). | 0g | 200 | Usually added to aspartame and sucralose based sweeteners | Canderel, Silverspoon |
| Aspartame | 0g | 200 | Tablets or powder | Supermarket Own, Silverspoon |
| Saccharine | 0.4g | 300 | Tablets or powder | Sweetex, Hermesetas |
| Sucralose | 0.5g | 600 | Tablets or powder | Splenda, Canderel, MyProtein Flavdrops |
- Please note some of the brands listed in the table may use a blend of different artificial sweeteners in their products.
Plant-Based Sweeteners – Natural Sugar Substitutes
So I use the term natural here loosely as even a sugar replacement derived from plants will have to go through some form of processing in order to create the final sugar substitute.
The main plant-based sweeteners available to buy in the UK as products in their own right (rather than in foods) are Erythritol, Stevia and Xylitol
These plant-based sweeteners tend to have a nutritive content (calories) and most, with the exception of stevia, are a 1:1 substitute for sugar.
Every plant-based sugar substitute listed in the table below boasts its own distinct flavour profile, impacting the taste and aftertaste of your dishes. Ultimately, the choice depends on your individual palate and preferences
Interestingly, despite all of them having a carbohydrate content we have found they do not in fact raise blood glucose levels as the body processes the carbohydrate differently. Because of this, we have found that we do not need to carb-count them.
The table below highlights the different profiles and some of the brands you will typically find in the UK.
| Plant-based Sugar Substitute | Carbohydrate per 100g | Potency (x sweeter than sugar) | Available | Brands |
| Erythritol | 100g | 0.7 | Granulated, Icing Sugar | Pure Via, Nkd Living |
| Stevia | 99.4g | 250 | Tablets or powder | Pure Via, Nkd Living, Truvia, Natvia, Splenda |
| Xylitol | 100g | 1 | Granulated, Caster, Icing Sugar | Pure Via, Nkd Living, Bon Raw, Total Sweet |
Sugar Substitutes and Diabetes Management
Sugar substitutes might not be for everyone and it really comes down to personal choice. And I am by no means promoting a sugar-free diet for people living with diabetes. For instance, we still consume sugar and sugary foods but just not regularly. However, in our experience, the use of sugar substitutes in some parts of our diet has allowed back some food freedom for my daughter who lives with type 1 diabetes.
Specifically, I made the switch to using a plant-based sweetener, xylitol, in our baking and desserts. This has meant that it has given back to her an element of choice, has supported her overall diabetes management strategy and she can even enjoy a sweet treat without the need for insulin. (which is a big deal!)
It is worth noting though that some of these products are costly when compared to a bag of sugar and they may take a little time to get used to, particularly when it comes to taste. But through trial and error, which let’s face it food and diabetes are just one big experiment, we have found sugar replacements that we like. We have also found they don’t raise our daughter’s blood glucose levels and have just given us another strategy to use in our overall management toolkit.
If you would like to read more about some of the other changes we have made in our diets to support diabetes management then take a look at these articles:
The Benefits of a Whole Food Diet
This article delves into the concept of a whole food diet and diabetes management. Exploring the potential benefits associated with eating this way, as well as suggestions on how you can incorporate more whole foods into your diet.
Type 1 Diabetes and Our Relationship with Food
This article explores the complex relationship between type 1 diabetes and our diet. Looking at the challenges faced and how our relationship with food can evolve.
Sugar Substitutes and the Impact on blood glucose levels
The Sugar substitutes looked at in this post do not affect your blood glucose levels. In fact, most artificial sweeteners are therefore considered “free foods.” Free foods don’t count as carbohydrates for insulin requirements.
However, something to bear in mind with using any of the sugar substitutes is that we all experience food and metabolise it differently. Each sugar substitute has its own unique properties, which when combined with our individuality means that what works for us may not work for you.
Using Sugar Substitutes in cooking and baking
The sugar substitutes looked at in this post come in a powder or granule form, tablets or liquid. However, it is worth noting that while most of them can be used in hot and cold food, not all are great 1:1 substitutes for sugar. Particularly when it comes to baking, as the end result may not be the same.
Here are some of the differences you may encounter when baking with a sugar substitute:
- Lighter colour – sugar substitutes don’t have the same browning effect as sugar so your bakes may look lighter in colour
- Less rise – Bakes may not have the same rise and may need an extra raising agent. Therefore, you should experiment or just use recipes that have already accounted for this like in my Sweet Treats section.
- Change in texture – They may make your bakes a little drier and denser, consequently, you may need to make some adjustments in your recipes
- Alter taste – All of the sugar substitutes have their own unique taste and sweetness profile. Therefore, It’s just about finding the one you like and playing with the quantity to suit your palette.
Potential Side Effects of Sugar Substitutes
Now I fully appreciate that some of you may have reservations about using sugar substitutes. But the UK’s Food Standards Agency has fully approved all of the sweeteners looked at in this article as safe for consumption, along with many more. The European Food Safety Authority has also supported health claims in relation to oral health and blood sugar level control for xylitol, sorbitol and sucralose.
Nevertheless, there are also some, not-so-pleasant side effects of sugar substitutes. Some of the possible side effects that can be experienced are bloating and diarrhoea. However, these side effects are only associated with usage above the acceptable daily intake (ADI). This daily intake will vary depending on the sweetener you are using and our tolerance of course will also vary from person to person.
However, from a personal perspective, we have not experienced any of these side effects in using xylitol in our cooking and baking. But I am also very careful when creating recipes to ensure that the ratio of sugar substitute to food is within recommended guidelines. In addition, we do not consume more than 1 to 2 servings of a sweet treat at a time.
Using Sugar Substitutes and Diabetes
There really is a lot to think about when it comes to sweeteners and using them in our diet. However, they are safe to use and can in fact be a great additional instrument in your diabetes management toolkit. Because they don’t impact blood glucose levels this has allowed back an element of food freedom which diabetes can take away. But it has also helped to remove some of the worries around the impact of certain foods, dealing with big blood glucose spikes and getting the bolus right!
Through trial and error, we have found sugar replacements that we like and work for us.
If you enjoyed this post or would like to share your experiences of using sugar substitutes please leave a comment below!
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Resources
The truth about sweeteners – NHS (www.nhs.uk)
Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis (who.int)
Approved additives and E numbers | Food Standards Agency
Sugar, sweeteners and diabetes | Diabetes UK
Which Artificial Sweetener Is Right For Me? (diabetes.co.uk)
Suitability of sugar alcohols as antidiabetic supplements: A review, J Food Drug Anal. 2021; 29(1): 1–14.
Nontokozo Z. Msomi,a Ochuko L. Erukainure,b and Md. Shahidul Islam (Suitability of sugar alcohols as antidiabetic supplements: A review – PMC (nih.gov))
Scientific Opinion on the substantiation of health claims related to the sugar replacers xylitol, sorbitol, mannitol, maltitol, lactitol, isomalt, erythritol, D-tagatose, isomaltulose, sucralose and polydextrose and maintenance of tooth mineralisation by decreasing tooth demineralisation EFSA Journal 2011
The Impact of Artificial Sweeteners on Body Weight Control and Glucose Homeostasis, Michelle D. Pang*, Gijs H. Goossens and Ellen E. Blaak Frontiers | The Impact of Artificial Sweeteners on Body Weight Control and Glucose Homeostasis (frontiersin.org) 07 January 2021
Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials
Alexander D. Nichol, Maxwell J. Holle & Ruopeng An European Journal of Clinical Nutrition volume 72, pages796–804 (2018) Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials | European Journal of Clinical Nutrition (nature.com)
Natural Alternative Sweeteners and Diabetes Management – PubMed (nih.gov)
