Navigating the world of sugar substitutes with type 1 diabetes can be overwhelming, especially with lots of conflicting information. This comprehensive guide aims to cut through the noise and explore various sugar substitutes readily available in the UK, focusing on their impact on blood sugar 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.
When you’re living with diabetes, it doesn’t mean having to sacrifice sweetness! While managing blood sugar levels is crucial, if you have a sweet tooth like me, there are still ways to enjoy delicious treats without relying on refined white sugar. For us, the use of sugar substitutes has helped us enormously. This article explores various sugar substitutes readily available in the UK, their impact on blood sugar, and how to incorporate them into your diet.
My Journey With Sugar Substitutes
Naturally, when you are diagnosed with diabetes, sugar takes on a whole new significance in your life. From how you choose to consume it along with it suddenly becoming a treatment mechanism when blood sugars are too low.
I started exploring the world of sugar substitutes not long after my daughter was diagnosed with type 1 diabetes. Soon realising that they had the potential to help support her diabetes management but also that there was a huge limitation in available human research.
I delved into the research and information available from reputable websites,(which I have shared in the resources at the end of this post). My focus was on sugar substitutes that are available in the UK:
- their safety
- taste profile
- whether they could potentially cause other dietary or health problems.
- what they are like to bake with.
- their impacts on blood sugar levels.
In this article, I share what I have learnt about sugar substitutes available in the UK and diabetes management. However from a particular focus on their impacts on blood glucose levels, rather than looking at this from a health, weight or diet perspective. I hope this can help you to make informed decisions about incorporating them into your diet.
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 have ultimately been used in the food industry to lower ultra-processed foods’ carbohydrate and calorific content. Interestingly, many 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 which can be misleading. News stories often incorrectly publish stories without specifying the difference and applying the same narrative across the board. Each sugar substitute is unique and should be considered as such. These different properties range from how they are made, the intensity of sweetness, their calorific content to their taste profile and how you use them in cooking and baking.
Why Choose Sugar Substitutes?
Consuming a large amount of sugar can significantly impact blood sugar control and is not good for our overall health. White sugar substitutes offer several benefits:
- Reduced Glycemic Index (GI): The GI measures how quickly a food raises blood sugar levels. Sugar substitutes often have a lower glycemic index, meaning they cause a slower and smaller rise in blood sugar compared to regular sugar.
- Fewer Calories: Many sugar substitutes contain significantly fewer calories than sugar.
- Dental Health: Some sugar substitutes, like sugar alcohols, may even help prevent tooth decay.
Important Note: While sugar substitutes offer advantages, they shouldn’t be seen as a free pass to consume excessively. It is still essential to minimise your sugar intake and exercise portion control while maintaining a balanced diet. Consulting a registered dietitian or healthcare professional can help you determine the best approach for using sugar substitutes.
Choosing the Right Sweetener
With various options available, selecting the best sugar substitute depends on individual preferences and needs. Here are a few factors for you to consider:
- Sweetness intensity: Some substitutes are much sweeter than others, requiring adjustments in recipe quantities. Examples are most of the artificial sweeteners and liquid sweeteners like stevia and sucralose drops
- Taste profile: Different sweeteners have varying taste characteristics. Experiment to find options that are palatable for you. Also, you may find you prefer one type of sugar substitute in your coffee and another in your baking.
- Availability and cost: Consider where you can easily find the sweetener and its affordability within your budget.
- Potential side effects: Be mindful of any potential digestive issues associated with certain sugar substitutes. Read more on this below.
Remember: Consulting a healthcare professional or registered dietitian is crucial before incorporating new sweeteners into your diet.
Different Types of Sweeteners
There are all sorts of sweeteners available in teh shops and online, from artificial ones to a more natural choice. Understanding what makes each one different can really help you pick the right sweetener for you. It’s all about knowing what fits best with your diet, your health goals, and your needs.
Below is a breakdown of the 3 main categories of sugar substitutes:
Artificial Sweeteners – Synthetic Sugar Substitutes
Artificial sweeteners are chemical sugar substitutes and 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 generally have a very low Glycemic Index or carbohydrate content. This means that generally, they won’t raise blood glucose levels. Very small quantities are needed to sweeten food as they are incredibly sweet, so they shouldn’t be used as a 1:1 sugar replacement. However, some people find their taste artificial or dislike the potential side effects reported.
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.
Please note some of the brands listed in the table may use a blend of different artificial sweeteners in their products.
Sugar Alcohols
Sugar alcohols occupy a unique space in the sweetener world. These naturally occurring or synthetically processed sugars offer a middle ground as they offer the sweetness without the full blood sugar spike of regular sugar. Examples include erythritol, xylitol, sorbitol, and maltitol.
They boast several advantages:
- They contain significantly fewer calories than sugar
- Has a lower impact on blood sugar levels
- Even promotes dental health by inhibiting the growth of cavity-causing bacteria.
However, it’s crucial to remember that sugar alcohols are not entirely calorie-free and can still cause a rise in blood sugar, albeit less significant than table sugar. We have found this varies widely. Where Erythritol and Xylitol do not cause any glucose rises, maltitol always causes a rise does but not as significantly as sugar.
Additionally, overconsumption can lead to digestive problems in some individuals. Therefore, navigating sugar alcohols requires careful consideration of individual needs and a balanced approach within your overall diabetes management plan.
The table below highlights the different profiles and some of the brands you will typically find in the UK.
Natural Sweeteners
So I use the term natural here loosely as even a natural sugar replacement derived from plants will have to go through some form of processing. A plant-based sweetener is typically derived from plant sources like fruits or leaves. These sweeteners can range from calorie-free to containing calories, have variable sweetness intensity and may even offer some nutritional value.
The main natural sugars available in the UK as products in their own right (rather than in foods) are Stevia, Honey, Agave Nectar, Maple Syrup, and Coconut Sugar. In the US Monk Fruit sweetener is also another popular natural substitute that is a zero-calorie sweetener and doesn’t raise blood glucose.
Every plant-based sugar substitute listed in the table below boasts its own distinct flavour profile, impacting the sweet taste and aftertaste of your dishes. Ultimately, the choice depends on your individual palate and preferences
The table below highlights the different profiles and some of the brands you will typically find in the UK.
Sugar Substitutes and Diabetes Management
Sugar substitutes might not be for everyone and it comes down to personal choice. 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 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 less processed sweetener, xylitol, in our baking and desserts. We have found this to be an excellent substitute and has even given back an element of choice, supported her overall diabetes management strategy and means that 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. They may also 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 work for us.
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:
Type 1 Diabetes and Our Relationship with Food
The Benefits of a Whole Food Diet
High vs. Low Glycemic Index of Flour on Blood Sugar Management
Sugar Substitutes and the Impact on blood glucose levels
Managing diabetes often involves making careful choices about the foods and drinks you consume. Whilst focusing on controlling blood sugar levels. Sugar substitutes can be a tempting alternative to traditional sugar, but their impact on blood glucose can vary considerably.
Sugar substitutes can be a useful tool for managing diabetes, but they should not be seen as a free pass to indulge in excessive sweetness. A balanced diet, regular physical activity, and close monitoring of blood sugar levels remain crucial for successful diabetes management.
In addition, something to bear in mind 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 covered in this post come in a powder, 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 and baked goods, 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 to 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.
To read more about Baking with Sugar Substitutes make sure to read the article below:
Baking with Sugar Substitutes
Baking with sugar substitutes for diabetes provides increased flexibility. Learn how you can bake with sweeteners with confidence!
Potential Side Effects of Sugar Substitutes
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 benefits around 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.
Frequently Asked Questions about Sugar Substitutes:
1. Are sugar substitutes safe for everyone with diabetes?
While generally safe for most individuals with diabetes, consulting a healthcare professional or registered dietitian is recommended. They can advise on the suitability of specific sugar substitutes based on your individual needs and health condition.
2. Do sugar substitutes cause weight loss?
While sugar substitutes are lower in calories than sugar, they are not a magic bullet for weight loss. A balanced diet and regular physical activity are crucial for achieving and maintaining a healthy weight.
3. Can I completely replace sugar with substitutes in all recipes?
Not necessarily. Sugar substitutes may not always replicate the functionality of sugar in baking and cooking. Experimentation and adjustments might be necessary to achieve the desired results.
4. What are some natural alternatives to sugar substitutes?
While not entirely calorie-free, some natural options like fruits, dates, fruit juices and puréed vegetables can add sweetness to your diet. However, these options still contain carbohydrates and can impact blood sugar levels, so moderation is key.
Understanding the different sugar substitutes available, their properties, and how to use them effectively, allows you the freedom to continue to enjoy sweet treats without compromising your blood sugar control.
Using Sugar Substitutes and Diabetes
Consuming too much sugar is not good for any of us but there is a lot to think about when it comes to sweeteners and adding them to our diet. They are safe to use and can in fact be a great additional part of your diabetes management toolkit. Because they don’t all impact blood glucose levels. This allows back an element of food freedom which diabetes can take away. For us 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. Nevertheless, what is the best sugar substitute for us may not be the best substitute for you!
If you enjoyed this article leave a comment below. I would love to hear from you!
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This information is for general guidance only. Consult a healthcare professional or registered dietitian for personalised advice on incorporating any of these sweeteners into your diet, as individual needs and health conditions may vary.
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)
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