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Diabetes and Artificial Sweeteners

Medical expert Dr. Mohan S. Palaniswami answers common questions about diabetes:

Q: Are artificial sweeteners safe for diabetics?

Q: Are artificial sweeteners safe for diabetics?

A: Artificial sweeteners can help you satisfy cravings without raising your blood sugar. But first, be careful of what you read: there are many different types of sugar, and they don't all appear as "sugar" on food labels. Look for glucose, fructose, levulose, maltose, and lactose, which are all different types of sugar.

Also watch out for sugar alcohols, such as sorbitol, xylitol and mannitol. These are sometimes called "reduced calorie sweeteners." They have about half the calories of regular sugar. As a general rule, you can subtract half the sugar alcohol grams from the total carbohydrate grams in foods made with sugar alcohols.

There are five types of artificial sweeteners approved by the Food and Drug Administration. They are acesulfame potassium, aspartame, neotame, saccharin, and sucralose.

Saccharin can be used on any type of food. When saccharin first was studied, it was found to cause cancer in rats when ingested in large quantities. The FDA approved it for human use when studies did not demonstrate similar problems in humans.

Aspartame, known as Nutrasweet, is 180 times as sweet as sugar. It actually has the same amount of calories per gram as sugar, but only a tiny amount is needed to sweeten food-so it hardly adds any calories at all. Aspartame is not usually used in baking, because it breaks down with prolonged heating. Patients who have been diagnosed with phenylketonuria (PKU) should not consume any food prepared with aspartame.

Neotame is thousands of times sweeter than sugar. It has a molecular structure similar to aspartame, although it doesn't appear to have the same risks for people with phenylketonuria.

Acesulfame potassium, also known as acesulfame-K or Sweet One, is 200 times sweeter than sugar and has no calories at all. It's a good option for cooking and baking, because it does not break down when heated.

Sucralose is 600 times sweeter than sugar. It's manufactured from natural sugar but can't be digested, so it doesn't have any calories. Sucralose holds up well in cooked foods and baked goods.

As with any foods, diabetics must monitor the amount of calories consumed even if they are "sugar-free." Planning one's diet should be done with the help of a diabetic nutritionist and a primary care physician. For more information on artificial sweeteners, please see