Question of the Week: Sugar Substitutes and Diabetes

Here is this week's question from FOODPICKER.org:

Q: What is the best sugar substitute to use for baking and daily use for diabetics?

A: These days, you have a choice of many sugar substitutes, unlike years ago when people with diabetes were stuck with saccharin. There are many more available today: Aspartame (NutraSweet or Equal), acesulfame potassium (Sunett and Sweet One), saccharin (Sweet'n Low), sucralose (Splenda), rebaudioside A (also called rebiana or reb-A, which is derived from the stevia plant) and various sugar alcohols (maltitol, xylitol, erythritol and many more). Truvia, a new sweetener on the market, is a combination of erythritol and rebiana.

If by "daily use" you mean for use in coffee or tea, the choice is really up to your tastebuds. However, please know that some artificial sweeteners do contain a small amount of carbohydrate. When used in moderation, these sweeteners should not hugely impact your blood glucose - but only you will know how it affects you when you check your blood glucose levels. Please be aware that sugar alcohols are not absorbed in the small intestine, and may cause gas or diarrhea - proceed with caution until you know how they affect you.

Since most sugar substitutes are many times sweeter than sugar, this creates volume and texture problems when making baked goods. However, there are some good options out there: Splenda and Truvia make a crystalline product which measures out the same as sugar, cup-for-cup. I would check each manufacturer's website for information on use in baking and recipe ideas.

While you may lower the carbohydrate content of baked goods by using a sugar substitute instead of sugar, be aware that flour is itself a source of carbohydrate. Just keep this in mind when planning your meals, and you can find a way to have some treats while also managing your blood glucose levels.

A final, personal note:

It is a myth that people with diabetes must buy special "diabetic" food (or supplements) and cannot have sweets. People with diabetes can eat a healthful diet of real foods - yes, treats too - just like everyone else should! The difference is in the planning and combination of foods, which is why it is essential for people with diabetes to meet with a Registered Dietitian (RD) or Certified Diabetes Educator (CDE) to formulate a meal plan.

Artificial sweeteners are often a hot-button issue. I respect the choice to use them, but I am not a huge fan of any of them. Our palates are quite malleable and, given the opportunity, will adjust to varying levels of tastes. Artificial sweeteners undermine this process by keeping the palate used to a heightened level of sweetness. I usually advise slowly cutting back on sugar and/or sugar substitutes bit by bit - try it, you might be surprised at what you can adapt to!