Sugar replacements can allow people with diabetes to enjoy foods like soda, chocolate, and other treats without sacrificing blood-sugar management and control. Some common brands of sugar substitutes include Equal, Nutrasweet, Sweet ‘n Low, and Splenda.

Our bodies don’t break down artificial sweeteners into simple sugars that elevate blood sugar levels, so people living with diabetes can generally consume them safely. Artificial sweeteners must be deemed safe by the U.S. Food and Drug Administration (FDA), and studies have found them to be generally safe in limited quantities. However, people living with type 1 diabetes should take some points into consideration when adding sugar replacements to their diet.

1. There Is a Difference Between Artificial and Natural Sweeteners

There are many different types of artificial sweeteners, which are in a separate category from natural sweeteners like honey, table sugar, molasses, maple syrup, and agave. Beware of foods that claim to have no added sugar, as these often contain natural sweeteners that can raise blood sugar levels — such as fruit juice, which contains the natural sweetener fructose.

Artificial sweeteners (also called nonnutritive sweeteners) are synthetically made replacements for natural sweeteners that don’t raise your blood sugar because they don’t contain natural sugars. They do not contain calories. Currently available artificial sweeteners include:

• Saccharin
• Aspartame
• Acesulfame potassium
• Sucralose
• Neotame

Artificial sweeteners are also different from sugar alcohols. Sugar alcohols are sweeteners derived from natural ingredients like corn or milk. They are often found in packaged food products like sugar-free chewing gum. Erythritol, maltitol, sorbitol, and xylitol are examples of sugar alcohols found in packaged items in the grocery store.

Unlike artificial sweeteners, sugar alcohols do contain calories, though about half as many as regular sugar. Also unlike artificial sweeteners, you won’t find sugar alcohols in a packet at your local coffee shop.

2. Artificial Sweeteners Don’t Automatically Make Foods Healthy

The most important thing to remember about artificial sweeteners is that they aren’t the only ingredient in the food you’re eating. They are a food additive with a lower glycemic index than sugar. When high-fat or processed foods like chocolate are sugar-free, that doesn’t make them healthy foods. They can still be high in fat, salt, and other ingredients that are not beneficial. Always check the nutrition label of foods before eating them.

3. Sugar-Free Foods Can Still Raise Your Blood Sugar

Products containing sugar substitutes still contain carbohydrates, though fewer than products that contain regular sugar. They also raise your blood sugar level more slowly, helping you to avoid the spike-and-drop blood sugar pattern that high-sugar foods induce. This means these foods don’t affect blood sugar levels as drastically. This improves your blood sugar control while allowing some sweetness in your life. Again, though, it’s important to read nutrition labels to see how many carbohydrates a particular product has.

4. You Should Consume Artificial Sweeteners Sparingly

The best strategy for diabetes management and general health is to eat artificial sweeteners as little as possible. Opting for fresh fruit can let you have a sweet fix while reducing your intake of sugar and artificial sweeteners.

Artificial sweeteners have what’s called an acceptable daily intake, which is the amount a person can consume on a daily basis without facing increased health risks. This can range from 5 milligrams to 50 milligrams per kilogram (approximately 2 pounds) of body weight, depending on the sweetener. That’s not a large amount. Try to moderate consumption of any sources of sweetness, regardless of whether they’re natural or artificial.

5. Artificial Sweeteners May Increase Hunger Levels

There are many reasons a person may seek out artificial sweeteners, including to lose weight or control diabetes. Replacing sugars with artificial sweeteners can be part of a weight-loss strategy.

However, preliminary animal studies have shown that artificial sweeteners can actually increase one’s hunger levels, leading you to eat more than intended. One study found that, after eating a diet containing artificial sweeteners for prolonged periods of time, fruit flies ate 30 percent more calories when given food that was naturally sweetened. Another found that mice also ate more after seven days on a diet of food sweetened with sucralose.

Other research suggests artificial sweeteners may affect a person’s natural gut microbiome (naturally occurring microorganisms in the digestive tract). This can lead to an overgrowth of bacteria that in turn can result in weight gain.

Additionally, researchers have found that artificial sweeteners can cause hyperactivity and insomnia and can impact sleep quality.

Talk With Others Who Understand

At myT1Dteam — the site for people with type 1 diabetes and their loved ones — people come together to learn more about type 1 diabetes and share their stories with others who understand life with the condition.

Do you have type 1 diabetes and use sugar replacements? Share your experience in the comments below.