by Bob Lloyd

Created on: November 16, 2010   Last Updated: November 17, 2010

Diabetics naturally avoid sugar and often use artificial sweeteners instead, but these may not be as sugar-free as we think.

When we have a coffee in a cafe, we often think that using a powdered sweetener will have no effect on our blood glucose level and for some, this is absolutely true.  But many sweeteners are not quite so benign.

Where the sweetener is sold in pellet form, bulk is not important and most of them contain no additional carbohydrates.  But those that are sold as powders have added bulk and it is the composition of that added bulk that can be the problem.

What's actually in them?

Dr Richard Bernstein, in his book Diabetes Solution, lists a number of popular brands of powdered sweetener which actually contain substantial amounts of sugars.  These include: Sweet'n Low; Equal; The Sweet One; Sunett; Sugar Twin; Spenda, and others.

In order to boost the bulk of these powdered sweetener sachets, additional powdered carbohydrate is added which will greatly boost the blood sugar level in diabetics. Bernstein argues that they usually contain 96% glucose or maltodextrin and around 4% artificial sweetener.

For diabetics trying to avoid taking sugar, this is quite a trap.  By having a coffee with sweetener, they can take in a harmful quantity of glucose pushing their blood sugar up to dangerous levels.

What to look out for

In the list of ingredients, we need to look for not just glucose but all other sugars as well.  Glucose is a small molecule but other sugars are build from it.  For example, fructose or fruit sugar has the same chemical composition as glucose.  Maltose consists of two molecules of glucose combined and is immediately broken down to glucose in the body.

Anything that ends in -ose is likely to be a sugar which will raise blood glucose levels. In addition, carbohydrates too are metabolised into glucose so even if the bulk of the sweetener is listed as carbohydrates, that too will have an effect on blood glucose.

Tablet sweeteners for diabetics

There are sweeteners in tablet form that do not contain added sugars.  These generally contain the artificial sweeteners aspartame, saccharin or cyclamate.

Despite the recent press scares about aspartame, the research indicates that it is a safe sweetener.

Diabetics need to understand that carbohydrates are to all intents and purposes the same as glucose. The only meaningful way of thinking about them is concerning the speed of release of the glucose together with the actual glucose content. You cannot trade off slow release against high content.

Low sugar foods

Some foods are marketed as low sugar but this is often very misleading.  Whereas the sugar level is often measured in grams of sugar per 100g, the density of the food and size of serving is crucial.  In addition, many sugar-free foods actually contain a high concentration of sugars under a different name.

Whilst the food may not contain sucrose, it could well contain dextrin, lactose, fructose, sorbitol, xylose, or a multitude of other substances that will raise your blood sugar levels.

Foods that are marketed as low-sugar often contain high concentrations of carbohydrates such as flour which will rapidly release glucose into the blood stream.

Unfortunately diabetics have no choice but to assess each foodstuff critically and to distrust many of the low-sugar claims made.  The important measure is the carbohydrate content including any sugars.

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