From the Guidelines
Sugar alcohols are a safe and suitable alternative to regular sugar for people with diabetes, as they have a minimal impact on blood glucose levels. According to the most recent and highest quality study 1, sugar alcohols produce a lower postprandial glucose response than fructose, sucrose, or glucose and have lower available energy values. The study also notes that the use of sugar alcohols appears to be safe, although they may cause diarrhea, especially in children.
Key Points to Consider
- Sugar alcohols have a glycemic index between 0-36, which is significantly lower than table sugar's 65 1.
- When counting carbohydrates for insulin dosing, half of the sugar alcohol grams can be subtracted from the total carbohydrate count, although erythritol can be fully subtracted due to its minimal impact on blood glucose.
- Moderation is essential when consuming sugar alcohols, as large amounts can cause digestive issues like bloating, gas, and diarrhea, particularly with sorbitol and maltitol.
- The body processes sugar alcohols differently than regular sugar due to their unique chemical structure, which limits their absorption and metabolism.
Recommendations for Diabetes Management
- Sugar alcohols can be a useful tool in diabetes management when used appropriately, as they have a minimal impact on blood glucose levels 1.
- Individuals with diabetes should consult with their healthcare provider or a registered dietitian to determine the best approach to incorporating sugar alcohols into their diet.
- It is essential to consider the overall nutritional content of the diet, including the amount of carbohydrate, protein, and fat, to ensure optimal blood glucose control and overall health.
From the Research
Sugar Alcohol and Diabetes Management
- Sugar alcohols, also known as polyols, have been found to be suitable as antidiabetic supplements, as they do not raise plasma glucose levels and are partially digested and metabolized 2.
- Replacing carbohydrates with sugar alcohols can alter diet composition and adequacy, making them a potential sugar substitute for a healthy lifestyle and diabetic foods 2.
- The use of sugar alcohols in diabetes management has been found to have beneficial effects on hyperglycemia, although possible side effects associated with their consumption need to be considered 2.
Blood Glucose Control
- Sugar alcohols such as xylitol, sorbitol, mannitol, maltitol, lactitol, isomalt, and erythritol have been found to have a low glycemic index, making them suitable for blood glucose control 2.
- The metabolism, absorption, and glycemic and insulinemic responses of sugar alcohols have been found to be beneficial for diabetes management, although more research is needed to define their safety 2.
Comparison with Other Diabetes Management Options
- Other glucose-lowering medicines such as metformin, sulphonylureas, and insulin are available for type 2 diabetes management, and the choice of treatment depends on individual patient characteristics and the mechanism of action of each drug 3, 4.
- Sulfonylureas have been found to be potent glucose-lowering drugs, although their use needs to be reevaluated in the context of newer glucose-lowering drugs with potentially less risk of hypoglycemia or cardiovascular and renal events 4.
Alcohol Consumption and Diabetes
- Moderate alcohol consumption (one to 3 drinks/d) has been found to be associated with a lower incidence of diabetes and diabetes-related coronary heart disease, although heavy consumption (>3 drinks/d) may increase the incidence of diabetes 5, 6.
- Moderate alcohol consumption has been found to reduce the risk of cardiovascular diseases and all-cause mortality in individuals with diabetes, although the type of alcoholic beverage, gender, and body mass index are factors that affect these outcomes 6.