Artificial Sweeteners and Diabetes: What to Know

Written by Nichole Owens
Medically Reviewed by Christine Mikstas, RD, LD on April 09, 2025
5 min read

Yes, they can. Artificial sweeteners are just as sweet — and sometimes, up to 700 times sweeter — than regular sugar, but they have no calories and don’t affect your blood sugar (glucose). While sugar is absorbed into your bloodstream and sent to your cells to be turned into energy, artificial sweeteners stay in your digestive tract until they pass in your stool or urine.

“Artificial sweeteners can help a person with diabetes reduce sugar intake without feeling suddenly deprived of foods that are sweet-tasting while having a much lower impact on glucose levels than real sugar,” says Amy Roak, MS, RDN, CCSD, LD, CDES, with Northside Hospital Diagnostic Clinic in Gainesville, Georgia.

Roak says there are many sugar substitutes for people with diabetes, and you should talk to your doctor about how much of each sweetener you can safely consume.

You can find many different artificial sweeteners on your grocer’s shelves. Here are some things to keep in mind as you compare them:

  • Sugars are naturally occurring carbohydrates. These include brown sugar, cane sugar, confectioners’ sugar, fructose, honey, and molasses. They have calories and raise your blood glucose levels (the level of sugar in your blood).
  • Sugar alcohols are a type of lower-calorie sweetener. They’re less sweet than other artificial sweeteners and break down slowly in your gut, which helps control your blood sugar. You often find these in candies or chewing gum, listed by names such as erythritol, isomalt, maltitol, mannitol, sorbitol, and xylitol.
  • Stevia and monk fruit extract are natural sugar-free sweeteners that are often less processed than other artificial sweeteners.
  • Artificial sweeteners are made in a lab and have no nutritional value.

The FDA has approved six artificial sweeteners. They include: 

Acesulfame potassium or ace-K (Sweet One, Swiss Sweet, Sunett). You can use it in both cold and hot foods, including for baking and cooking.

Advantame. This is a food additive that's about 20,000 times sweeter than table sugar. It is used as a general-purpose food sweetener.

Aspartame (NutraSweet, Equal). Aspartame is about 200 times sweeter than sugar. You can use it in both cold and warm foods. It may lose some sweetness at high temperatures. People who have a condition called phenylketonuria should avoid this sweetener.

Neotame (Newtame). It’s often used as a sugar substitute in baked goods.

Saccharin (Sweet'N Low, Sugar Twin). You can use it in both hot and cold foods. Talk to your doctor before you use saccharin if you are pregnant or breastfeeding.

Sucralose (Splenda). You can use it in hot and cold foods, including for baking and cooking. Processed foods often contain it.

Does aspartame affect blood sugar?

No. Despite having no or low calories, aspartame does not raise blood sugar levels.

Does Splenda raise blood sugar?

It may, in some cases. Splenda is the brand name of the artificial sweetener sucralose. Studies show that it can affect how well your body regulates blood sugar. Talk to your doctor if you have questions or concerns.

Low sugar, no sugar — what do these terms mean? Use this “cheat sheet” to understand what’s used to sweeten the foods you buy.

  • No sugar or sugar-free: The product contains less than 0.5 grams of sugar per serving.
  • No added sugar: No extra sugar or sugar-containing ingredients were added during processing or packaging.
  • Reduced sugar: The product contains at least 25% less sugar per serving than the regular item per serving.
  • Dietetic: This refers to meal choices or food planning/prep to help manage or prevent certain health conditions, such as diabetes.

To know for sure what kind of sweetener a food product contains, check the Nutrition Facts label on the back of the box or package. In the carbohydrate section, you can see how many carbohydrates the product has, and how much of these are in the form of sugar or sugar alcohol.

If a food contains artificial sweeteners, you’ll find those in the list of ingredients on the package. The FDA requires producers to list any added sweeteners, such as sugars, sugar alcohols, or artificial.

By understanding more about artificial sweeteners and diabetes, you will be able to make better food choices as you balance sweetness with good blood sugar control.

If you have diabetes, artificial sweeteners can help you enjoy the taste of sugar without the risks. These low- or no-calorie sweeteners can satisfy your sugar cravings without raising your blood sugar or adding to your weight. 

But for all their benefits, some artificial sweeteners pose risks. Talk to your doctor if you have health concerns.

And just like sugar, you should limit your use of artificial sweeteners if you have diabetes. It’s important to eat a diet rich in whole foods, such as fruits, vegetables, whole grains, and lean proteins, to manage diabetes effectively.

Which is worse, sugar or artificial sweeteners?

Too much of anything can harm you. Eating too much sugar can lead to weight gain, higher blood sugar, and a higher risk of type 2 diabetes. All of these can harm your heart. 

But eating too many artificial sweeteners can also lead to these same health conditions. And just like sugar, artificial sweeteners are addictive. The more you eat, the more you crave. The catch? You may be more likely to feed your cravings because you think you’re eating fewer calories.

A better option? Fruits, which have natural sugars and added benefits, such as fiber and nutrients.

What sweetener should people with diabetes avoid?

The FDA has approved artificial sweeteners for use, but as with all things, they may carry risks. For example, if you have a rare genetic disorder called phenylketonuria (PKU), you should avoid aspartame.

Studies also suggest that some artificial sweeteners, such as aspartame and sucralose, may reduce good bacteria in your gut. More research is needed, but talk to your doctor if you have gut issues before using artificial sweeteners.

Why was stevia banned?

Stevia is an herb grown in South America. It’s an all-natural sweetener that’s 200 to 400 times sweeter than sugar. The FDA banned stevia in 1991 after studies linked it to cancer. The FDA reversed course in 2008 and declared it Generally Recognized as Safe (GRAS) as a food additive. Stevia is now widely used in foods and beverages, soft drinks, wines, yogurts, and more.