Artificial Sweeteners in Diabetic Diet

Diabetics are advised not to consume glucose or rapidly absorbable sugars in their diet. However, it is considered that the provision of suitable alternative sweetener in persons suffering with diabetes is an important factor in achieving their dietary compliance.

A number of sweetener alternatives are available nowadays, which are generally classed as nutritive (such as fructose, xylitol, sorbitol and aspartame), or non-nutritive (such as saccharin). The nutritive sweeteners have a caloric value that has to be included in the diabetic diet.

Fructose is a common monosaccharide (form of carbohydrate) that is found in its free form in substances like honey and fruit. Recent technical advances have made pure crystalline fructose available for clinical as well as commercial use. Fructose has a little effect on blood glucose level than the effect of glucose, sucrose, or some other complex carbohydrates, in both controlled diabetics and non-diabetic people. Although, it can result in increase in the blood glucose levels in those persons who are poorly controlled diabetics.

Sorbitol and Xylitol have relatively small effects on blood glucose and insulin levels in well-controlled diabetics but can lead to osmotic diarrhea when ingested in amounts greater than 30-50 grams.

Aspartame is the newest member of the sweetener family. It is 120-280 times sweeter than sugar, depending on the food system in which it is used. It can reduce calories in some products to a great level. It is a nutritive substance and not an artificial sweetener, because its components are found naturally in foods and it is metabolized in the body in the same way as the naturally occurring amino acids. It cannot be used in frying, boiling or baking as prolonged heat causes a breakdown of the molecule and loss of sweetness. Consequently, it does not replace all sweetener needs.

Saccharin is 300-400 times sweeter than sucrose and has no caloric value but it has a bitter after-taste that is objectionable to many people.