Ask a Qualicare Specialist: Non-natural Sweeteners and Diabetes

Question:

Dear Qualicare, I am currently taking care of my elder friend who has diabetes. She suffers with diabetic seizures regularly and I am concerned she is addicted to sugar, the worst substance for a diabetic, and adds brown sugar to everything thinking that is a safe alternative. Is there a better sugar substitute that I can use while cooking, something that will make her feel like sugar is added, but won't negatively affect her sugar levels?

Thanks for any help you can offer.

Sally-Anne B.

Answer: Thanks for your question Sally-Anne.

People with diabetes often wonder if it is okay to have foods sweetened with sugar - white, brown or substitutes, even if ever so slightly added. Food is "sweetened" in two different ways: natural and non-natural and it depends on what route you take that can have a negative impact on your glucose levels.

Natural sweeteners added to foods are sugar (both brown and white), molasses, honey, maple and corn syrup. They will increase blood sugar as they contain glucose.

Non-natural sweeteners, sugar substitutes or artificial sweeteners do not influence blood sugar levels when added to foods. Examples include cyclamate, aspartame and sucralose and acesulfame potassium. Many people are afraid to consume these products, however, after years of research, Health Canada has proven they are safe to consume in a "normal amount."

These artificial sweeteners are very helpful for diabetics looking to eat something sweet without it affecting their blood sugar levels.

Aspartame is found in two forms. It is NutraSweet when added to foods such as breakfast cereals, soft drinks, desserts and candy or called Equal™, a powder bought at the grocery store. Although it is a nutritive sweetener that breaks down into calories, it is 200 times sweeter than sugar and very little is needed to give food a sweet taste.

Cyclamate or Sucary|™ is found in Sugar Twin™. It is 30 times sweeter than table sugar and has no aftertaste. This sweetener is heat stable, so it can be used in hot and cold foods. You can cook and bake with it.

Sucralose or Splenda™ is made from sugar itself and is 400 to 800 times sweeter than table sugar. It is found in cold and hot drinks, baked goods and frozen fruits and vegetables. It is very clsoe to sugar in its chemical structure but the body does not recognize it as sugar and it does not affect blood sugar levels.

Acesuflame Potassium (AceK) or Sunett is the newest non-nutritive sweetener approved by Health Canada. It is found in many types of foods such as beverages, fruit spreads, baked goods, hard candies, chewing gum and breath fresheners and is 200 times sweeter than table sugar. People who are on a potassium restricted diet or have sulfa-antibiotic based allergies should talk to their physicians before using this product.

In the past, people with diabetes were told to avoid sugar and only use foods sweetened with artificial sweeteners. Current research shows that it is the amount of sugar eaten and the rate of its digestion that are the most important factors in blood glucose control. Sugar can be included in a healthy diet as part of a carefully planned meal plan. If eaten it has to be spread evenly over the day, as part of slowly digested meals. Foods made with natural sugar have extra calories but foods or drinks made with artificial sweeteners may not always be low in calories either. If ou are concerned about calories, it is important to check the nutrition information panel on the food label.

Foods with added sugar and sugar substitutes when used in moderation as part of a healthy and well-balanced diet can increase the joy of eating, which is so important in achieving good quality of life - especially in the older adult population. However, if you require a special diet, are not clear on a particular product, its sugar content or had questions in regards to what you eat as a diabetic, meet and discuss these issues with a Registered Dietician.

Nicole Shuckett, MSRD

Dietitian

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