Low calorie sweeteners in diabetes: Doctors explain their role in glucose control

Science news from the ISA sessions at the 31st National Congress of the Mexican Diabetes Federation


  • Low calorie sweeteners are safe and people with diabetes can have benefits from their use as sugar substitutes.
  • Blood glucose levels are not increased by low calorie sweeteners and, thus, can be used in place of sugars for better glycaemic control in people with type 1 and type 2 diabetes.
  • When used as part of a healthy diet, low calorie sweeteners can be a helpful tool in programs of body weight loss and maintenance.

The fact that low calorie sweeteners do not cause a spike in blood glucose levels has been affirmed by regulatory authorities that also confirm their safety further to research of almost four decades. However, even if this benefit is well documented, there are still questions among people with diabetes about how low calorie sweeteners should be used and fit in their diet. That is why it is very important that healthcare professionals provide helpful and accurate information about low calorie sweeteners’ use in place of sugar.

In the context of the 31st National Congress of the Mexican Diabetes Federation this year, that took place in Acapulco, Mexico, on 14-16 March 2019, the ISA supported two sessions on low calorie sweeteners, where medical experts presented the latest scientific evidence1,2,3,4 to both healthcare professionals and patients with diabetes. Dr. Héctor Sánchez Mijangos, MD, Medical President of the Mexican Diabetes Federation, provided the most recent scientific data in a presentation to scientists and healthcare professionals, while Dra. Marisol Gil Pérez, MD, president and founder of the NGO Historias de Vida y Azúcar, talked to people with diabetes about the role of low calorie sweeteners and provided practical information about their use in everyday diet.

Presenting the more recent and important scientific papers examining the role of low calorie sweeteners in weight management and glucose control, Dr. Sánchez Mijangos concluded that, when low calorie sweeteners are used to replace sugars in the context of a controlled dietary plan, they can help people reduce their intake of energy and carbohydrates and, in turn, assist in managing more effectively their body weight and glucose control. Dr. Sánchez Mijangos also presented the outcomes of a position statement on low calorie sweeteners by the Mexican Diabetes Federation2, that was published in 2016, and which supported that low calorie sweeteners do not increase insulin and glucose levels in the blood and have no adverse effects on longer term glycaemic control (as measured with glycosylated hemoglobin – HbA1c).

Talking to people with diabetes in a session entitled “Sugar replacers: Are they for me?”, Dra. Marisol Gil Pérez explained the evidence that support that low calorie sweeteners are safe and showed how the regulatory authorities thoroughly examine this evidence to decide about the safety of sugar substitutes, and further talked about their role in diabetes management. Discussing about challenges in their diet, the doctor and the attendees of the session talked about their experience and Dra. Gil Pérez gave some practical examples of how low calorie sweeteners can be used to replace calories and sugars in food and beverages.

The key take-home message from both talks is that low calorie sweeteners can be a helpful tool for better glycaemic control in patients with type 1 and type 2 diabetes, when used to replace sugar together with a healthy eating plan and an active lifestyle.

  1. Aldrete-Velasco J, et al. Análisis de la evidencia disponible para el consumo de edulcorantes no calóricos. Documento de expertos [Analysis of the available evidence regarding the consumption of low calorie sweeteners. An expert document]. Medicina Interna de Mexico 2017; 33(1): 61-83
  2. Postura de la Federación Mexicana de Diabetes, A.C. (FMD) sobre edulcorantes no calóricos [Position of the Mexican Federation of Diabetes on low calorie sweeteners]. Diabetes Hoy 2016; vol XVII
  3. Laviada-Molina H, et al. Posición de la Sociedad Mexicana de Nutrición y Endocrinología sobre los edulcorantes no calóricos [Position of the Mexican Society of Nutrition and Endocrinology about low calorie sweeteners]. Rev Mex Endocrinol Metab Nutr 2017; 4: 24-41
  4. Laviada-Molina H, et al. Consenso de la Asociación Latinoamericana de Diabetes sobre uso de edulcorantes no calóricos en personas con diabetes [Consensus of the Latin-American Association of Diabetes on low calorie sweeteners’ use in persons with diabetes]. Rev ALAD. 2018;8:152-74