The good news is that sugar does not need to be excluded from your diet if you have diabetes. The myth that people with diabetes shouldn't eat any sugar still persists but the truth is that people with diabetes can eat sugar. Although sugar should be limited as part of a healthy balanced diet, good blood glucose control can still be achieved when sugar and sugar-containing foods are eaten.
There are different types of sweeteners available and these are outlined below.
What is a sweetener?

The term 'sweetener' is used to describe added ingredients such as sucrose (sugar), fructose (fruit sugar), non-nutritive sweeteners (also known as artificial or intense sweeteners) and nutritive sweeteners (also known as bulk sweeteners).
Sweeteners

1. Sucrose
Sucrose is the formal name for 'table sugar'. Diabetes UK advises that sucrose can be included in the diet for people with diabetes provided that it is used in the context of a healthy balanced diet.
2. Fructose
Fructose is naturally found in fruit. When it is added to foods as a sweetener it has no advantage to sucrose. It contains just as many calories, still affects blood glucose levels, and when eaten to excess can cause a laxative effect. However, fructose as fruit should be eaten regularly, having at least 5 portions of fruit and vegetables per day.
Nutritive Sweeteners

Polyols
Polyols, such as sorbitol, maltitol, xylitol, isomalt and mannitol have less of an effect on blood glucose levels than sucrose and fructose and are lower in calories. However as they are often added to foods such as chocolate, biscuits and confectionary they can still be high calories and saturated fat and therefore not aid in weight management.
Products containing polyols are safe to consume but should be eaten in moderation. Excessive consumption can have a laxative effect and may result in diarrhoea, and or flatulence, especially in young children because of their low body weight. The maximum amount of polyols is different for all the polyols and tolerance of these products varies between individuals.
Important note: If polyols are consumed, people who take insulin and count carbohydrate may need less insulin as not all the carbohydrate from polyols is absorbed.
Non-nutritive sweeteners

There are five non-nutritive sweeteners which are permitted for use in the UK: aspartame, saccharin, acesulfame potassium (acesulfame K), cyclamate and sucralose. They are virtually free of calories, do not affect blood glucose levels and do not cause to tooth decay.
These sweeteners are used in a wide range of manufactured sugar-free, reduced sugar and low calorie foods and drinks and are also available as tablet, liquid and granulated sweeteners. They can be helpful for people who are trying to manage their weight to sweeten drinks or as a table sweetener on cereal for example. Sugar-free, diet or low calorie drinks tend to be sweetened with non-nutritive sweeteners.
Important note: People with phenylketonuria must not use products that contain aspartame.
Using sweetener tablets or liquids

There are many dispensers available containing these sweeteners. These can be in tablet form which is ideal for using in hot drinks – particularly useful if you are out and about.
Cold desserts such as fruit fool and hot puddings, such as fruit pies, crumbles, bread pudding or custard, can be sweetened to taste with liquid or granulated sweeteners instead of sugar. Some sweeteners can be used in cooking and baking.
Top Tips

Desserts

Choose the reduced sugar versions of foods which you tend to eat larger portions of and which you may eat regularly as part of a healthy diet (such as tinned fruit, sugar-free jelly, reduced sugar tinned milk puddings and low sugar instant whip). This may help to reduce your overall sugar or calorie intake if you are trying to manage or control your weight.
Cooking and baking

Experiment by reducing the sugar you add in your baking recipes. Most cakes eg sponge will work even if the sugar in the recipe is cut by a half. Recipes such as fruit cakes, fruit scones or tea breads can be made without added sugar. They do not require sugar for bulk and the dried fruit will provide sweetness.
There are many alternatives to the traditional butter cream, icing and jam so often used to fill and top cakes. Instead try adding fruits such as chopped mango and passion fruit to fromage frais.
Puddings and cakes are usually high in fat as well as sugar and should be limited as part of a healthy diet. If you make them regularly you may want to reduce the sugar as well as the fat content, but you don't need to adapt your recipes if you only eat them on special occasions such as birthdays.
Are sweeteners safe?

The government provides food manufacturers with guidelines on the maximum levels of sweetener that can be used in specified foods. The government also surveys sweetener consumption in the general population and in specific groups such as people with diabetes and young children in order to monitor trends and ensure that the Acceptable Daily Intake (ADI) of individual sweeteners is not exceeded. Current trends show that most adults are unlikely to exceed the ADI for each sweetener on a regular basis.

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