Understanding Sugar Alcohols: A Guide for Managing Type 2 Diabetes

With all the different names for sweeteners, navigating food labels can be quite challenging. One of the common ingredients found in many "sugar-free" and "low-sugar" products is sugar alcohol. But how do sugar alcohols affect your blood glucose levels when you have type 2 diabetes? Are they helpful or harmful? Let’s explore the facts.

What are sugar alcohols?

Despite the name, sugar alcohols (also known as polyols) are neither sugar nor alcoholic beverages. They are a type of carbohydrate whose chemical structure partially resembles both sugar and alcohol.¹

Manufacturers use them as a sugar substitute to decrease the calorie content in products while maintaining a sweet taste. On average, sugar alcohols provide roughly half the calories per gram that regular sugar provides. Sugar-free gum, diet sodas, and keto-friendly snacks are common examples of items containing sugar alcohols.

What are the benefits of sugar alcohols?

Because they are lower in calories, sugar alcohols can be a helpful option for weight management. For individuals with type 2 diabetes, the primary benefit relates to how the body processes them. Sugar alcohols are not fully absorbed and digested by the body.

As a result, they cause a significantly smaller increase in blood sugar and insulin levels compared to regular sugar. Foods sweetened with sugar alcohols may allow people with diabetes to maintain better glycemic control while still enjoying sweet treats in moderation.¹

Are there any negatives?

As with other sugar substitutes, consuming sugar alcohols can come with side effects. Because they are incompletely digested, they can ferment in the intestines, causing discomfort.

Many people report a laxative effect, as well as increased gas, bloating, and diarrhea. Research evaluating the gastrointestinal tolerance of sugar alcohols has found that substances like xylitol are more likely to induce stomach upset and diarrhea, whereas erythritol tends to have a milder effect on the digestive tract, only causing nausea and gas when consumed in very large doses.²

Additionally, emerging clinical research suggests that caution is warranted regarding high intakes. Recent studies have linked elevated circulating levels of certain sugar alcohols, specifically erythritol, to an increased risk of cardiovascular events—including heart attacks and strokes—due to enhanced blood clotting.³

If you are concerned about side effects or cardiovascular risks, it is best to consume sugar alcohols in small amounts and closely monitor your body’s reaction.

How do I know if my foods have sugar alcohols?

Sugar alcohols appear under multiple names on ingredient lists. Check the labels of foods claiming to be “lower in sugar” or “sugar-free” for these common terms:

• Xylitol: Often used in sugar-free gum, it is about as sweet as regular sugar. It is extracted from wheat straw and cereals, and is commercially manufactured from corncobs.
• Maltitol: About 75 percent as sweet as sugar and derived from corn syrup.
• Erythritol: 60 to 80 percent as sweet as sugar. It is found naturally in foods like pears, watermelon, and soy sauce, and is commercially manufactured by fermenting corn.
• Mannitol: 50 to 70 percent as sweet as sugar. It is naturally present in carrots, olives, and asparagus, and is commercially extracted from seaweed.
• Isomalt: About 45 to 65 percent as sweet as sugar and primarily derived from beet sugar.
• Sorbitol: About half as sweet as sugar. Found naturally in apples and pears, it is also manufactured from corn syrup.
• Lactitol: Provides about 40 percent of the sweetness of sugar and is derived from milk.
• Hydrogenated Starch Hydrolysates (HSH): Ranging from 40 to 90 percent as sweet as sugar, these are produced by blending various sugar alcohols.

Speak with your physician or a registered dietitian if you have any specific questions about incorporating sugar alcohols into your diet and diabetes management plan.