Is Stevia a Safe Sugar Substitute for Those with Diabetes?

April 2, 2023

by Cathe Friedrich

Is Stevia a safe sugar substitute if you’re trying to control your blood sugar? If you have diabetes or prediabetes, you already know that sugar is not your friend. Excessive sugar intake can cause your blood glucose levels to spike. It’s best to give up all sugar and sweeteners since they have no nutritional value, but unless you’re highly motivated, you may have a hard time doing that.

Sugar isn’t a nutritionally sound choice for anyone, but diabetics and those with prediabetes should be especially mindful of how much sugar they consume. It can be a challenge, as sugar is in most packaged foods. The problem is that sugar is hiding in most packaged foods, even in those that we wouldn’t expect. That’s why it’s important to read food labels and be mindful of the amount of sugar you consume.

Why Sugar is Harmful to Diabetics

Consuming excessive sugar can lead to weight gain and make your cells resistant to insulin. This is true for both diabetics and healthy folks alike. So, it’s always a good idea to keep an eye on your sugar intake to maintain a healthy weight When cells become insulin-resistant, they don’t take up glucose as easily. Insulin levels increase to try to move glucose into cells, making it even easier for your body to store more body fat.

As your pancreas struggles to make more insulin to meet the growing demand for more insulin to get glucose into cells, it eventually tires and can’t meet the demand. That’s when glucose levels rise. and type 2 diabetes sets in. However, you can often control mild type 2 diabetes through simple lifestyle changes, although you should always consult with your physician about the best course of action if you have type 2 diabetes.

Uncontrolled high blood sugar is harmful to health. A high blood sugar level leads to more glucose in the bloodstream. The free glucose form complexes called advanced-glycation end-products or AGEs that damage nerves and blood vessels. AGEs also contribute to aging. These little guys are not your friends – they can cause damage to your nerves and blood vessels, and even contribute to the aging process.

Stevia as a Sugar Alternative for Diabetics

If you have diabetes and still like a little sweetener in your coffee or tea, you might turn to Stevia. The main active ingredient in Stevia that gives it sweetness is glycosides, compounds that the Food and Drug Administration (FDA) classifies as generally recognized as safe. (GRAS) The glycosides come from the Stevia rebaudiana shrub native to Brazil and Paraguay, where it’s popular as a sweetener. Stevia is also a popular sweetener in Asian countries, including Japan and China.

Stevia is available as a liquid or powder, for sweetening foods and beverages. Since your body doesn’t break down glycosides, it doesn’t cause a rise in blood glucose, as sugar does. Plus, it has no calories. So, you get the taste of sweetness without the calories or rise in blood sugar. It’s also 250 to 300 times sweeter than sugar, so you don’t need much to sweeten foods and beverages.

Is Stevia Safe for Diabetics?

A small study of lean and obese individuals in 2010 published in the journal Appetite found that Stevia lowered blood glucose and insulin levels among participants. Another perk is that the subjects who consumed Stevia felt fuller, even though they consumed fewer calories. One concern with artificial sweeteners is that they might not satisfy hunger as much as real sugar, but as this study shows, this doesn’t hold true for Stevia.

This is fantastic news for anyone who struggles with portion control or cravings. Often when we eat foods high in sugar, we experience a sugar rush, followed by a crash that leaves us feeling hungry and unsatisfied. With Stevia, you get the sweetness without the crash, which can help you stay on track with your healthy eating goals.

Some studies also show that Stevia reduces blood triglycerides, total cholesterol, and LDL-cholesterol, the type linked with a greater risk of cardiovascular disease. That’s beneficial, since the leading cause of death in people with diabetes is heart disease. Plus, studies show Stevia has antioxidant and anti-inflammatory activity that could help counter inflammation inside blood vessels, a contributor to cardiovascular disease.

Can Stevia Lower Blood Sugar Too Much?

Stevia appears beneficial to diabetics as an alternative sweetener, but there is one concern. Stevia is so effective at lowering blood sugar that it could lower blood glucose enough to cause low blood sugar symptoms. This would be of concern mostly for type 1 diabetics and type 2 diabetics who use insulin or take blood sugar-lowering medications.

Stevia May Be Mixed with Other Sweeteners

Some versions of Stevia you buy at supermarkets or online are mixed with sugar alcohols, usually erythritol. Although sugar alcohols are safe, they can cause digestive upset if you consume too much at one time. People who consume them in large quantities experience bloating, flatulence, stomach cramping, and loose stools. So, read the label and determine if the product you choose is pure Stevia, or whether Stevia is combined with another sweeter, like a sugar alcohol.

Also, be aware that a recent study found that erythritol increased the risk of blood clotting in a mouse study. It’s an area that needs more research, and it’s unclear if this holds true in humans. Still, it’s safest to choose a version of Stevia that doesn’t have erythritol until there’s more clarity.

Conclusion

Stevia is a calorie-free sweetener that may have other health benefits for diabetics, by helping with blood sugar, appetite, and weight control, and by lowering blood cholesterol and triglycerides. It’s unclear whether Stevia is safe to use during pregnancy or while breastfeeding. Also, talk to your doctor if you’re diabetic before using large quantities of Stevia, as it could lower your blood sugar too much if you’re taking medications or on insulin.

References:

Ajami M, Seyfi M, Abdollah Pouri Hosseini F, Naseri P, Velayati A, Mahmoudnia F, Zahedirad M, Hajifaraji M. Effects of stevia on glycemic and lipid profile of type 2 diabetic patients: A randomized controlled trial. Avicenna J Phytomed. 2020 Mar-Apr;10(2):118-127. PMID: 32257884; PMCID: PMC7103435.
Anton SD, Martin CK, Han H, Coulon S, Cefalu WT, Geiselman P, Williamson DA. Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels. Appetite. 2010 Aug;55(1):37-43. doi: 10.1016/j.appet.2010.03.009. Epub 2010 Mar 18. PMID: 20303371; PMCID: PMC2900484.
“Everything You Need to Know About Stevia – Healthline.” 03 Dec. 2018, .healthline.com/health/food-nutrition/stevia-side-effects.
Jan, S.A., Habib, N., Shinwari, Z.K. et al. The anti-diabetic activities of natural sweetener plant Stevia: an updated review. SN Appl. Sci. 3, 517 (2021). https://doi.org/10.1007/s42452-021-04519-2.
Effect of stevia leaves (Stevia rebaudiana Bertoni) on diabetes: A systematic review and meta-analysis of preclinical studies. Akibul Islam Chowdhury, Mohammad Rahanur Alam, M Maruf Raihan, Tanjina Rahman, Saiful Islam, Oumma Halima. First published: 24 April 2022 https://doi.org/10.1002/fsn3.2904
“Popular artificial sweetener erythritol linked to higher risk for blood ….” 04 Mar. 2023, https://www.pbs.org/newshour/show/popular-artificial-sweetener-erythritol-linked-to-higher-risk-for-blood-clots.