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What is sugar alcohol in sugar free foods?

William Lee Dubois
Endocrinology Diabetes & Metabolism
Sugar alcohols are artificial sweeteners that are commonly used to replace sugar or corn syrup in sweetened beverages, candy, and sugar free cakes and ice creams. The most commonly seen are maltitol and sorbitol. They have a significantly reduced glycemic impact compared to sugar, but contrary to the marketing on packages, do not have zero effect on blood sugar.

Starting with the Atkins Diet craze of a few years back, and carrying on through to modern “diabetic friendly” sugar free foods, manufacturers print a “net carbs” banner on the outside of the package. This often makes foods look like they have less of a blood sugar impact than they actually do, as loopholes in the FDA food labeling requirements allow food manufacturers to count the sugar alcohol carbs at zero.

In fact, most sugar alcohols have a 50% impact. If you are taking fast-acting insulin proactively, you count your carbs in advance of eating and take an appropriate amount of insulin to cover the meal. Sugar alcohol can be dicey, in that, if you count them at zero your blood sugar will likely run too high; whereas if you count them at their fully printed value, you will likely over-dose and run too low.

In practice, eating foods with sugar alcohol can involve a lot of “field math.” OK, so here we go. Looking at the food label, find Total Carbohydrate. Under this heading are several sub-headings such as Sugars and Sugar Alcohol. To understand how the food will impact your blood sugar you need to subtract the Sugar Alcohol from the Total Carbs to get the non-sugar alcohol carb count. Add back into that 50% of the carb count of the Sugar Alcohol. Then subtract the fiber and you’ve got a total carb value that needs to be covered by insulin. Total Carbs – Sugar Alcohol + 50% of Sugar Alcohol – Fiber = Impact Carbs

In my experience, by the time you’ve done all of this, your non-diabetic companions will have polished off all the candy, so all of your work will have been for nothing.

However, if this happens, your companions will get their just deserts, because no discussion of sugar alcohol would be complete without a brief discussion of their most notorious side effect: diarrhea. Painful, days-long diarrhea. Generally speaking, the more you eat the greater the risk. To me, a candy that parks you in the bathroom for three days if you eat too much doesn’t really sound like too bad of an idea.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.