What Are Sugar Alcohols?

If you have diabetes, then you’re probably very good at reading food labels and know that it’s important to pay attention to total carbohydrates and added sugars. But what about sugar alcohols? How do they affect blood sugar?

Despite the name, sugar alcohols are not the same thing as sugar or alcohol.¹  Here’s a closer look at sugar alcohols— the most common types, their impact on blood sugar, and some potential side effects of getting too much in your diet.

What exactly is sugar alcohol?

Sugar alcohols (polyols) are carbohydrates and sweeteners with fewer calories compared to sugar. As their name suggests, sugar alcohols are composed of both sugar and alcohol, consisting of a sugar molecule with an alcohol group attached to it. However, sugar alcohols aren’t alcoholic. They are employed as substitutes for traditional sugars. They’re popular sugar substitutes and sweeteners for people living with diabetes because they are only partially broken down, absorbed, and processed in the body; sugar alcohols lead to smaller increases in blood sugar and insulin.² 

People who have diabetes often come across sugar alcohols, which are present in many of the foods we consume every day. It is important to understand the effects of sugar alcohols and how to find them in various foods, drinks, and snacks.  

While sugar alcohols occur naturally in certain fruits and vegetables, most of the sugar alcohols you find in foods today are processed from other sugars.¹

A variety of different sugar alcohols are used as sweeteners today. They all differ slightly in calorie content and taste. Common sugar alcohols include:²

Xylitol

Xylitol is the most frequently used sugar alcohol and is often found in sugar-free gum, toothpaste, and sugar-free mints. Its sweetness is comparable to sugar, yet it boasts fewer calories and is better for dental health as it doesn't promote tooth decay. This makes xylitol a preferred choice for a variety of oral care and sugar-free products. 

Sorbitol

Sorbitol is a sugar alcohol with a cool, smooth taste and can be found in sugar-free drinks and foods, such as soft candies and jams. It even helps lower blood sugar levels by blocking the absorption of sugar in the intestines.¹ 

Erythritol

Erythritol, known for its pleasant taste, is used in conjunction with stevia to create the popular sweetener blend called Truvia. This combination offers a delightful sweetness with fewer calories, making it a preferred choice for those seeking a reduced-calorie alternative to sugar in their drinks and recipes.

Erythritol has zero calories and does not affect glucose or insulin levels.¹ However, there is also new research that examined erythritol's impact on cardiovascular health and found that it might be linked to a higher risk of heart disease, like heart attacks or strokes.³

Maltitol

Maltitol is a sugar alcohol that has a sweet taste and texture that’s remarkably close to real sugar, making it a popular choice in various sugar-free and reduced-sugar products and as a sugar substitute for diabetes. 

Maltitol can be beneficial for a diabetes diet by slowing down carbohydrate digestion, reducing the absorption of glucose, and managing post-meal blood sugar spikes.¹

Being aware of your sugar alcohol consumption is essential for people with diabetes. While some studies suggest that sugar alcohols can help with diabetes management, due to changes in tolerance, some people may experience adverse side effects when consuming sugar alcohols in standard or higher amounts, such as diarrhea and other digestive problems.¹ 

Sugar alcohols are still carbohydrates, which means sugar alcohols can raise your blood sugar.¹ When you look at nutrition labels, you will notice that “sugar-free” foods containing sugar alcohols may still have a lot of calories.

Sugar alcohols vs sugar

When it comes to sugar alcohols vs. sugar, here are the benefits:

•  Fewer calories –  Sugar has around four calories per gram, but sugar alcohols usually have about two calories per gram while tasting nearly as sweet.¹ The exact amount of calories depends on the specific type of sugar alcohol and how it is metabolized by the body.
• No sudden blood sugar spikes – Consuming sugar alcohols vs. sugar can make it easier to manage blood sugar. That’s because sugar alcohols don’t cause sudden spikes in blood sugar like sugar does. ¹
• Fewer carbohydrates – Sugar alcohols are a better choice, even if you’re following a low-carbohydrate diet, because even though they have carbohydrates, they’re less than regular sugar.

Sugar alcohols and digestive issues

The body can’t fully digest sugar alcohols, which is why sugar alcohols don’t cause major spikes in blood sugar levels.¹ However, this may also result in unpleasant side effects after eating them.

Some people notice that they experience bloating, excessive gas, and diarrhea after eating sugar alcohols, with xylitol appearing to be a common culprit.^1,4 Research shows that the sugar alcohol erythritol is generally better tolerated and less likely to cause stomach issues.⁴

While sugar alcohols have benefits for people with diabetes, it’s important to consume them in moderation. When following a healthy diet for diabetes, you can discuss the use of sugar alcohols with your healthcare provider to help reduce your intake of sugar.

Sugar alcohols, such as erythritol, are commonly regarded as a sweet alternative to regular sugar, particularly for people with diabetes. However, some experts worry that excessive use could have long-term health effects.³ While there's no solid proof yet, there are concerns about a possible link to heart disease, a risk that may be even higher for people with diabetes. The World Health Organization recommends that instead of relying on sugar substitutes to lose weight, focus on a well-balanced diet with less sugar.⁵ This way, you're not just swapping one concern for another but taking a step towards healthier eating habits.

Sources:

1. Msomi NZ, Erukainure OL, Islam MdS. Suitability of Sugar Alcohols as Antidiabetic Supplements: A Review. J Food Drug Anal. 2021;29(1):1-14.
2. Schiweck H, Bär A, Vogel R, et al. Sugar Alcohols. In: Wiley-VCH, ed. Ullmann’s Encyclopedia of Industrial Chemistry. 1st ed. Wiley; 2012.
3. Witkowski M, Nemet I, Alamri H, et al. The artificial sweetener erythritol and cardiovascular event risk. Nat Med. 2023;29(3):710-718.
4. Mäkinen KK. Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals. Int J Dent. 2016;2016:1-16.
5. Use of Non-Sugar Sweeteners: WHO Guideline [Internet]. WHO. 2023 [cited 2025 Jul 9]. Available from: https://www.who.int/publications-detail-redirect/9789240073616