Stevia is a sugar substitute that is very low in calories. There is growing interest in the use of stevia to help people with diabetes manage their blood sugar levels.

Stevia is a natural sweetener that comes from a shrub native to North and South America. It is an ingredient in many brands of sweetener, including SweetLeaf, Truvia, and Pure Via.

As a sweetener, stevia has been growing in popularity in recent years, especially among people with diabetes. Some studies suggest that it does not raise blood sugar levels, making it safe for people with this condition.

Stevia contains compounds known as steviol glycosides that are about 300 times sweeter than sugar. However, stevia is so low in calories that it is technically a "zero-calorie" product.

Although they are sweet, steviol glycosides can have a bitter aftertaste. Due to this, most stevia products contain other ingredients to counteract this.

In this article, we look at the benefits and risks of stevia for people with diabetes.

Is stevia safe for people with diabetes?

Stevia extracts are generally safe for most people in moderate amounts.

The United States Food and Drug Administration (FDA) categorize steviol glycosides as "generally recognized as safe," or GRAS. As a result, manufacturers may add certain high-purity steviol glycosides to foods and beverages.

Steviol glycosides are often present in sugar-free drinks, jams, and dairy products.

In a joint statement, the American Heart Association (AHA) and the American Diabetes Association (ADA) said that stevia and similar sweeteners can be beneficial for people with diabetes if they use them appropriately and do not compensate by eating extra calories at later meals.

Research supports this statement by suggesting that stevia may assist with blood sugar control.

Can stevia treat or cure diabetes?

Due to the focus on stevia for people with diabetes, many people wonder if it can treat or cure the condition.

There is currently no cure for diabetes, but people can manage the condition by making dietary and lifestyle changes and taking medications.

Using stevia in place of sugar in sweetened foods and drinks may help people with diabetes stabilize their blood glucose levels.

This replacement may also reduce the number of calories that a person consumes, which is likely to aid weight loss. Excess weight is a risk factor for type 2 diabetes and for its complications, which include heart and kidney problems.

Many people with diabetes also have high blood pressure. Some research suggests that stevia may lower blood pressure in people with hypertension, but not all studies support this. More research is necessary to confirm this possible effect.

What the research says

Several studies have investigated the effects of stevia on blood sugar levels.

A 2016 study reported that dried stevia leaf powder significantly lowered blood sugar levels in people with diabetes, both while fasting and after eating. The study participants also experienced a reduction in their triglyceride and cholesterol levels.

The researchers concluded that stevia is safe for people with diabetes to use as a substitute for sugar and other sweeteners.

A 2013 study in rats reported that using whole stevia leaf powder as a dietary supplement led to lower blood sugar levels. The results also suggested that stevia reduced liver and kidney damage in the animals.

Other research from 2013 found that stevia had antioxidant potential and significantly lowered blood sugar levels in mice.

Stevia may also reduce hunger and improve satiety in people. In a small-scale study, researchers gave participants a snack to eat before their main meal, which is a dieting technique known as preloading. The preload contained either stevia, aspartame, or sucrose, which is also known as table sugar.

The sucrose preload had 493 calories, while both the stevia and aspartame preloads only contained 290 calories. Despite this, all three groups of participants reported similar hunger and satiety levels.

The people who ate the stevia preloads had significantly lower blood glucose levels after meals when compared with the sucrose group. They also had lower insulin levels than those in both the aspartame and sucrose groups.

It is important to note that most of this research used dried stevia leaf rather than stevia extracts. Stevia extracts typically contain other ingredients, some of which may affect blood sugar levels. However, stevia leaf does not have GRAS status with the FDA, who do not permit its importation for use as a sweetener.

Benefits of stevia

Scientific studies suggest that stevia may offer the following benefits:

• possible antioxidant properties
• blood sugar control, both when fasting and after meals
• improved satiety and reduced hunger
• less desire to eat extra calories later in the day
• lower blood pressure in people with hypertension
• protection against liver and kidney damage
• reduced triglyceride and cholesterol levels

Another benefit of stevia is that it is relatively versatile. This sweetener is suitable for use in hot and cold beverages, and people can sprinkle it over oatmeal or fruit.

Stevia may also be suitable for some baking, depending on the particular sweetener product and the recipe. However, it does not caramelize and cannot substitute sugar in all types of cooking and baking.

Risks and side effects

Safety studies on stevia do not report any negative side effects, as long as people consume the sweetener in moderate quantities. The FDA recognizes purified stevia products as being generally safe for most people.

Some stevia products contain additives that may have side effects. For example, sugar alcohols may cause the following symptoms in some individuals:

• bloating
• nausea and vomiting
• stomach pain and cramping
• other digestive issues

However, sugar alcohols are otherwise safe for people with diabetes. According to the ADA, sugar alcohols contain fewer calories than sugar and do not affect blood glucose levels as much as other carbohydrates.

People with diabetes should check that their chosen stevia product does not contain other sweeteners that may increase blood glucose levels.

Alternatives to stevia for people with diabetes

Other artificial sweeteners may help people with diabetes manage their cravings for sweet foods and beverages.

According to the ADA, the FDA has approved the following artificial sweeteners:

• acesulfame potassium (Sunnet, Sweet One)
• advantame
• aspartame (NutraSweet)
• neotame
• saccharin (Sweet'N Low, Sugar Twin)
• sucralose (Splenda)

Some of these sweeteners are available for purchase online, including Sweet'N Low and Splenda.

Except for aspartame, the body does not break down these sweeteners. Instead, they pass through the digestive system and leave the body in the urine and stool. As with stevia, these sweeteners do not provide extra calories.

Sugar alcohols also increase sweetness without affecting blood sugar levels. The sugar alcohols that manufacturers commonly add to foods and beverages are:

• erythritol
• isomalt
• lactitol
• maltitol
• sorbitol
• xylitol

However, many foods with artificial sweeteners as an ingredient still contain calories and carbohydrates. Sometimes, these foods can have almost as many carbohydrates as the sugar-rich versions. For this reason, people should check nutrition labels carefully before selecting products to eat or drink.

Summary

Stevia is a sugar substitute that has very few calories. Stevia products contain a highly-purified extract from the stevia plant, which the FDA considers to be generally safe.

Some scientific evidence suggests that stevia may help people reduce their risk of diabetes or help those with the condition manage their blood sugar levels.

Stevia use alone is unlikely to affect a person's blood sugar control significantly, but it could be beneficial alongside other treatments and lifestyle changes.

When choosing a stevia product, it is always essential to check the label for other ingredients that may affect blood sugar levels. Anyone who is unsure can seek advice from a doctor or dietician or contact the manufacturer of the sweetener.

A range of stevia products is available to purchase online.