Stevia and Diabetes

The Stevia plant is a perennial summer bloom that first originated in South America. Stevia Rebaudian is known as Sweet Leaf and comes in many forms, and is a natural sweetener.

Stevia extract comes from the stevia leaf. The primary components extracted from the stevia leaf is known as Steviol Glycoside; this is what is used in stevia sweeteners to provide a sweet taste without calories. 

Although there are over 200 species, Stevia Rebaudiana Bertoni is the most prized variety and used to produce the most edible products. The amount of sweetness varies among choices. Some describe the taste as licorice-like. Because of the dense sweetness, any substitution is not made cup for cup. 

There are many stevia products; here, we explore the types available:

Stevia Powder

Stevia powder is the most common form used in Japan. The powder is 200-300 times stronger than sugar being sweetest of all stevia products by weight. The powder is the extract of the sweet glycosides in the stevia leaf. Not all stevia extract powders are the same.

The amount of refinement affects the sweetness, taste, and cost of the white stevia powders. The quality of the plant harvested will also likely affect the taste. With some of the more refined powders, you may find more of an aftertaste. Because of its intense sweetness, minute amounts flavor things like teas or beverages.

Fresh Stevia Leaves

Stevia Leaves is an herb that is in its most natural stateThis part of the plant will taste almost like licorice. Although fresh leaves are not as sweet as in the dried form, it is still much more than table sugar.

For stevia to have a more practical application as a tea or sweetener, the leaves must be dried or put through an extraction process. Extraction makes the sweet taste even more potent.

  • Dried Leaves When dried, the sweet constituents of the stevia leaf are released. Drying and crushing are necessary. A dried leaf is considerably sweeter than a fresh one. Dried stevia leaf may come in bulk or package like tea bags, or you can find it finely powdered. It has a greenish color. Dried leaves are useful in various foods and beverages, including coffee, shelf-stable items like hot cereals and applesauce. 

  • Liquid Concentrates Nutritionally speaking; there is no difference between liquid stevia and its other forms. Liquid concentrate is prepared by taking Stevia liquid and boiling it with water. Others may prepare it by taking dried leaves and covering it with vodka, letting it steep for several weeks, then straining it. While using a concentrate requires a little finesse, this chart can make substitutions easier. 

Stevia leaf extract comes in several forms. When boiling leaves, the result is a syrupy black liquid. The stevia extract can enhance the flavor of many foods. Another type is made by steeping stevia leaves in distilled water or a mix of water and grain alcohol. One can also mix the white powder with water to make a concentrate.

What effect does it have on blood sugar levels?

Stevia, in its natural form, contains glycosides and plenty of antioxidants. Stevia may help to lower blood pressure and reduce the risk of insulin and blood sugar problems.7

In a 2018 study, researchers tested the effects of a stevia-sweetened coconut jelly on participants 30-120 minutes after consumption at half-hour intervals. The research found that postprandial glucose (after-meal blood sugar levels) started to go down 60-120 minutes after eating the jelly, even before the secretion of insulin initiates.6

Benefits of stevia for diabetes

Sugar consumption, outlined by the ADA (American Dietetic Association) and AHA (American Heart Association) in the U.S. as well as the NHS (National Health Services) in the U.K. Due to the “The U.S. obesity epidemic and increasing rates of type 2 diabetes”, the report urged that recommended daily calories from added sugars be lowered from 10% to 6% in the new guidelines.8

Many are criticizing this recommendation stating that sugar intake should be much lower. The NHS standard recommendation is that added sugar shouldn’t make up more than 5% of the energy (calorie intake) you get from food and drink each day. That’s about 30g of sugar or the equivalent of 7.5 tsp. (3)

Diabetes is a group of diseases. In this state, the body has stopped producing insulin, or insulin secretion has slowed. If the body is still making insulin, it may not be using it. When any of these things happens, the body cannot get sugar from the blood into the cells. That leads to high blood sugar levels. Blood glucose levels are the concentration of sugar in your blood.  Insulin resistance occurs due to diet-induced inflammationoften from sugar intake.

The cells within the muscles, liver, and fat cells do not respond well to insulin. Your pancreas tries to compensate by producing more insulin. If it is unable to keep up, your blood sugar falls out of range. Non-nutritive Sweeteners (NNS) do not raise blood sugar levels.4

Studies have targeted weight gain and blood sugar control utilizing diabetic rats over the last few decades. One study of interest fed one group of rats sucrose (sugar) and the other group NNS. Over eight weeks, the sucrose rats gained considerable weight while the NNS rats showed the same weight gain as controls.

The results show that artificial sweeteners’ substitution for sugars prevents weight gain and promotes weight loss in rats5. When a person has a high sugar diet, weight gain increases, a diabetic can choose to reduce sugar intake by choosing a low-calorie sweetener. It will reduce inflammation and control blood sugar levels with fewer calories.

Risk and side effects

While Stevia leaf extract is safe to consume, it’s one of eight low and no-calorie sweeteners permitted by the FDA for use in the U.S. food supply. Global health authorities, such as the European Food Safety Authority (EFSA), Joint Expert Committee on Food Additives (JECFA), have found low and no-calorie sweeteners safe.

Stevia leaf extract is  Generally Recognized as Safe (GRAS) by the FDA for use in foods and beverages since 2008. An ADI (acceptable daily intake) is the amount of a substance that safe to consume each day throughout a person’s lifetime. The FDA has established an acceptable daily intake (ADI) level for the high-intensity sweeteners approved as food additives.

For each of these sweeteners, the FDA determined that the estimated daily intake would not exceed the ADI even for high substance consumption. (FDA) Insulin sensitivity does seem to increase with stevia intake, and it may be necessary to increase periodic checks of glucose levels. When consumed in small amounts, there are no adverse side effects.

Stevia alternatives for people with diabetes

Sweeteners classify into two groups Nutritive and Non-nutritive:

Nutritive sweeteners are those which have calories (carbohydrate) and provide nourishment. Nutritive sweeteners such as sugars and sugar alcohols add carbohydrates to food and calories to your diet that contain few vitamins or minerals. They are’ empty’ calorie foods. 

Artificial sweeteners offer sweetness but without the burden of calories. Within Nutritive sweeteners, there is the sub-class of Sugar alcohol and sugar. Sugar alcohol does contain a small number of calories, so one cannot consume it endlessly.

If eaten in excess, they can contribute to weight gain or cause G.I. distress. In diabetic patients, small amounts are harmless. When reading food labels, sugar alcohols appear by these names:

  • Sorbitol 

  • Xylitol 

  • Isomalt 

  • Mannitol

Other types of sugar that are considered Nutritive:

  • Fructose (fruit sugar)

  • Sucrose: brown sugar, white table sugar, and confectioner sugar, corn sugar, and High Fructose corn syrup

  • Dextrose Maltose 

  • Hydrogenated Starch Hydrolysates (HSH)  

These sugars usually come from sugar cane and sugar beets. But they can also come from grains like corn. Corn sweeteners include high fructose corn syrup-this category of sugar sweetens beverages, candy, cakes, bread, cereals. Added sugars are very high in empty calories and give the body zero nutrients when you consume them. With an increase in added sugar, several things occur. There is a disruption in your body’s insulin level secretion-the result is body inflammation, weight gain, and insulin resistance.

The other group is Non-nutritive sweeteners; these are calorie-free and provide no nourishment. Stevia falls within the category of Non-nutritive sweeteners. Non-nutritive sweeteners play a crucial role in weight maintenance or loss, making this an excellent option for diabetes or those with the desired weight loss. Non-nutritive sweeteners are calorie-free items. Some example of non-nutritive sweeteners include:

Aspartame  200 times sweeter than sucrose. This sweetener has been in use for 40 years, utilized in thousands of food products. It is not stable in heat or liquid form and is not useful in cooking. Consumers with phenylketonuria (PKU), a rare genetic disorder, have difficulty metabolizing phenylalanine, an aspartame component. Sensitive consumers can avoid food products containing aspartame by looking at the label of such products.4

Acesulfame-K is 200 times as sweet as sucrose. Europe has approval for use in soft drinks, and there are no safety concerns regarding its use. This sweetener is most useful in dry items, such as gelatin, baked goods, and desserts.


Sucralose has been around a relatively shorter time compared to its counterparts. It became a popular non-caloric sweetener in the late 1990s. This product is derived from sugar and is 600 times sweeter than sugar, meaning a minimal amount is required to sweeten. Sucralose is heat-stable, meaning it’s useful in baked items.

Research shows it has no effect on blood sugar and is deemed safe for use in all age populations, including pregnant women and children. It is currently endorsed in the United States by the American Heart Association (AHA)and the American Diabetes Association. (ADA) At one point, people believed  Sucralose raised the risk of Type 2 diabetes. It was targeted as potentially boosting the spike in blood sugar when carbohydrates are consumed with or soon after Sucralose. Multiple studies have refuted these ideas.4


Cyclamate is a calorie-free sweetener that is 30 times sweeter than sucrose. It has a long shelf life at It is soluble in liquids, and it is stable in heat and cold. This sweetener came into use in the late 1930s.

European nations and 100 countries worldwide have approved use. In the United States, Cyclamate is not allowed. Outdated studies linked its use with increased cancer risk. There is a current petition for its re-approval submitted to the U.S. Food and Drug Administration.4

Swingle fruit, commonly known as monk fruit, is a small round fruit native to southern China. Eastern medicine utilizes it as a cold and digestive aid. It is useful to sweeten foods and beverages. Mogrosides are compounds that give the Monk fruit it’s sweetness. Mogrosides are not absorbed in the gastrointestinal tract and do not lend calories.

Consumption does not negatively affect body weight. When they reach the large intestine, gut microbes break off the glucose molecules and use them as an energy source. The rest of the magrosides metabolites excrete from the gastrointestinal tract. Monk fruit is 150-200% sweeter than sugar. As a result, only a small amount is necessary. Its uses are diverse, applicable in desserts, beverages, and baked goods. 


You may be curious if sugar substitutes are safe. The Food and Drug Administration (FDA) has approved the use of the following non-nutritive sweeteners: acesulfame potassium, aspartame, neotame, saccharin, sucralose, and stevia. Concerns have circulated over the years that artificial sweeteners may be associated with increased risks of cancer.

These fears originate from animal studies, during which mice developed cancer when fed high doses of non-nutritive sweeteners. These studies show no translation of carcinogenic effects in humans. Equally approved for use in the U.K.6 As a diabetic patient, it is essential to understand the pros and cons and applications of natural and artificial sugar.

The positive use of  Stevia in diabetes is proven over multiple research studies. Stevia is one of the many safe weight loss options. Stevia is helpful in blood pressure reduction and blood sugar control. As a person with diabetes, these choices can complement other healthy lifestyle choices.

Explore More


Monk Fruit Sweetener: Good or Bad?


  1. 1.U.S. News and World Report. (, 2020). New Dietary Guidelines for Americans Ignore Recommendations on Sugar, Alcohol. Available: Last accessed 1/9/20
  2. 2.Faima Bakar. (, 2018). What is the recommended daily sugar intake? Read more: Twitter: | Facebook: https://ww. Available:,a%20day%20for%20those%20aged%2011%20and%20over.. Last accessed 1/9/21.
  3. 3.By Sara Glanz, MS, R.D., L.D., CNSC. (, 2018). Sweet Truth: A Review of Non-Nutritive Sweeteners. Available: Sweet Truth: A Review of Non-Nutritive Sweeteners. Last accessed 1/9/21
  4. 4.Editor. (, 2019). Nutritive and Non-nutritive Sweeteners. Available: Last accessed 1/9/21.
  5. 5.K P Porikos 1, H S Koopmans. (, 1988). The effect of non-nutritive sweeteners on body weight in rats. Appetite . 11 Suppl 1:12-5 (11 Suppl 1:12), 5.
  6. Jayne Leonard. (, 2019). Can stevia benefit people with diabetes?. Available: Last accessed 1/16/21.
  7. 6.Stephen D. Anton, Ph.D. (2010). Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels. Appetite. 55 (10.1016), 37-43.
  8. 7.FDA. (, 2014). High-Intensity Sweeteners. Available: Last accessed on January 17, 2021.
  9. 8. Eliza Pope, (2010). Sugar substitutes during pregnancy. Appetite. 55 (1), 37–43G

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