Elaine L., a reader of this column in the St. Louis Post-Dispatch, writes, “I have diabetes and my mouth often gets very dry. Sucking on candy helps, but I really don’t need the sugar. I’ve looked for sugar-free candy, but all I’ve found have sugar alcohols that upset my stomach. Are there any candy that are neither sugar alcohols nor sugar?”
I may be confused on this point, Elaine. Sugar alcohols are the main ingredient in most low-sugar candy. If there are any products that don’t contain sugar alcohols, I can’t think of any. However, there are some other things to consider:
I don’t know your health history, but dry mouth is a common problem for people with diabetes. It could be related to high blood sugar or certain medications. A thorough evaluation by your healthcare provider may help find a solution.
Sugar alcohols (collectively known as “polyols”) are chemically similar to sugar and alcohol (but not the type found in alcohol), according to the U.S. Food and Drug Administration. Called things like mannitol, sorbitol, xylitol, lactitol, isomalt, erythritol, and maltitol, these substances are often used in sugar-free products for a few reasons:
Because they’re not fully digested (leading to diarrhea if consumed in excess), they contain about half the calories of regular sugar, and dentists say these sweeteners may actually help prevent tooth decay.
Sugar alcohols occur naturally in some fruits, vegetables, and mushrooms. But when processed into individual compounds, they are classified as sweeteners. The FDA requires sugar alcohols to be listed on the Nutrition Facts label, so it’s easy to tell if a product contains them.
The American Diabetes Association says that sugar alcohols and other sweeteners are “acceptable substitutes for sugar when consumed in moderation.” However, not all sugar alcohols have the same effect on everyone.
According to several reputable sources, limiting your sugar alcohol intake to less than 20 grams per day may result in fewer digestive issues, and some research suggests that erythritol and xylitol may be gentler on the digestive tract than sorbitol and mannitol.
But there may be other concerns: Although sugar alcohols are “generally recognized as safe” by the FDA, in 2023 researchers at the Cleveland Clinic found that people with higher amounts of the sugar alcohol erythritol in their blood have a higher risk of heart attack and stroke.
By the way, Elaine, diabetes educators like me see you as a “person with diabetes” and not a “diabetic.” Just as there is more to sugar alcohols than meets the eye, you are more than your health condition.
Barbara Quinn-Intermill is a registered dietitian and certified diabetes educator at Monterey Peninsula Community Hospital. She is the author of Quinn-Essential Nutrition (Westbow Press, 2015). Email her at [email protected].
