Sugar alcohols are saccharides that have a hydroxyl group in place of the normal ketone or aldehyde group. The more common sugar alcohol found in food is xylitol. This is due to its sweetness level being roughly the same as sucrose, making it a good sugar alternative. The difference is that xylitol has about 2.4 kcal/g while sucrose has 4 kcal/g. Due to their composition and caloric differences, sugar alcohols will inherently be digested and metabolized differently. Most of the ingested sugar alcohols are absorbed in the small intestine, but a small amount remains unmetabolized, indicating that sugar alternatives provide less energy than sucrose.
This incomplete absorption can be beneficial for diabetics. Studies have shown that in diabetic and nondiabetic individuals xylitol does not raise one’s glycemic and insulinemic responses as high as normal sugar would. For example, the glycemic and insulinemic index of sucrose are 69 and 48, respectively. However, the glycemic and insulinemic index of xylitol are much lower at 13 and 11, respectively.
The findings summarized by Msomi and others indicate that sugar alcohols can help diabetics if implemented into their diets. Sugar alcohols are already found in foods such as gum, protein bars, ice cream, candy, and much more. However, overconsumption can cause gastrointestinal problems. A recommended range would be about 20 to 70 grams per day with the dosage varying between individuals. The review concluded that while sugar alcohols can help diabetics, more research should be done on the effects that these sugar alternatives have on the body.
Reference
Msomi, N. Z., Erukainure, O. L., & Islam, M. S. (2021). Suitability of sugar alcohols as antidiabetic supplements: A review. Journal of food and drug analysis, 29(1), 1–14. https://doi.org/10.38212/2224-6614.3107
It's good to know that sugar alcohols such as xylitol can be helpful in keeping glucose and insulin levels low for people with diabetes! After reading this blog, I was curious what effects these sugar alternatives have on the body and what research needs to be done regarding them. I found that potential side effects include irritable bowel syndrome, diarrhea, and kidney stones when consumed in excessive amounts (https://doi.org/10.1007/s00253-020-10708-7). Taking very high does can also cause tumors (https://www.webmd.com/vitamins/ai/ingredientmono-996/xylitol). Beside these potential side-effects, long-term effects still need to be studied. Particularly in relation with one's age, gender, and underlying diseases or conditions. Until then, is there a cohesive list of what kind of patients should avoid xylitol and potential replacements?
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