Does Aspartame Raise Blood Sugar?

If you are one of the millions of people who live with diabetes, you have probably seen your fair share of confusing headlines about the artificial sweetener aspartame and whether it has an effect on your blood sugar levels and weight.

There's been quite a bit of debate on this issue in the medical literature, so you likely have many questions: Does aspartame raise blood sugar? Does aspartame spike insulin? And most importantly, is aspartame safe?

"This has been an issue of concern for a while, but the data that we have now suggest that aspartame is safe for people with diabetes, does not raise blood sugar levels and can reduce both your calorie and carbohydrate intake," says Gerald Bernstein, MD, director of the diabetes management program at the Friedman Diabetes Institute in New York City. A May 2018 review study in the European Journal of Clinical Nutrition confirms that artificial sweeteners don't cause a spike in blood sugar.

Read more: A List of Foods Containing Aspartame

Commonly called a sugar substitute, aspartame is considered a non-nutritive sweetener because it has no calories or nutritional value. The Food and Drug Administration (FDA) approved aspartame for use in food in 1981, and in 1983 the agency approved its use in carbonated beverages like diet sodas. In 1996, aspartame garnered FDA approval for use as a sweetener available in packets for personal use.

Brand names include Nutrasweet, Equal and Sugar Twin. Aspartame is about 200 times sweeter than table sugar (sucrose), says the FDA, so you need much less of it to satisfy your sweet tooth.

Aspartame is considered to be safe for the general population except under certain conditions. For instance, the FDA explains, if you have a rare hereditary disease known as phenylketonuria (PKU), which means you have trouble metabolizing phenylalanine, a component of aspartame, you should avoid aspartame-containing foods and beverages.

Aspartame is not the only sugar substitute available. Others include:

• Saccharin (Sweet'N Low)
• Acesulfame potassium (Sunett)
• Sucralose (Splenda)
• Stevia (Pure Via, Truvia)

Read more: What Are the Dangers of Splenda, Sucralose and Aspartame?

These sweeteners don't affect your blood sugar and are considered "free" foods if you have diabetes. Foods with fewer than 20 calories and 5 grams or less of carbohydrates don't count on a diabetes exchange, according to the Mayo Clinic.

Obesity tends to travel with diabetes, and both conditions raise the risk for heart disease. Low- or no-calorie sweeteners may help with your weight loss efforts, Dr. Bernstein says. Aspartame is also completely digested into aspartic acid, phenylalanine and methanol in the upper small intestine, and then it is absorbed into the blood.

As such, aspartame does not disturb the balance of good and bad bacteria in your gut. It's when these levels are out of whack that digestive issues can occur, according to the American Association of Diabetes Educators. That organization states that the safe limit for aspartame is 50 milligrams per kilogram of body weight. For a 150-pound adult, this translates to 3,409 milligrams of aspartame. A 12-ounce drink of aspartame-sweetened soda contains 200 milligrams.

However, there isn't unanimous approval for aspartame. Dana Greene, RD, a dietitian in Brookline, Massachusetts, prefers that her diabetes patients use aspartame sparingly. "Use it in moderation and try to cut down or eliminate it over time," she suggests. Her concern is that aspartame and other artificial sweeteners will whet a person's appetite for more sweets.

Greene suggests talking to a registered dietitian or certified diabetes educator to come up with a personalized meal plan to help control your diabetes. He or she will be able to discuss what role, if any, aspartame or other artificial sweeteners can play in your diet. Be aware that there are different health concerns with some of the other sugar alternatives, which could influence your decision to use any or all of them.