Does Stevia Raise Blood Sugar? Sometimes, Here’s How

If you have diabetes, you know to watch out for foods or drinks that raise your blood glucose (sugar). But did you know that both natural and artificial sweeteners like stevia can also raise your blood sugar?

Pure stevia leaf has a low glycemic index of near 0. This means that it has little to no effect on your blood sugar level. But some preparations of stevia have a high glycemic index and can actually raise your blood glucose. 

What is in stevia?

Stevia is a natural sweetener made from a plant in the sunflower family. It has a number of chemicals that make it up to 300 times sweeter than table sugar. Because it’s so sweet, just a bit of it can sweeten foods and beverages. 

But many stevia products also contain other ingredients. These additives can give the product bulk, improve how easily it flows, and make it simpler to measure. Additives include:

• Maltodextrin

• Erythritol 

• Dextrose 

• Inulin 

• Xylitol 

Is stevia healthy?

Pure stevia is a safe food product. In moderation, stevia doesn’t have significant health risks. The FDA categorizes stevia as “generally recognized as safe” (GRAS). 

A review of the scientific data found that stevia has a number of health benefits, such as:

• Improving insulin production

• Decreasing inflammation

• Lowering blood pressure

• Reducing the risk of dental cavities

• Improving kidney function

• Slowing the growth of cancer cells in lab tests

One study showed that some people had allergic reactions to whole-leaf stevia. Whole-leaf stevia or crude extracts are not approved by the FDA.

EXPERT PICKS: WHAT TO READ NEXT

• Stevia vs. other sweeteners: See how stevia compares to sugar and other sweeteners.

• Understanding the glycemic index: Here’s how the glycemic index can help you manage your blood glucose. 

• The best (and worst) drinks for diabetes: Whether you’re looking for something sweet or refreshing, check out our guide to the best beverages for diabetes.

Researchers also warned that not all stevia preparations are high quality. Some were found to contain saccharin or cyclamates, which are banned in the U.S. 

Does stevia raise blood sugar?

Pure stevia doesn’t raise blood sugar. But stevia products sold in stores that use dextrose, maltodextrin, or other high glycemic additives may raise your blood sugar. 

Maltodextrin has a glycemic index of 95, and dextrose has a glycemic index of 100. These are common additives in stevia products. Depending on the type of stevia product you use — and how much you use — it can raise your glucose level a lot. That’s why it’s important to read the list of ingredients to check for additives that’ll raise your blood sugar.

You’ll also want to avoid added chemicals that you don’t tolerate well. For example, some people get an upset stomach from sugar alcohols like xylitol. 

Should people with diabetes avoid stevia?

If you have diabetes, stevia might be a good alternative sweetener for you. But make sure to read the list of ingredients to avoid getting an unexpected rise in your blood sugar from additives. And, like with other sweeteners, use stevia in moderation.

If you take other medications, you may need to limit how much stevia you use. Stevia can interact with some medications like:

• Lithium

• Medications that lower blood sugar

• Medications that lower blood pressure

How much stevia is OK to have?

You can safely have up to 12 mg of stevia for each kilogram of body weight each day. For example, a person who weighs 130 lbs could have about 27 packets of stevia a day.

Stevia is generally well tolerated, but there can be side effects. These can include:

• Nausea

• Vomiting

• Bloating

There isn’t much data on what happens when people use very large amounts of stevia.

Which natural sweeteners don’t affect blood sugar levels?

In addition to stevia, many natural sweeteners have a low glycemic index. This means they don’t raise your blood sugar. Some of the natural sweeteners with the lowest glycemic indexes are:

• Allulose (glycemic index 0)

• Monk fruit (glycemic index 0)

• Agave (glycemic index 11)

• Xylitol (glycemic index 12)

Which sweetener should you choose if you have diabetes?

Among the best natural sweeteners for people with diabetes are usually those with the lowest glycemic index. But the glycemic index isn’t the only thing to consider when choosing a sweetener. 

For example, agave has a low glycemic index and doesn’t raise blood glucose very much. But it contains fructose. Fructose has been tied to conditions like metabolic syndrome, fatty liver, and high triglycerides. If you have diabetes, you may want to avoid or limit your agave use. 

Erythritol has a glycemic index of 0 and doesn’t raise blood glucose. But a 2023 report found that people with the highest blood levels of erythritol had a greater risk of blood clots, heart attacks, and stroke. More research is needed to understand the effects of erythritol and what doses are safest to consume. 

If you have diabetes, it’s important to find a sweetener with the fewest side effects and the best safety profile. If one sugar alternative doesn’t agree with you, try another.

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Written by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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