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. And people with diabetes learn quickly that sugar-sweetened foods and drinks are most likely to raise your blood sugar level. But did you know that foods with natural and artificial sweeteners like stevia can also raise your blood glucose?

Pure stevia leaf has a low glycemic index of near 0. This means that it has little to no effect on your blood glucose 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 naturally occurring 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. Since stevia is so sweet, it takes only a small amount to sweeten foods and beverages. 

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When stevia is packaged to be sold, it’s often used with other ingredients to give it bulk, improve how easily it flows, and make it simpler to measure. Common additives include:

• Maltodextrin

• Erythritol 

• Dextrose 

• Inulin 

• Xylitol 

Is stevia healthy?

A review of the scientific data looked at studies on the safety and health benefits of pure stevia extract. And experts believe that stevia is safe. They also 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

• Increasing blood flow to the kidneys

• 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.

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. 

How does stevia affect 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 what type of stevia product you use, and how much you use, it can raise your glucose level a lot. 

It’s important to read the list of ingredients to make sure there aren’t any high glycemic chemicals added in that will 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 with sugar alcohols, so xylitol wouldn’t be a good option for you. 

Should people with diabetes avoid stevia?

If you have diabetes, the right stevia product 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 because of the added chemicals. It's always a good idea to use stevia or other sweeteners in moderation.

And if you take other medications, you may need to limit your use of stevia. Stevia can interact with some medications like:

• Lithium

• Blood sugar lowering medication

• Blood pressure lowering medication

How much stevia is OK to have?

According to the FDA, you can safely have up to 12 mg of stevia for each kilogram of your body weight per day. For a 130-pound person, this comes out to 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 the effects of people who take large amounts of stevia.

Which natural sweeteners don’t affect blood sugar levels?

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

• Allulose

• Monk fruit 

• Xylitol (glycemic index 12)

• Agave (glycemic index 11)

Which sweetener should you choose if you have diabetes?

The best natural sweeteners for people with diabetes are those with the lowest glycemic index. But glycemic index isn’t the only thing to think about when choosing sweeteners. 

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 in a recent report, people with the highest blood levels of erythritol had a greater risk of blood clots, heart attacks, and stroke. More research is needed on the effects of erythritol and safest doses 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. 

Why trust our experts?

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:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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