If you have Type 2 diabetes are artificial sweeteners good for you? The short answer: No

From nortonhealthcare.com

If you have Type 2 diabetes and use artificial sweeteners, learn how they can affect blood sugar, inflammation and possibly brain health — get a doctor’s tips on healthier ways to manage your sweet cravings

Patients with Type 2 diabetes often are told to cut down on how much sugar they eat. If you have a sweet tooth, you may think you should cut sugar altogether and switch to artificial sweeteners.

“With Type 2 diabetes, your body does not correctly use the insulin created by your pancreas,” said Manikya Kuriti, M.D., an endocrinologist with Wendy Novak Diabetes Institute, a part of Norton Healthcare. “Instead of the insulin being used by cells as energy, your cells don’t respond. When the body produces more insulin to overcome this issue, your blood sugar rises — which can turn into serious health issues.

“This then requires you to manage your blood sugar in other ways, including with diet and exercise or medication. Each patient is different.”

The role of artificial sweeteners

If you need to reduce your blood sugar, you might think that consuming less “sugar” and replacing it with artificial sweeteners is the way to go. But it’s not that simple, according to Dr. Kuriti.

“There are studies that have found links between higher intake of artificial sweeteners and  cognitive decline,” Dr. Kuriti said. “The thought is these sweeteners can change the gut microbiome, which then causes inflammation. They also may change metabolic signals and disrupt how the body responds to insulin.”

There are a few artificial sweeteners available, and they affect the body in different ways:

• Aspartame: Based on observational studies, use of aspartame can result in cognitive complaints and mood fluctuations.
• Sucralose, saccharin, acesulfame potassium (also called acesulfame K or ace-K): These sweeteners have been shown to change the gut microbiome as well as interfere with normal metabolic processes. This could lead to inflammation.
• Stevia: This plant-derived product is newer than the others but is still a processed product. It seems to have minimal effect on insulin and glucose and leads to limited microbiome disruption compared with the others. Its potential benefits for people with diabetes derive from the fact that it is only partially absorbed in the small intestine, with much of it being fermented by gut bacteria in the colon. Because of this, its impact on blood glucose and insulin is much less than that of conventional sugar.
• Tagatose: A newly discovered sweetener called tagatose is not yet on the market and requires more research to determine if it has any long-term effects on health. At this time, clinical studies show very low increases in plasma glucose or insulin after ingestion of tagatose. Unlike sucrose, which fuels cavity-causing bacteria in the mouth, tagatose appears to reduce the growth of some of those bacteria, and evidence suggests it has probiotic effects to support healthy oral and gut bacteria. 

“It’s important to note that current research does not show artificial sweeteners directly cause dementia,” Dr. Kuriti said. “For people who already have a risk of dementia, there is a greater need to limit use of artificial sweeteners for long-term health.”

Those at greatest risk are people with diabetes who are older than 65 and have a history of stroke, high blood pressure, vascular disease and other heart issues.

If you have Type 2 diabetes, what should you do about sugar?

Patients who have Type 2 diabetes do need to monitor sugar intake, and high use of artificial sweeteners is not the answer.

“The best answer is to start with small changes that can improve your diet, your diabetes and your risks for other diseases,” Dr. Kuriti said.

This means working with your provider on a plan. You’ll need to reduce sugar-sweetened and artificially sweetened drinks and foods, replacing them with healthier alternatives to help with glycemic control. Instead of sweetened drinks, try sparkling water. Instead of processed sweets, try fruit, and always work to increase fiber.

“Long-term use of artificial sweeteners or diet beverages might not be a healthier option, but the goal is to make smarter substitutions to retrain your tastes,” Dr. Kuriti said. “Diabetes in most cases is a lifelong condition and requires changes to lifestyle and diet to reduce further risks.”

Tips to reduce use of artificial sweeteners:

• Start with one meal a day, decreasing how much sweetener you use.
• Each day, reduce the amount you use.
• Decrease the amount of processed foods you eat and increase natural items such as berries, nuts and vegetables.
• Drink plenty of water or try sparkling water or unsweetened tea.

https://nortonhealthcare.com/news/if-you-have-type-2-diabetes-are-artificial-sweeteners-good-for-you-the-short-answer-no/

7-Day No-Sugar Vegetarian Meal Plan for Diabetes, Created by a Dietitian

From eatingwell.com

By Emily Lachtrupp, M.S, RD 

Reap the benefits of a vegetarian diet while skipping added sugars in this delicious meal plan for diabetes 

In this seven-day no-sugar-added vegetarian meal plan for diabetes, we map out a week of plant-forward meals tailored to promote stable blood sugars. To help, we skipped added sugars while focusing on more nutrient-dense options, like whole fruits, vegetables and legumes. The average American consumes about 17 teaspoons of added sugars each day, significantly above the American Heart Association’s recommended daily max of 9 teaspoons for men and 6 teaspoons for women. Added sugars can certainly be included in moderation in a healthy diet, but with so many of us eating more than we realize, they can be a low-hanging fruit to tackle if we’re looking to improve blood sugar levels. When grocery shopping, double-check the nutrition label and ingredient list to see where added sugars may be making their way into your foods.

Why This Meal Plan Is Great for You

To further support healthy blood sugar levels, we aimed for a moderate carbohydrate level. In this plan, about 40% of total daily calories are from carbohydrates, which is below the 2020-2025 Dietary Guidelines for Americans' recommendation of 45% to 65% of calories from carbohydrates. In this plan, the seven-day average carbohydrate intake is 152 grams per day, which equals about 40% of total daily calories. It’s important to note that there is no one-size-fits-all recommended amount of carbohydrates to eat per day, and an individual's total needs depends on factors such as activity level.

In addition, we also paid close attention to fibre intake. The seven-day average of fibre intake amounts to 38 grams per day. Fibre is a type of indigestible carbohydrate that doesn’t raise blood sugars but is included in the total carbohydrate count. Fibre is found in fruits, vegetables, whole grains and legumes. This important nutrient has a ton of health benefits and plays an important role in promoting more stable blood sugar levels.

Because weight loss can help improve blood sugar levels for some people, we set this plan at 1,500 calories, which is a level at which many people will lose weight. For those with other calorie needs, we also included modifications for 1,200 and 2,000 calories per day. As with all meal plans, this is meant to serve as a template for a diabetes-friendly eating plan. Make adjustments to fit your lifestyle and taste preferences, if desired. Check out all of our Diabetes-Friendly Vegetarian Recipes for more inspiration.

Is the Vegetarian Diet Good for People with Diabetes?

Many people follow a vegetarian diet for an array of reasons, such as trying to reduce their impact on the environment, supporting animal rights or simple personal preference. We can add improved blood sugar levels to the list of reasons why someone may go vegetarian. Following a plant-based vegetarian diet is associated with a reduced risk of developing type 2 diabetes, improved blood sugar levels and improved blood lipid (cholesterol) levels.

Whether you’ve been vegetarian for years, are looking to try something new or are just aiming to cut back on animal proteins, this meal plan can help provide some inspiration. And if you’re not interested in being fully vegetarian but want to reap the health benefits, don’t fret. The flexitarian diet may be a better fit and you can enjoy more plant-based meals while still having the occasional animal protein. 

Vegetarian Foods to Focus On 

• Fruits
• Vegetables
• Beans
• Lentils
• Soy (tofu, edamame, tempeh)
• Seitan
• Nuts
• Seeds
• Whole grains (such as oats, bulgur, brown rice and more)
• Eggs
• Dairy (yogurt, kefir, milk, cheese)
• Oils (such as olive oil and avocado oil)
• Herbs and spices

How to Meal-Prep Your Week of Meals:

• Make Vegan Lentil Soup to have for lunch on Days 2 through 5.

Day 1

Breakfast (319 calories, 38g carbohydrate)

• 1 serving Feta, Egg & Spinach Breakfast Taco
• 1 medium apple

A.M. Snack (42 calories, 11g carbohydrate)

• ½ cup blackberries

Lunch (512 calories, 41g carbohydrate)

• 1 serving Loaded Cucumber & Avocado Sandwich
• 1 (5.3-oz.) container low-fat plain strained (Greek-style) yogurt

P.M. Snack (208 calories, 35g carbohydrate)

• ¼ cup unsalted dry-roasted shelled pistachios
• ½ cup raspberries

Dinner (427 calories, 36g carbohydrate)

• 1 serving Grilled Cauliflower Steaks with Almond Pesto & Butter Beans

Daily Total: 1,508 calories, 82g fat, 66g protein, 141g carbohydrate, 35g fibre, 1,723mg sodium

Make it 1,200 calories: Omit apple at breakfast, reduce to ½ cup low-fat plain Greek yogurt at lunch and omit pistachios at P.M. snack.

Make it 2,000 calories: Add ¾ cup low-fat plain kefir to breakfast, 1 serving Cottage Cheese Snack Jar with Fruit to A.M. snack and 1 serving Caprese Salad with Cherry Tomatoes to dinner.

Day 2

Breakfast (368 calories, 26g carbohydrate)

• 1 serving Tofu Scramble
• 1 medium orange

A.M. Snack (59 calories, 14g carbohydrate)

• 1 medium peach

Lunch (332 calories, 48g carbohydrate)

• 1 serving Vegan Lentil Soup
• ½ cup cucumber, sliced
• 2 Tbsp. hummus

P.M. Snack (215 calories, 12g carbohydrate)

• 1 serving Cottage Cheese Snack Jar with Fruit

Dinner (521 calories, 42g carbohydrate)

• 1 serving Shakshuka (Eggs Poached in Spicy Tomato Sauce)
• 1 serving Avocado Caprese Salad

Daily Totals: 1,494 calories, 73g fat, 82g protein, 143g carbohydrate, 37g fibre, 1,579mg sodium

Make it 1,200 calories: Omit orange at breakfast and cucumber with hummus at lunch and change P.M. snack to 1 clementine.

Make it 2,000 calories: Add 1 cup low-fat plain kefir to breakfast, ¼ cup unsalted dry-roasted almonds to A.M. snack and 1 serving Apple with Cinnamon Almond Butter as an evening snack.

Day 3

Breakfast (319 calories, 38g carbohydrate)

• 1 serving Feta, Egg & Spinach Breakfast Taco
• 1 medium apple

A.M. Snack (215 calories, 12g carbohydrate)

• 1 serving Cottage Cheese Snack Jar with Fruit

Lunch (332 calories, 48g carbohydrate)

• 1 serving Vegan Lentil Soup
• ½ cup cucumber, sliced
• 2 Tbsp. hummus

P.M. Snack (234 calories, 23g carbohydrate)

• ¼ cup unsalted dry-roasted shelled pistachios
• 1 medium peach

Dinner (406 calories, 38g carbohydrate)

• 1 serving Chipotle Tofu Tacos
• 1 serving Spicy Cabbage Slaw

Daily Totals: 1,507 calories, 73g fat, 70g protein, 159g carbohydrate, 33g fibre, 1,449mg sodium

Make it 1,200 calories: Omit apple at breakfast and change P.M. snack to 1 plum.

Make it 2,000 calories: Add 1 cup low-fat plain kefir to breakfast, ¼ cup guacamole to dinner and 1 medium banana with 2 Tbsp. almond butter as an evening snack.

Day 4

PHOTOGRAPHER: FRED HARDY, FOOD STYLIST: JENNIFER WENDORF, PROP STYLIST: LYDIA PURSELL

Breakfast (368 calories, 26g carbohydrate)

• 1 serving Tofu Scramble
• 1 medium orange

A.M. Snack (142 calories, 13g carbohydrate)

• 1 (5.3-oz.) container low-fat plain strained (Greek-style) yogurt
• ½ cup raspberries

Lunch (332 calories, 48g carbohydrate)

• 1 serving Vegan Lentil Soup
• ½ cup cucumber, sliced
• 2 Tbsp. hummus

P.M. Snack (136 calories, 15g carbohydrate)

• 1 large hard-boiled egg
• 1 medium peach

Dinner (536 calories, 54g carbohydrates)

• 1 serving Baked Feta & Tomato Chickpeas

Daily Totals: 1,513 calories, 65g fat, 89g protein, 157g carbohydrate, 37g fiber, 1,751mg sodium

Make it 1,200 calories: Omit orange at breakfast, yogurt at P.M. snack, hummus at lunch and hard-boiled egg at P.M. snack.

Make it 2,000 calories: Add 1 cup low-fat plain kefir to breakfast, ¼ cup unsalted dry-roasted almonds to P.M. snack and 1 serving of Grilled Eggplant Salad to dinner.

Day 5

Breakfast (319 calories, 38g carbohydrate)

• 1 serving Feta, Egg & Spinach Breakfast Taco
• 1 medium apple

A.M. Snack (215 calories, 12g carbohydrate)

• 1 serving Cottage Cheese Snack Jar with Fruit

Lunch (332 calories, 48g carbohydrate)

• 1 serving Vegan Lentil Soup
• ½ cup cucumber, sliced
• 2 Tbsp. hummus

P.M. Snack (234 calories, 23g carbohydrate)

• ¼ cup unsalted dry-roasted shelled pistachios
• 1 medium peach

Dinner (492 calories, 55g carbohydrate)

• 1 serving Vegetarian Butternut Squash Chili with Black Beans
• 2 cups mixed greens
• 1 serving Lemon-Garlic Vinaigrette 

Make-Ahead Tip: Reserve 2 servings Vegetarian Butternut Squash Chili with Black Beans to have for lunch on Days 6 and 7.

Daily Totals: 1,493 calories, 70g fat, 64g protein, 166g carbohydrate, 41g fibre, 1,533mg sodium

Make it 1,200 calories: Omit apple at breakfast and change A.M. snack to 1 plum.

Make it 2,000 calories: Add 1 plum to lunch, add ½ an avocado (sliced) to the salad at dinner and add 1 medium banana with 2 Tbsp. almond butter as an evening snack.

Day 6

Breakfast (368 calories, 26g carbohydrate)

• 1 serving Tofu Scramble
• 1 medium orange

A.M. Snack (163 calories, 19g carbohydrate)

• 1 (5.3-oz.) container low-fat plain strained (Greek-style) yogurt
• 1 cup sliced strawberries

Lunch (244 calories, 41g carbohydrate)

• 1 serving Vegetarian Butternut Squash Chili with Black Beans

P.M. Snack (210 calories, 30g carbohydrate)

• 1 medium banana
• 1 Tbsp. natural peanut butter

Dinner (517 calories, 38g carbohydrate)

• 1 serving Greek Salad with Edamame
• 1 serving Everything Bagel Avocado Toast

Daily Totals: 1,501 calories, 70g fat, 83g protein, 154g carbohydrate, 43g fibre, 1,608mg sodium

Make it 1,200 calories: Omit orange at breakfast, yogurt at A.M. snack and peanut butter at P.M. snack.

Make it 2,000 calories: Add 1 cup low-fat plain kefir to breakfast, 1⁄4 cup unsalted dry-roasted almonds to A.M. snack and a medium apple to lunch. Increase to 2 Tbsp. natural peanut butter at P.M. snack.

Day 7

GREG DUPREE

Breakfast (319 calories, 38g carbohydrate)

• 1 serving Feta, Egg & Spinach Breakfast Taco
• 1 medium apple

A.M. Snack (215 calories, 12g carbohydrate)

• 1 serving Cottage Cheese Snack Jar with Fruit

Lunch (244 calories, 41g carbohydrate)

• 1 serving Vegetarian Butternut Squash Chili with Black Beans

P.M. Snack (223 calories, 8g carbohydrate)

• 2 stalks celery
• 2 Tbsp. natural peanut butter

Dinner (488 calories, 41g carbohydrate)

• 1 serving Chickpea Pasta with Mushrooms & Kale
• 2 cups mixed greens
• 1 serving Lemon-Garlic Vinaigrette 

Daily Totals: 1,489 calories, 80g fat, 65g protein, 141g carbohydrate, 38g fibre, 1,459mg sodium

Make it 1,200 calories: Omit apple at breakfast and peanut butter at P.M. snack.

Make it 2,000 calories: Add 1 (5.3-oz.) container of low-fat plain Greek-style yogurt to lunch, ½ an avocado (sliced) to the salad at dinner and ¼ cup unsalted dry-roasted almonds and 1 plum as an evening snack.

https://www.eatingwell.com/7-day-no-sugar-vegetarian-meal-plan-for-diabetes-8637096