4 Healthy Natural Sweeteners for Diabetics and Hypertensives

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The demand for lifestyle changes which involves excluding sugar and carbs from one's diet has become popular recently for treating diabetes and high blood pressure due to scientific studies. 

Since processed sugar and many other artificial sweeteners are a major risk factor of hypertension and diabetes, there is a need for natural sweeteners that can help prevent or manage rise in blood pressure or blood sugar. Therefore this article will focus on:

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4 healthiest natural sweeteners for diabetics and hypertensives 

Based on years and lots of studies, drug-free methods to manage diabetes have become popular, and natural sweeteners that have no effect on blood sugar have been explored. here are natural sweeteners that scientifically do not raise blood sugar or blood pressure, making them suitable for people with diabetes or hypertension:

1. Stevia

If you're diabetic or hypertensive and still want to enjoy your food with added sweeteners, stevia should be your first stop. 

Stevia is a natural sweetener derived from the leaves of the plant Stevia rebaudiana, native to South America. It is widely used as a sugar substitute due to its sweetness and its negligible caloric content.

Stevia sweetness level: 100–300x sweeter than sucrose (sugar).

Stevia contains compounds called steviol glycosides, which primarily include stevioside, rebaudioside A (Reb A), and rebaudioside C, D, M (less common).

Stevia has no significant impact on blood glucose levels, making it suitable for people with diabetes or those managing their carbohydrate intake.

A 2024 review of 26 studies on the effect of stevia on blood glucose and HbA1C revealed that pure stevia might lead to a reduction in blood glucose levels, particularly in individuals with a higher BMI, as well as those with diabetes and hypertension.

The review further stated that consuming stevia for a period of 1–4 months can effectively reduce blood glucose levels.

However, stevia products containing high glycemic additives, like dextrose and maltodextrin, may raise your blood sugar 

Some clinical studies suggest that the stevioside compound in stevia may have a mild blood pressure-lowering effect, particularly in individuals with hypertension. This compound widens the blood vessels to help lower blood pressure.

Side effects 

As good as stevia is for those with hyperglycemia and hypertension, there are some common side effects to it.

Here are some commonly reported side effects of stevia:

I. Digestive issues: Often due to additives like erythritol, maltodextrin, or inulin in stevia blends. These additives can cause bloating, gas, or diarrhea in sensitive people. People with digestive sensitivity especially to sugar alcohols or fiber fillers should sparingly use stevia.

II. Bitter or metallic aftertaste: This is common with less refined stevia or stevioside-heavy formulations. Taste perception varies.

III. Nausea or dizziness: Although this is rare, nausea or dizziness at the use of stevia is usually associated with large amounts being used or personal sensitivity. This is very rare and often anecdotal.

IV. Blood sugar lowering: Though beneficial for most, may potentially exaggerate hypoglycemia in some individuals taking insulin or glucose-lowering drugs, because naturally stevia, as revealed in a 2016 study, can significantly lower blood sugar levels in people with diabetes, whether during fasting or not.

V. Blood pressure lowering: As good as this sounds, people on BP meds should significantly lower the use of stevia, as it may reduce their blood pressure to a dangerous level. This only applies to those on hypotensive meds.

VI. Allergic reactions: Rare, but possible in people allergic to Asteraceae family (ragweed, daisies, marigolds).

V. Pregnant or breastfeeding effect: No known side effects for pregnant or breastfeeding women, as research is limited on this. It is better to consult a doctor.

Uses

Here are a few ways you can use stevia: 

  • Sweetening drinks (coffee, tea, lemonade)
  • Smoothies
  • Low-carb baking
  • Yogurt, oatmeal, sauces

Safety and where to get stevia

Stevia is FDA (Food and Drug Administration) approved in the United States for sale and use. Highly purified stevia extracts (e.g., Reb A) are GRAS (Generally Recognized As Safe).

If you're substituting stevia for sugar, begin with 1/8 to 1/4 teaspoon of pure stevia extract to replace 1 cup of sugar, since it is much sweeter tan sugar

However, whole-leaf stevia and crude extracts are not approved as food additives in the U.S. due to insufficient safety data.

Highly purified stevia extracts are sold on Amazon. You can also talk to a healthcare professional around you for possible places you can get pure stevia extracts. 

Here are a few highly rated pure stevia extracts on Amazon for US, Nigeria nationals, and individuals from countries it is approved:

2. Monk Fruit (Luo Han Guo) Extract

Monk fruit, also known as Luo Han Guo, is a small green melon native to southern China and northern Thailand. It has been used in traditional Chinese medicine for centuries to treat coughs and sore throats. The sweetening extract comes from the dried fruit and is known as mogroside, particularly mogroside V—not fructose or glucose—which is the main active compound. Monk fruit has zero calories and no carbohydrates, making it popular in low-carb and ketogenic diets.

Monk fruit sweetness level: 150–250 times sweeter than table sugar.

Monk fruit sweetener does not raise blood glucose levels, making it safe for diabetics and individuals with insulin resistance. A 2019 study conducted on rats, revealed that monk fruit decreases blood glucose level and improves insulin sensitivity. Although this type of study hasn't been applied to humans, it is strongly believed that monk fruit can also improve insulin sensitivity and enhance weight loss, as it does not contain fructose or glucose.

There is no direct evidence that monk fruit extract affects blood pressure. However, since its sweetness comes from mogroside V, which is an antioxidant agent in the fruit, it is generally considered heart-friendly. Antioxidants are enablers of nitric oxide that dilates or relaxes blood vessels, which reduces blood pressure on vessel walls.

Possible side effects

Although most people tolerate it well, there are still some rare side effects may, which may include:

I. Allergic reactions (especially in people allergic to gourds like cucumbers, melons, and squash).

II. Digestive issues: This occurs mostly when monk fruit isn't in its pure form but mixed with sugar alcohols like erythritol in commercial blends.

III. Like stevia, children and pregnant women should cautiously take monk fruit, due to limited research concerning possible side effects for them. For now, no known risk.

IV. People with fruit or gourd allergies should use monk fruit with caution.

Uses

Some people prefer monk fruit over stevia due to its more "sugar-like" flavor profile. It taste more like sugar. It should also be applied in small amount, as it is sweeter than sugar.
  • Baking and cooking: Heat stable, so suitable for baking.
  • Beverages: Used in soft drinks, teas, and smoothies.
  • Packaged foods: Found in protein bars, sugar-free snacks, and flavored waters.
  • Home use: Can replace sugar in coffee, tea, sauces, and dressings.

Safety concerns 

Monk has been approved as Generally Recognized As Safe (GRAS) by the FDA in the US since 2010.

In Canada it is allowed as a food additive in table-top sweeteners, while it is still under evaluation (not yet widely approved) by the European Union.

In Asia (China/Japan), it has a long history—spanning centuries—of use in traditional medicine and food.

Where to buy monk fruit sweetener

It's quite easy to get for those in Asia. For those outside Asia, pure form of monk fruit sweetener can be acquired from online retailers, like Amazon, iHerb, Thrive Market, Vitacost. It can also be purchased from health food stores and local grocery chains.

Here are a few highly rated monk fruit sweeteners without a mix of erythritol:

3. Allulose 

Allulose (also called D-psicose) is a rare sugar found naturally in small amounts in a few foods, such as:

  • Figs
  • Raisins
  • Maple syrup
  • Wheat

Commercially, it's produced through an enzymatic conversion of fructose (from corn or other plants), resulting in a low-calorie (~0.2 to 0.4 kcal/gram vs. 4 kcal/gram for sugar) sweetener that mimics sugar’s taste and texture

Sweetness: About 70% as sweet as sucrose (table sugar)—no bitter aftertaste. 

Allulose has minimal to no effect on blood glucose or insulin levels. A 2023 study shows allulose may even reduce postprandial (the amount of glucose or sugar in the blood after eating a meal) blood sugar spikes for healthy individuals.

Additionally, another randomized controlled trial published in the Journal of Functional Foods demonstrated that adding allulose to sucrose significantly lowered both postprandial glucose and insulin responses compared to consuming sucrose alone. This suggests that allulose may be beneficial in managing blood sugar levels when included in carbohydrate-containing meals.

As for blood pressure, no direct impact. Allulose is considered neutral regarding cardiovascular effects.

Possible side effects

Allulose is generally well tolerated in moderate amounts. However, at higher doses (>0.4 g/kg body weight), some people may experience:

I. Bloating

II. Gas

III. Diarrhea

IV. People with fructose malabsorption or sensitive digestion may want to start with small amounts.

V. No known harm for children and pregnant women, but consult a doctor due to limited studies.

VI. Individuals on a very low FODMAP diet may react to allulose, though it's not a classic FODMAP.

These effects are usually milder than with any other sugar alcohols like xylitol or maltitol.

Uses

Allulose is extremely versatile due to its sugar-like taste. It is used for:

  • Baking: Ideal for soft cookies, cakes, brownies (caramelizes and browns like sugar).
  • Beverages: Dissolves well in cold or hot drinks.
  • Sauces and syrups: Great in jams, glazes, and dressings.
  • Ice cream: Doesn’t recrystallize, giving a smooth texture.

Safety concerns

In the United States, allulose was declared Generally Recognized As Safe (GRAS) by the FDA in 2012. In 2019, the FDA ruled that allulose doesn’t need to be counted as sugar or added sugar on nutrition labels, a significant benefit for food manufacturers and diabetics.

In Asia it is also approved and increasingly used in Japan and South Korea. However, allulose is still under regulatory review—not yet fully approved—as a sweetener in Canada and the EU.

Where to Buy

Pharmaceutical and grocery stores are a good place to purchase allulose. However there are lots of online retailers you can get it from, an example is Amazon.


4. Erythritol

Erythritol is a type of sugar alcohol (polyol) used as a low-calorie sweetener.
It occurs naturally in small amounts in some fruits (e.g., grapes, melons), fermented foods (like wine and soy sauce), and is industrially produced by fermenting glucose (often from corn or wheat starch) with a yeast called Moniliella pollinis. Erythritol is virtually calorie-free at approximately 0.2 kcal/g, with sugar-like taste.

Sweetness level: Erythritol is approximately 60–80% as sweet as sucrose (table sugar).

With a glycemic index of 0, erythritol does not raise blood glucose or insulin levels, according to a 2017 study on Applied Microbiology and Biotechnology. Erythritol has a glycemic index of 0 and is very safe for diabetics and low-carb/keto dieters.

Although erythritol is generally safe for diabetics and hypertensives in low quantity use, however, MR analyses show that at higher concentration industrial processed erythritol has deleterious cardiometabolic effects.

Common Uses

Erythritol is used in:
I. Sugar-free gum, candy, chocolate
II. Keto desserts and baked goods
III. Low-carb protein bars and shakes
IV. Beverages (flavored waters, energy drinks)
V. Blends with other sweeteners (e.g., stevia or monk fruit)
VI. Baking: It caramelizes less than sugar but holds bulk well

Note: Erythritol may crystallize in some recipes (e.g., frostings or sauces).

Potential side effects & cautions

These are some potential side effects, usually at higher doses:
  • Bloating
  • Laxative effect (much milder than with other sugar alcohols like xylitol or sorbitol)
  • Cooling or “minty” sensation on the tongue
  • People with gastrointestinal sensitivity should be cautious.
  • People with cardiovascular risk factors may want to limit intake until more research emerges, especially if consuming erythritol in large quantities.

Regulatory Approval

In the United State, erythritol is GRAS by the FDA, while the EU approved it as a food additive (E968).

It is also approved in Canada, Australia, and others. In Japan it is widely used and accepted since the 1990s.

Where to Find It

  • Amazon
  • Walmart
  • Whole Foods
  • Sprouts Farmers Market
  • Natural grocers
  • iHerb, Thrive Market
  • Local grocery stores
Here are some of the most rated on Amazon:
There are many other natural sweeteners that have been immensely used to serve as an alternative to sucrose, but here's a clear breakdown of why diabetics and hypertensive individuals should be cautious with the some of these sweeteners:

1. Sugar Alcohols: Xylitol, Sorbitol, Maltitol

Pros:
  1. These are low-calorie sweeteners.
  2. They don’t spike blood sugar as sharply as regular sugar.
  3. Common in sugar-free gums, mints, and diabetic-friendly foods.
Why diabetics should be cautious:
Maltitol, in particular, has a higher glycemic index than xylitol or sorbitol and can raise blood sugar noticeably.

While xylitol and sorbitol have a smaller effect, in large amounts, they can still contribute to elevated blood glucose. Their effects vary between individuals, depending on insulin sensitivity and overall diet.

Why hypertensives should be cautious:
Some sugar alcohols may contribute to inflammation or metabolic strain, which can indirectly affect blood pressure. Frequent consumption may lead to weight gain, a key risk factor for both high blood pressure and diabetes.

2. Natural Sweeteners: Agave Nectar, Coconut Sugar, Honey, Maple Syrup

Pros:
  1. Natural sources. They contain small amounts of antioxidants or minerals (like zinc or magnesium).
  2. They're marketed as “healthier alternatives” to refined sugar.
Why diabetics should be cautious:
Despite being natural, they still contain high amounts of sugar:
  • Agave nectar: very high in fructose, which doesn't spike blood glucose directly but can cause insulin resistance and increase liver fat (fatty liver)—which can be healed through natural processes—over time.
  • Honey and maple syrup: mostly glucose and sucrose, leading to quick spikes in blood sugar.
  • Coconut sugar: has a slightly lower glycemic index but still raises blood sugar.
  • Dates (natural or processed): If used as a primary sweetener or snack without balancing nutrients, dates can spike blood sugar in people with diabetes. They have a high glycemic load because they are dense in carbs.
Note: All of the aforementioned can worsen glycemic control if used frequently or in large amounts.

Why Hypertensives Should Be Cautious:
High intake of sugars from these natural sources can contribute to:
  • Weight gain
  • Increased triglycerides
  • Insulin resistance
  • Higher blood pressure
Fructose (especially from agave) has been linked to increased uric acid, which can contribute to hypertension and gout.

In Summary 

Cutting out carbs and sugar from diabetic and hypertensive diets could be a very difficult thing to do. This has brought about the use of sweeteners and alternatives to sugar. In this article safe diabetic-safe ones are explored to help people with diabetes and hypertension enjoy their meal with after-effects.

In no particular order, here are the best sweeteners for diabetic and hypertensive individuals:

1. Stevia

  • Source: Natural extract from the stevia plant.
  • Glycemic Index (GI): 0
  • Blood Sugar Impact: None
  • Calories: 0
  • Taste: Sweet, sometimes with a slight aftertaste.
  • Best Use: Beverages, baking (look for baking blends).
Final note: Look for pure stevia or Reb A extracts to avoid blends with sugar or dextrose.

2. Monk Fruit (Luo Han Guo)

  • Source: Extract from monk fruit, a small melon native to Asia.
  • Glycemic index (GI): 0
  • Blood Sugar Impact: None
  • Calories: 0
  • Safe for hypertension
  • Taste: Very sweet, with no bitter aftertaste (often more pleasant than stevia).
  • Best Use: Coffee, tea, sauces, some baking blends.
Final note: Often sold mixed with erythritol, so read labels if you're sensitive to sugar alcohols.

3. Allulose

  • Source: Rare sugar found in small amounts in wheat and fruit.
  • GI: Near 0
  • Blood Sugar Impact: Very minimal, even lowers post-meal glucose
  • Calories: ~0.2 kcal/g
  • Safe for hypertension
  • Taste: Almost identical to sugar.
  • Best Use: Baking, syrups, ice cream, desserts.
Final note: Can cause digestive upset in large amounts, especially above 10g in one sitting.

4. Erythritol (with caution)

  • Source: Naturally found in fruits, produced by fermentation.
  • GI: 0–1
  • Blood Sugar Impact: Negligible
  • Calories: 0.2 kcal/g
  • Safe for hypertension: Generally safe, but recent studies suggest it might promote blood clotting in high blood levels — use moderately.
  • Best Use: Baking, candies, low-carb recipes.
Final note: Can cause bloating or gas in large amounts but usually better tolerated than other sugar alcohols.

Check labels before you purchase any of the above sweeteners.

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