How erythritol impacts blood sugar in people with diabetes

Erythritol has almost no direct impact on blood sugar or insulin in people with diabetes, which is why it is widely used as a sugar substitute in this group.

Effect on Glucose and Insulin

Studies in both healthy and diabetic individuals show that erythritol does not raise blood glucose or insulin levels, even when given as a 20 g oral dose. Its glycemic index is 0 and insulin index is around 2% of glucose, meaning it behaves almost like a “non-carbohydrate” for blood sugar control.

Short-Term Diabetes Studies

In a small 2‑week trial in people with diabetes, 20 g/day of erythritol was associated with a drop in HbA1c from 8.5% to 7.5%, suggesting improved long‑term glucose control, although data are still limited. Animal models and in vitro studies also show that erythritol can reduce fasting glucose and improve insulin sensitivity, supporting its use as a sugar replacement.

Gut Hormones and Meal Response

Erythritol slows gastric emptying and stimulates gut hormones like GLP‑1 and CCK, which can blunt post‑meal glucose spikes when consumed with carbohydrates. When taken alongside sucrose, erythritol has been shown to reduce postprandial glycemia compared with sucrose alone, which is helpful for people with impaired carbohydrate metabolism.

Safety and Cautions

For most people with diabetes, erythritol in moderate amounts appears metabolically neutral for blood sugar, but very high circulating levels have been associated in observational studies with cardiometabolic risk, so heavy long‑term use is still being researched. Using small to moderate amounts of erythritol to replace sugar, alongside overall diet and lifestyle changes, is currently considered a reasonable strategy for glycemic control.

1. https://diabetesjournals.org/diabetes/article/73/2/325/153839/Erythritol-as-a-Potential-Causal-Contributor-to
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC10638257/
3. https://www.webmd.com/diet/what-is-erythritol