If you’re living with type 2 diabetes, you’ve probably heard a lot about sugar substitutes. They’re found in diet sodas and sugar-free snacks, and are even sold in individual packets. But one thing that doesn’t have a clear answer is whether sugar substitutes affect potassium levels.

The short answer is we don’t completely know. Right now, there’s no strong medical research that shows whether sugar substitutes directly raise or lower potassium levels in the body. In this article, we’ll explore what we do know about sugar substitutes and their possible effects on the body.

What Are Sugar Substitutes?

Sugar substitutes are ingredients used to sweeten food and drinks without adding regular sugar. They’re often lower in calories and don’t raise blood sugar levels (also called blood glucose levels) the same way sugar does. For that reason, many people with diabetes often use them.

Here are some common types of sweeteners:

• Aspartame, found in brands like Equal
• Sucralose, which is found in Splenda
• Saccharin, a main ingredient in Sweet’N Low
• Stevia, a plant-based sweetener
• Acesulfame potassium (or acesulfame K), sold as brand name Sunett
• Sugar alcohols like sorbitol, xylitol, and maltitol, which are commonly added to processed foods
• Monk fruit extract

Keep in mind that while these sugar substitutes add few or no calories, they are often much sweeter than regular sugars. For example, sucralose is about 600 times sweeter than table sugar. This means you only need a tiny amount of sugar substitutes to get the same sweetness.

Do Sugar Substitutes Directly Affect Potassium?

Some research has linked sugar substitutes to a higher risk of cardiovascular diseases such as heart disease. Specific types of sugar substitutes, like sugar alcohols, have also been shown to increase weight gain for some. However, most of the common sugar substitutes don’t directly affect potassium levels in healthy people, but there could be indirect effects in certain situations.

Possible Indirect Effects

Some sugar substitutes, especially sugar alcohols like sorbitol, can cause stomach problems if you eat too much. Consuming large amounts of sugar-free gum or candy that contains sorbitol may cause bloating, gas, and diarrhea. Some dieting candies also contain sugar substitutes that produce a laxative effect, leading to diarrhea.

Diarrhea can lead to potassium loss because your body flushes out fluids and electrolytes more quickly. So while the sweetener itself might not change your potassium levels directly, potential side effects of consuming it could.

Some research suggests that the use of artificial sweeteners may change the makeup of gut bacteria. Researchers are still determining whether these changes could affect how your body manages sugar cravings and regulates different nutrients, including minerals like potassium. But right now, scientists don’t have clear answers.

Why Potassium Matters for People With Diabetes

Potassium is an important mineral that helps your heart beat regularly, your muscles work properly, and your nerves send signals throughout your body. Low potassium levels can cause the body to release less insulin and have higher blood sugar levels. It can also increase the risk of developing type 2 diabetes.

A normal amount of potassium in the blood is between 3.6 and 5.2 millimoles per liter (mmol/L). Having too much or too little potassium can be dangerous.

What if You Have Kidney Disease?

If you have kidney disease, you need to be extra careful about your potassium levels. People living with kidney disease are at risk of having potassium levels outside of the goal range. When your kidneys don’t work as well as they should, they may not be able to remove extra potassium from your blood.

Be sure to talk to your doctor about sugar substitutes if you’re living with kidney disease or are on a potassium-restricted diet. This is especially important if products you’re consuming contain potassium-based additives or affect your electrolyte balance. You’ll also want to be sure to monitor your sodium intake and limit added sugars as well.

What You Should Do

There’s no research that directly links sugar substitutes to changes in potassium levels for people with type 2 diabetes. That means scientists can’t say for sure whether they’re safe or harmful, so more research on this relationship is needed.

If you’re managing type 2 diabetes and are concerned about your potassium levels, you can:

• Read labels carefully to avoid any potassium additives or salt substitutes.
• Watch for side effects like diarrhea, which could cause electrolyte imbalances and affect your potassium levels.
• Consume sugar substitutes in moderation, and try to limit all sugar intake in general.
• Ask about your kidney health, particularly if you’ve had abnormal lab results or symptoms.

Keep in mind that everyone’s body is different. Before making any big changes to your diet, consult your doctor or dietitian. Your healthcare team can help you choose the best sweeteners for your needs and make sure your potassium levels stay in a safe range.

Join the Conversation

On DiabetesTeam, people share their experiences with diabetes, get advice, and find support from others who understand.

Have you noticed any changes in your potassium levels when consuming sugar substitutes? Let others know in the comments below.