Like 21 million other Americans, my mother has type 2 diabetes. Despite multiple trips to the doctor, she is still confused about which sweeteners are okay for diabetics. She also likes to bake (a multiple blue-ribbon winner in the area State Fair for pies and cakes), and is even hazier on which diabetic sweeteners work best as substitutes for sugar in cooking. So she sent me an email asking for my help.

Her timing was great. At the moment, I am writing a series of articles on type 2 diabetes. A few hours before her note popped in, I was asking all of those same questions. Here’s what I found.

By the way, I am not a licensed physician and this does not constitute medical advice. Check with your doctor before making any health decisions.

Comparison of diabetic sweeteners

Dr. Murray compares all the natural and artificial sweeteners on his webpage. Pretty thorough and no fancy language.

However, he doesn’t cover which diabetic sweeteners to use in cooking. There is a difference for everyday use and baking/cooking. Here’s a quick run-down:

• For all-purpose use, stevia is the hands-down winner. It’s derived from a leaf, and in it’s pure form it contains no synthetic chemicals. It comes in powdered and liquid forms. You can bake with it. You’ll have to experiment some to find the right amounts of liquid to add. Animal studies show that it also lowers blood pressure, which could be a big bonus for diabetics.

• Doctors also like “–ol” sweeteners, like xylitol (derived from a tree and a common ingredient in German chewing gum that prevents cavities) and mannitol, especially for baking. Splenda also gets high marks for baking because it can take the heat, but it’s dervied from sugar, and therefore, very processed. You can buy any of these at health food stores or online.

• Two other compound sweeteners are also safe for most diabetics. Phenylalanine (marketed as Equal or Nutrasweet) is derived from two amino acids. These are naturally occurring in food so nothing weird here. However, people with PKU (a rare genetic disorder) cannot use this sweetener. Unfortunately, phenylalanine doesn’t bake well. Saacharin been around since the ’70s, tastes slightly odd, may cause cancer, and doesn’t bake well either.

• Honey, real maple syrup and other fructose-based sweeteners (like rice and barley syrup) are okay in small amounts — like a teaspoonful in your tea, but in larger amounts (like for baking and cooking) they spike blood sugar and should be used in limited amounts. However, these sweeteners produce baked goods that are most similar to those made with sugar and require less experimentation to get the recipe right.

Unfortunately, brown and raw sugars impact blood sugar about the same as white sugar. So using “sugar in the raw” or brown cane sugar does not help control diabetes. These sugars are about the same as potatoes, white rice, white bread and drinks with high fructose corn syrup in terms of spiking blood sugar.

In fact, doctors recommend that people with diabetes cut out all white items and carbonated sodas from their diets. This presents a huge challenge because these are staples in our American diet. Guess that goes a long way toward explaining why 20.8 million of us have type 2 diabetes with millions more still to be diagnosed.

Whichever diabetic sweetener you decide one, good luck with your new eating plan! Here’s to your health.