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how to bolus for sugar alcohol t1d

Sugar alcohols are used as sweeteners in many sugar free foods. They are named sugar alcohols because their structure resembles, you guessed it, sugar and alcohol. While they are labeled as a “sugar free” sweetener, they will raise blood sugar. Deceiving, right? That’s because technically they aren’t “carbohydrate free”. Technicalities man! Technicalities.

 

How To Bolus for Sugar Alcohols

As a rule of thumb, it’s a good idea to subtract half (50%) of the sugar alcohol grams from the total carbohydrates (source). From there you would subtract fiber and bolus. Not subtracting fiber? Check out this post on why you probably ought to.

Here’s an example of what it would look like….

sugar alcohols nutrition label

Subtract 7g (half of sugar alcohol) from 28g (total carbs). This leaves you with 21g carbs….. subtract 3g (for fiber) and that leaves you with 18g. 18g is what you would bolus for.

There is one MAJOR caveat! The sugar alcohol called Erythritol (popular brand name, Swerve). Erythritol cannot be digest by the body. Meaning it does not raise blood sugar, meaning you would subtract 100% of the sugar alcohol from the total carbohydrates.

For example, using that same label as above here is what the math would look like if the sugar alcohol was erythritol: Subtract 14g (ALL of the sugar alcohol) from 28g (total carbs). This leaves you with 14g carbs….. subtract 3g (for fiber) and that leaves you with 11g. 11g is what you would bolus for.

Sugar alcohols are also slower to act than most carbs, meaning the blood sugar rise will occur later than usual.

 

Know What Sugar Alcohol You’re Working With

Since all but one sugar alcohol raises BG, you gotta read those labels.

Sugar alcohols that raise your blood sugar are:

  • Mannitol
  • Xylitol
  • Sorbitol
  • Lactitol

Sugar alcohols that don’t raise your blood sugar

  • Erythritol (popular brand name Swerve)

 

The Stinky Side

Sugar alcohols often cause gas, bloating, indigestion, and diarrhea. This is because they are poorly absorbed and hard for the body to digest.

 

Let’s keep the conversation going!

What’s your experience with sugar alcohol been like? Love it? Hate it? Somewhere in the middle?

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Leave A Comment

  1. Hannah B March 9, 2021 at 1:59 pm - Reply

    I’ve seen this on the label before and never knew how to bolus for it. Thank you!!! Not that I eat a lot of sugar free anything anymore, but very good information to have in my back pocket. Appreciate this and your blog so much!

  2. Rick Phillips March 9, 2021 at 8:35 pm - Reply

    I bolus full on for it. No half’s. For me if I do not I end up doing it anyway as I try to bring it down once it hits 170. Damned if you do and well always dammed if you dont.

  3. Dave C March 21, 2021 at 9:17 am - Reply

    Thanks for sharing all those informations.
    We are not feeling alone with you 🙂
    I found this thing that helped me a lot with diabetes, I hope it will help to someone else too.
    https://bit.ly/3tHTb8I

  4. The Diabetic Survivor April 10, 2021 at 6:54 am - Reply

    Hey Rachel, brilliant article. I should have seen this around St. Patrick’s day!

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