JR lives with type 1 diabetes and is excited to eat a stack of blueberry pancakes with a new type of maple syrup sweetened with allulose. The syrup label reads that there are 28 grams of carbs in 2 Tablespoons of Zero Sugar Maple syrup. JR adds up the total carbs in the pancakes and syrup, and takes 6 units of bolus insulin (4 for the pancakes and 2 units for the syrup). Within a half hour, JR realizes their blood sugar is dropping fast and grabs some glucose tabs to treat the sudden low. Trying to figure out what went wrong, JR double confirms the nutrition in the pancakes and then takes a closer look at the Maple Syrup label.

Is the Maple Syrup to blame for the Unexpected Low Blood Sugar?

Looking at the label, JR confirms that there are 28 gm of carbs per serving of this unique maple syrup and 26 of those carb grams come from Allulose. Allulose is a low-calorie sugar that is Generally Recognized As Safe (GRAS) approved by the FDA in 2022. Allulose is considered a rare sugar found naturally in figs, raisins, wheat, maple syrup, and molasses or it can be commercially produced and added to foods. It’s roughly 70% as sweet as sugar and it tastes very similar. Allulose is hardly digested or absorbed, so it provides very few calories – approximately 0.4 calories per gram, compared with 4 calories per gram in table sugar.

Because very little of ingested allulose is absorbed, the impact on post-meal glucose levels is negligible.

Allulose labeling Can Cause Confusion for People Matching Insulin to Carbs

In 2019, US Food and Drug Administration (FDA) issued guidance, allowing food manufacturers to exclude allulose from total and added sugar counts on Nutrition and Supplement Facts labels. Like sugar alcohols and dietary fiber, allulose still counts towards total carbohydrates on the nutrition label.

The fact that allulose hardly raises blood sugar may lead people who match insulin to carbs to take more insulin than needed.  

FDA Labeling Rule for allulose:

• Not included in “Total Sugars” or ”Added Sugars”

• Included in Total Carbohydrates

• Calories calculated with 0.4 kcals/gram

• Must be in the ingredient list

Take home message for People Counting Carbs for Accurate Insulin Dosing

Look on labels to see if allulose is listed under carbohydrates or included in the ingredient list. If it is, subtract allulose carbs from the total carbs to get an accurate carbohydrate measurement.

For other people, allulose may be a sweet-tasting alternative to sugar that provides few calories and doesn’t raise blood sugar.

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