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Q: About six years ago my husband went on an insulin pump, which has been a lifesaver. I can't imagine anyone keeping a better record of his carbohydrates and insulin. In looking for sugar-free products, we've been reading a lot of labels and have discovered that most cookies that claim to be sugar-free are sweetened with sugar alcohol. Can you explain what sugar alcohol is and if it's OK for him to eat?

A: First of all, good work on reading labels -- it's the best way to know what's in the foods you're eating. Sugar alcohols are a group of calorie- and carbohydrate-containing sweeteners that are neither sugar nor alcohol. Unlike non-nutritive artificial sweeteners, which are also used to sweeten some sugar-free foods, sugar alcohols can elevate blood glucose levels, but to a lesser degree than the same amount of carbohydrates.

Sugar alcohols are metabolized incompletely by your body, so they contribute fewer calories and have less impact on blood glucose levels than sugar has. They can contain an average of 2 calories per gram versus 4 calories per gram of other carbohydrate sources. Commonly used sugar alcohols include:

• sorbitol
• mannitol
• xylitol
• maltitol
• lactitol
• erythritol
• isomalt
• hydrogenated starch hydrolysates

People who take insulin or some oral diabetes medications may have problems with insulin reactions after eating foods made with sugar alcohol because of the slow digestion rate. You may need to take less insulin if you eat such products. You should also know that desserts made with sugar alcohol typically are not much lower in calories and fat than their regular counterparts. The 2008 Nutrition Recommendation published by the American Diabetes Association states that "there is no evidence that the amounts of sugar alcohol likely to be consumed will reduce glycemia (sugar in the blood), energy intake, or weight."

If eaten in excess, sugar alcohols can have a laxative effect or cause gas. There is also a range of glycemic responses to different sugar alcohols, so research is under way to determine appropriate recommendations. If you have questions about a particular sugar alcohol, talk to a registered dietitian or a certified diabetes educator to find out how it might fit into your husband's daily eating plan.

Jeannette Jordan, M.S., R.D., CDE, is the American Dietetic Association's national spokesperson for African-American nutrition issues and oversees nutrition education at the Medical University of South Carolina.

Madhu Gadia, M.S., R.D., is a certified diabetes educator.