Type 2 Diabetes Nutrition & Weight Loss The Truth About Agave Nectar and Diabetes By Stacey Hugues linkedin Stacey Hugues, RD is a registered dietitian and nutrition coach who works as a neonatal dietitian at Beth Israel Deaconess Medical Center in Boston. Learn about our editorial process Stacey Hugues Medically reviewed by Medically reviewed by Lindsey Waldman, MD, RD on November 06, 2019 linkedin Lindsey Waldman, MD, RD, is a board-certified pediatrician and pediatric endocrinologist. Learn about our Medical Review Board Lindsey Waldman, MD, RD Updated on August 11, 2020 Print Pat_Hastings / iStock Agave nectar, also called agave syrup, is a sweetener often recommended for people with diabetes. It is made either by heating extracts of the succulent Agave salmiana plant or by breaking them down with water in a process called hydrolysis. The resulting liquid is processed with enzymes derived from a mold called Aspergillus niger. Agave is also fermented to make tequila. It's easy to see why agave nectar appears to be a smart alternative to table sugar, as it's lower on the glycemic index (GI)—one indication of how a given carbohydrate is likely to affect the levels of glucose (sugar) in the blood. However, this assessment isn't as cut-and-dried as it may seem. If you have diabetes, you'll want to understand how agave sugar really stacks up to sugar before working it into your diet or that of someone with the disease you care for. Glycemic Index of Common Foods Agave Nectar vs. Table Sugar The differences between agave nectar and table sugar are negligible when it comes to calories, carbs and total grams of sugar. They diverge in terms of type of sugar and where each ranks of the glycemic index. It is these two factors that make agave nectar a questionable alternative to sugar. 1 Teaspoon Table Sugar 16 calories 4 grams carbohydrates 4 grams sugar 50% sugar from fructose GI rank: 60 to 65 1 Teaspoon Agave Nectar 20 calories 5 grams carbohydrate 4.7 grams sugar 90% sugar from fructose GI rank: 20 to 30 Fructose Fructose is a simple sugar (monosaccharide) found naturally in fruits and vegetables. It is relatively low on the glycemic index. However, when fructose is highly processed—as is the case with agave nectar—it can become problematic if consumed in excessive amounts. Fructose is metabolized in the liver, which turns excess fructose into triglycerides—a type of fat—some of which can become trapped and lead to any of a number of chronic medical conditions. For example, large amounts of high-fructose corn syrup have been linked to non-alcoholic fatty liver disease, insulin resistance, metabolic syndrome, obesity, and type 2 diabetes. What's more, although agave is one and a half times sweeter than table sugar—meaning you may be able to use less of it—some researchers believe it's easy to eat too much fructose as it seems to bypass the body's satiety signals. Agave contains more fructose than high-fructose corn syrup, table sugar, and fruit. Food Fructose Percentage Agave Nectar 90% High Fructose Corn Syrup 55% Table Sugar 50% Whole, Fresh Fruit 5 to 6% Glycemic Index Foods and beverages that are low on the glycemic index, typically defined as those with a score of less than 55, are less likely than higher-ranking foods and beverages to cause spikes in blood sugar levels. Agave's ranking of 20 to 30 certainly places it in the category of low glycemic foods. However, there is some controversy regarding the usefulness of the GI for controlling blood sugar. This is because the index doesn't account for portion sizes of foods. What's more, many of the factors that determine a food's GI score (how the food is prepared, for example, or the laboratory in which it is measured) can be inconsistent. In other words, the fact that agave nectar is a highly processed sweetener containing a high percentage of fructose, paired with the possible inaccuracy of the Gi for determining a foods true potential affects on glucose levels, makes it a less viable alternative sweetener for people with diabetes than it appears to be at first glance. Ups and Downs of Blood Sugar in Diabetes A Word From Verywell If you have diabetes, it is advisable to reduce your intake of all types of sugar, including agave. If you really want to use a sweetener, try honey or maple syrup, which contain beneficial vitamins and minerals, or no- or low-calorie natural alternatives, such as stevia or monk fruit. Was this page helpful? Thanks for your feedback! We know healthy eating is key to help manage diabetes, but that doesn't make it easy. Our free nutrition guide is here to help. Sign up and receive your free copy! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Chung, et. al. Fructose, high-fructose corn syrup, sucrose, and nonalcoholic fatty liver disease or indexes of liver health: A systematic review and meta-analysis. Am J Clin Nutr. 2014 Sep; 100(3): 833–849. doi:10.3945/ajcn.114.086314 Lowette K, Roosen L, Tack J, et al. Effects of high-fructose diets on central appetite and cognitive function. Front Nutr.2015;2:5. doi:10.3389/fnut.2015.00005 Vega-Lopez S, Venn BJ, Slavin JL. Relevance of the glycemic index and glycemic load for body weight, diabetes, and cardiovascular disease. Nutrients 2018, 10(10), 1361. doi:10.3390/nu10101361 Additional Reading Cleveland Clinic. The 5 best and worst sweeteners: Your dietitian's picks. Apr 28, 2020. The American Heart Association. Sugar 101. Apr 17, 2018.