Diabetes
ByStacey Hugues
Updated on April 03, 2022
Medically reviewed byDanielle Weiss, MD
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.
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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 linkedto 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 muchfructoseas 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.
Frequently Asked Questions
What are the benefits of agave nectar?
As a sweetener, the primary benefit of agave nectar is that calorie for calorie it is almost twice as sweet as table sugar. This means you need less agave to get the same result.
Is agave good for people with diabetes?
Every person metabolizes food differently. People with diabetes need to limit the amount and types of sugar in their diet and should monitor their blood sugar.
Agave has a low glycemic index, which may make it easier on your blood sugar than other sweeteners. It is also sweeter than sugar and honey, so you need less agave to get the same amount of sweetness. However, it contains more fructose, which may affect some people’s blood sugar more than others.
The only way to know how agave affects you is to test your blood sugar after using it.
Is agave a good substitute for honey?
It depends. In baking, you can substitute agave for honey at a 1-to-1 ratio. But nutritionally, honey and agave are different.
See AlsoMaple Syrup GradingHoney contains more vitamins, minerals, and other micronutrients than agave. Honey also has a lower fructose ratio, making it easier on blood sugar than agave.
One big difference: Agave tastes sweeter than honey, so you may need to use less of it to sweeten your coffee.
Everybody is different and the only way to know for certain how agave and honey measure up on your blood sugar is trial and error.
3 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. Nutrients2018,10(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.
By Stacey Hugues
Stacey Hugues, RD is a registered dietitian and nutrition coach who works as a neonatal dietitian at Beth Israel Deaconess Medical Center in Boston.
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