Alternative sweeteners are widely advocated and used. However, there is insufficient scientific information to determine whether alternative sweeteners are of value in the management of diabetes, either in improving dietary adherance or in contributing to the achievement or maintenance of a lower body weight. Each of the available sweeteners has advantages and disadvantages; no one is preferred. Recommendations about alternative-sweetener use should be tailored to the specific dietary and life-style patterns of the individual. Diabetes Care 11:174-82, 1988 S ucrose, glucose, and foods containing large amounts of the two refined sugars have been restricted in various dietary approaches throughout the history of diabetes therapy (1), particularly throughout much of this century, as a means of limiting excursions of blood glucose. (Simple sugars in the form of fruits, vegetables, and dairy products have variably been excluded from this practice.) Consequently, alternative sweeteners, both caloric (fructose, sorbitol, mannitol) and noncaloric (saccharin, aspartame, cyclamate), have played a dominant role in the provision of sweetness in diabetic diets. Despite this, many questions about their use remain. Are alternative sweeteners actually of any value in the management of diabetes? Do they help people with diabetes adhere to their diabetic diets? Do they help in the treatment of the obesity associated with type II (non-insulin-dependent) diabetes? What are the side effects of the different sweet-