Sherri Thibeaux, RD, CDE, Clinical Nutritionist from UCSF Medical Center in San Francisco, California, cautions her diabetic patients that sugar free is not carbohydrate free.Sugar alcohols such as mannitol, sorbitol, xylitol and isomalt, are often used in products geared for people with diabetes millitus. Labels may claim that the product is sugar free because technically sugar alcohols are not sugars. However, they are still carbohydrates. Labeling like this can be misleading to the person with diabetes.Sugar alcohols are caloric sweeteners and still contribute to blood glucose. The grams of carbohydrate contributed by sugar alcohols will be listed on the label in the total carbohydrate gram amount, not in the sugars column. When reading the label, be sure to look at the grams of total carbohydrate contained, not just the grams of sugar. Total carbohydrate content is a better indication of the product’s potential to affect the blood sugar level.Many people who consume sugar alcohols complain of gas, bloating and cramping. Sugar alcohols can cause osmotic diarrhea. Those who experience these common side effects may wish to avoid sugar alcohols completely. Sugar alcohols can be identified by looking at the list of ingredients, and are most commonly used for items such as diabetic ice creams and candies.