Joanne Milo diabetes advocate

Joanne Laufer Milo, a native New Yorker, has been living on the West Coast for some time now, enjoying the sunshine and all variety of diabetes advocacy activities -- she writes, blogs, creates videos, organizes local JDRF events and other support groups and was even one of our 2015 DiabetesMine Patient Voices Contest winners who attended our Summit.

Today, she's sharing some hard-learned wisdom on paying close attention to what goes in your mouth, even if it seems quite "diabetes-friendly." 


Look Out for Sorbitol, by Joanne Milo

Beware! Sorbitol hides in unexpected places, unless you read the ingredients in food labels. Here’s my latest encounter, which I hope not to repeat (and I share with you, to spare you the distress!).

I’ve had T1 for 51 years and I live in southern California. For a variety of reasons (warm weather, long-term diabetes, lots of exercise), I know that I should stay very hydrated. But sometimes drinking plain water can be downright boring.

For a while, I was drinking 1-2 sugar-free RockStar energy drinks until my internist asked me to cut down on the amount of caffeine. As I mentioned that I was hydrating, he reminded me that caffeine is a diuretic (bad for your blood pressure, kidneys, etc.)… so I was working at counter-purposes. So I cut out the RockStar, except for an occasional one. One cup of coffee a day is my max on caffeine.

My nephrologist reminded me to hydrate. When I asked how much I should drink, he said that whatever I was currently doing, do more! 

Then I found a delicious sugar-free alternative… and I found it was easy to drink lots. It’s Arizona Diet Blueberry Tea.  Yummmmy!  I’d fill up a thermos in the morning, then add more about lunch time and then once more in the afternoon. I started consuming this wonderful and “healthful” beverage about 6 weeks ago.  I thought I was golden ~ a great, sugar-free, delicious way to get all the hydration I needed.Arizona diet tea

I started to notice that I was feeling bloated and had a low-grade tummy ache.  I chalked it up to just “something inflammatory,” and kept drinking. I developed a strange, headband-like daily headache, a noisy, gassy stomach and a touch of diarrhea. 

It got so uncomfortable that I finally made an appointment to see my gastroenterologist. After all, after living with diabetes for so long, your mind can think it’s just another medical problem.

BUT THEN CAME MY EPIPHANY!  Let me preface with this by saying that I’ve been reading food labels since I was a young teenager (well, whenever there was a nutrition label, way back in the dark ages). I mostly look for carbs, fiber and fat… and always just simply calories. 

I was preparing my usual thermos of yummy thirst-quenching tea, getting ready to head out for the day.  And I stopped and thought, “I wonder what’s in here?” I think I may have actually said that out loud!  I read the list of ingredients… and the second item was sorbitol! SORBITOL!!! That had NEVER occurred to me! I just saw “Diet” and assumed “Sugar-free."

Sorbitol, for those of you who don’t know, is a natural sugar alcohol found in fruit with a sweet taste which the human body metabolizes slowly. It is also used as a sugar substitute in diet foods, mints, cough syrups and sugar-free candies and gum. 

However, in excess (like lots of ice tea, sugar-free gum or candy), it becomes its other use: as a non-stimulant laxative, resulting in gastrointestinal distress. Yup!  My AHA moment!

I Sweetener productspoured the tea down the sink and reverted to my old standby: water.  I tried liquid flavor enhancers. But again, read the labels. Most contain Sucralose, another artificial sweetener, and often a lengthy ingredient list, such as “Water, Citric Acid, Salt, Propylene Glycol, Potassium Phosphate, Malic Acid, Contains Less than 2% of Niacinamide, Vitamin B6, Vitamin B12, Natural Flavor, Sucralose and Acesulfame Potassium (Sweeteners), Potassium Citrate, Polysorbate 60, Red 40, Blue 1, Potassium Sorbate (Preservative).” 

I tried Crystal Light Blueberry Raspberry which has sucralose… and I liked it a lot. That is, UNTIL I read that it has sucrose acetate isobutyrate, a thickening or “weighting” agent, also found in printing ink!

I also liked Mio Berry Pomegranate… UNTIL I found that it contained propylene glycol, a preservative, thickening agent and stabilizer, also uses antifreeze to de-ice airplanes, as a plasticizer to make polyester resins and found in electronic cigarettes!

As you read the ingredients in these water enhancers, you will lose your desire pretty fast. There may be two that are acceptable:

  • SkinnyGirl Water Enhancers, which, while it still has preservatives, it doesn’t contain antifreeze and “weighting” agents.  It does have vegetable juice for color and stevia extract and can sugar for sweetness
  • Stur, which also contains no antifreeze or “weighting” agents, and it contains stevia extract. 

I haven’t tried these yet, but probably will. OR… perhaps I should just drink plain old, old-fashioned water?!

The reality is, water doesn’t need to be enhanced, at least from a nutritional perspective. Tinkering with water is sort of like trying to “enhance” blueberries or kale. Water is already nature’s perfect drink…and the one and only beverage we need to stay alive. Pure, clear water keeps you hydrated, replenishes bodily fluids, helps your body eliminate waste, lubricates joints, and allows your body to digest food.

So it’s water for me, straight and simple. And I relearned a strong lesson: Read labels!  Not only the nutritional values but also the ingredients!

I did find some ways to spice up your water, the healthy way:

  • Add frozen fruit (as long as you allow for the carbs): Slip some frozen fruit into your water bottle.  As the fruit thaws, it cools your drink and releases sweetness and fruit flavor. And if you enjoy the fruit after you are done sipping, you get a dose of antioxidants, as an added bonus.
  • Make mint ice cubes!  Add some mint leaves with water in your ice cube trays and freeze them. Then throw a few mint ice cubes to your water bottle. It’s delicious and sugar-fee and chemical-free!
  • Throw a splash of 100% fruit juice into your water for a hint of sweetness and flavor (remember to allow for the small additional carbs).


Thanks Joanne, for the great reminder to read those labels!

Check out more of Joanne's wisdom on her blog, The Savvy Diabetic.

AND... if you're interested in the topic of sweeteners, stay tuned for a feature coming here soon on Agave.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.