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Q: A while ago I was diagnosed as prediabetic.  My weight was normal, and I thought I was pretty good at limiting sugar.  However, my dad and grandfather were both diabetic in later life, despite physically active jobs.  Anyhow, no way did I want to do daily blood tests and possibly even injections.  I cut back even more on sugar, and now I am no longer testing as prediabetic.  I do like cocoa and was drinking an occasional cup made with unsweetened cocoa powder and low-fat milk added.  Recently, I’ve tried adding xylitol to it and really enjoy the sweet taste.  What do you think about xylitol? It does seem strange to me to be drinking something apparently squeezed out of a birch tree.  On the other hand, my husband loved maple syrup, and I never thought that was a strange flavor source.

A: Xylitol is a natural sweetener found in plants and birch bark.  Unlike sugar, xylitol has little impact on blood sugar or insulin levels (Foods, Nov. 2, 2020).  If you enjoy it in your cocoa, there is no reason to stop.  Do be careful about the dose, though. Like most sugar substitutes, xylitol can have a laxative effect.  Too much could cause diarrhea.  Be sure to keep xylitol well away from pets.  It is extremely toxic to dogs.