Nonnutritive sweeteners have been utilized in the diet of diabetic patients an an agent to replace glucose and sucrose. Since saccharin might be removed from the marketplace, the nutritive sweeteners fructose, xylitol, and sorbitol are being considered as possible alternatives for glucose and sucrose. This review considers the effects of these nutritive sweeteners on the main dietary concerns in the diabetic diet—control of blood glucose levels, obesity, and hyperlipidemia. The potential side effects of these agents are also reviewed.