Specially in reference to nutraceuticals and drug.
I personally think such synthetic sweetener cause secondary damage to liver and kidney in diabetic patients.
We need to differentiate between refined sugar preparations and naturally occuring sugar containing foods. Your concerns are very important and valid.
Here is a link which is interesting:
It also provides link to AHA statement on artificial sweeteners for diabetes, obesity, etc.
http://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030
In General, it is not justified to avoid sugar with replacements of sorbitol, maltose dextin, and other synthetic sweetener when we see with respect to their indication and its pharmacological properties. In a special case, we reduce the sugar concentration up to the critical level that may not hamper the normal physiology as well not helpful in the progression of a disease like diabetes e.g. use of cane sugar juice for Bhavana in Vasant kusumar rasa which highly potent drug for diabetes in Ayurveda.
Most switeners finish into lare intestine and after fermentation deliver energy to the body
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