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Humans absorb xylitol slowly, and the sweetener when ingested orally is absorbed at from 50 to 95 percent. However, in dogs, xylitol is rapidly and totally absorbed within about 30 minutes. Just a small amount of xylitol can cause a dangerous insulin surge and a rapid drop in blood sugar. The toxicity of xylitol in dogs is dose-dependent. The dose required to trigger hypoglycemia (low blood glucose) is approximately 0.1 grams/kg, while the amount needed to cause liver failure is about 0.5 grams/kg.
People with diabetes sometimes use xylitol as a sugar substitute. Blood sugar levels stay at a more constant level with xylitol than with regular sugar. This is because it is absorbed more slowly by the body. Some types of gum or oral care products, such as toothpaste and mouthwash, also contain xylitol. Mouth bacteria can't use xylitol as a source of energy, so this may help prevent tooth decay. Researchers have studied xylitol in children with frequent earaches to prevent acute attacks of middle ear inflammation (otitis media). One way it may help is by inhibiting the growth of bacteria.