Low calorie sweeteners do not affect glucose control nor increase diabetes risk

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Study findings presented at EASD annual meeting by Young et al. are not supported by a number of earlier studies by the same research group

In response to a Press Release1 issued in light of the presentation of a new study by Young et al. at the 53rd annual meeting of the European Association for the Study of Diabetes (EASD), the International Sweeteners Association (ISA) would like to draw attention to the overwhelming body of evidence, including from studies by the same Australian research team, showing that low calorie sweeteners do not affect glucose control.

Surprisingly, this Press Release neglected to report the outcomes of a considerable number of studies published by the same authors2, which consistently found no impact of low calorie sweeteners on blood glucose regulation. Additionally, the collective evidence from well-designed human studies supports that low calorie sweeteners do not adversely affect glycaemic control in healthy individuals and in people with diabetes, e.g., by affecting total insulin secretion, glucose uptake and/or glucose utilization either by direct effect or via effects on incretins (gut hormones).3

In fact, the beneficial effect of low calorie sweeteners in post-prandial glucose is recognised also in a health claim authorised in Europe, further to the scientific opinion by EFSA4: “Consumption of foods with low calorie sweeteners instead of sugar induces a lower blood glucose rise after their consumption compared to sugar-containing foods”.

Low calorie sweeteners cannot increase diabetes risk, while on the contrary, when used instead of sugar, they can be a helpful strategy for people with diabetes for whom glycaemic control is fundamental. This is in line with the fact that low calorie sweeteners contribute no carbohydrates to the diet. In the 2017 guidelines ‘Standards of Medical Care in Diabetes5, the American Diabetes Association supports that “non-nutritive sweeteners have the potential to reduce overall calorie and carbohydrate intake“.

For people with diabetes, low calorie sweeteners used in foods and drinks as well as table-top sweeteners and as part of a healthy diet are an option that can aid in glucose control6 and offer broader food choices by providing the pleasure of sweet taste without raising blood glucose.

  1. Press Release, Diabetologia. “Small study suggests consuming large amounts of artificial sweeteners may increase risk of developing type 2 diabetes
  2. Wu et al. Diabetes Care, 2013; Wu et al. Am. J. Clin. Nutr. 2012; Ma et al. Br J Nutr. 2010; Ma et al. Am J Physiol Gastrointest Liver Physiol, 2009
  3. Grotz et al. Regulatory Toxicology and Pharmacology 2017; Bryant and McLaughlin Physiol Behav 2016; Romo-Romo et al. PLoS ONE 2016; Bryant et al. Eur J Clin Nutr. 2014; Brown et al. Nutr Res 2011; Renwick and Molivary. Br J Nutr 2010; Grotz et al. J Am Diet Assoc, 2003
  4. EFSA Scientific opinion on the substantiation of health claims related to intense sweeteners. EFSA Journal 2011; 9: 2229
  5. ADA® 2017 Standards of Medical Care in Diabetes. Diabetes Care 2017; 40 (S1): S33-S43
  6. Gardner C, et al. Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association. Diabetes Care. (2012) Aug;35(8):1798-808.