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Artificial Sweeteners and Diabetes

The Sweet Truth about Artificial Sweeteners and Diabetes

I have been compensated for my time by McNeil Nutritionals, LLC, the maker of SPLENDA® Sweetener Products. All statements and opinions are my own. I have pledged to Blog With Integrity, asserting that the trust of my readers and the blogging community is vitally important to me.

What’s the first thing that comes to mind when you think about diabetes? If you thought of sugar, you’re not alone. The connection between diabetes and excess sugar in the urine was first made by a Greek physician over 2000 years ago. Back when I was studying the disease in college, patients were still expected to test the sugar content of their urine several times a day to see if they were in good control.

We have learned much more about the causes, symptoms and treatment of diabetes in the past 200 years, but its connection to sugar remains strong.

In recognition of American Diabetes Month, I’d like to share the results of some new research on the role of sugar and artificial sweeteners (sugar substitutes) in diabetes, to bring you up to date.

Two Types of Diabetes

There are two classifications of diabetes, commonly known as type 1 and type 2. Only 5 percent of people who have diabetes have type 1, and most are diagnosed when they are children or young adults. Their bodies do not produce the insulin they need to convert sugar and starches into energy, so they must take insulin by injection or other means.

People with type 2 diabetes experience high blood glucose (sugar) levels because they don’t make enough insulin or their body does not use it properly. Being overweight, inactive, and having high blood pressure are some of the risk factors for type 2 diabetes. You may want to take this brief “Type 2 Diabetes Risk Test” offered online for free by the American Diabetes Association.

A combination of lifestyle changes and medications can help keep blood sugar levels within normal limits in people with diabetes. 

The Role of Diet in Diabetes

The treatment of both type 1 and type 2 diabetes includes consuming a healthy diet and maintaining a healthy body weight. This can be accomplished by following the same eating patterns recommended for us all in the Dietary Guidelines for Americans (pdf). People with diabetes do not have to buy special foods or have different foods prepared for them if the meals the rest of their family is eating are well balanced, but need to be more careful managing their carbohydrate intake. 

The key to managing one’s weight is to manage caloric intake. Since sugar has calories, the amount eaten must be controlled just like any other source of calories. But since most people really like sweet-tasting foods and beverages made with sugar, it’s easy to consume too much of them. That why using low calorie sweeteners, such as SPLENDA® No Calorie Sweetener, can be a big help. They let you enjoy the great sugar-like taste, but with few or no calories added.

In fact, numerous studies have found that the use of no-calorie sweeteners (like sucralose), can help people with diabetes in several ways. Some of the benefits of low calorie sweeteners are that they:

  • Can aid in weight loss and maintenance when used in place of sugar
  • Can help limit total carbohydrates in the diet to help regulate blood glucose levels and insulin requirements
  • Can help make reduced calorie and/or carbohydrate diets more palatable which may improve compliance
  • Can help satisfy sweet cravings without increasing hunger or appetite
  • Have no effect on gastric emptying or intestinal sweet receptors
  • Do not contribute to dental caries

Having counseled hundreds of people in my career who were diagnosed with type 2 diabetes, I always felt it was a shame they didn’t know about the healthy diet and lifestyle I was recommending to them before they got the disease, because if they had it’s possible that they could have prevented it. So to commemorate American Diabetes Month, I’d like to recommend to everyone who does not have diabetes to adopt this way of life to help reduce the risk of developing diabetes.

Robyn Flipse, MS, MA, RDN, “The Everyday RD,” is an author and nutrition consultant who has headed the nutrition services department in a large teaching hospital and maintained a private practice where she provided diet therapy to individuals and families. With more than 30 years of experience, Robyn is motivated by the opportunity to help people make the best eating decisions for their everyday diet. She believes that choosing what to eat should not be a daily battle and aims to separate the facts from the fiction so you can enjoy eating well.

References:

  • Polonsky KS. The Past 200 Years in Diabetes. N Engl J Med. 2012;367:1332-1340
  • Jophnson CA, Stevens B, Foreyt J. The Role of Low-calorie Sweeteners in Diabetes. US Endocr.2013;9(1):13-15
  • Anderson GH, Foreyt J, Sigman-Grant M, Allison DB. The use of low-calorie sweeteners by adults: impact on weight management. J Nutr.2012;142:1163S–1169S
  • Phelan S, Lang W, Jordan D, Wing RR. Use of artificial sweeteners and fat-modified foods in weight loss maintainers and always-normal weight individuals, Int J Obes.(Lond).2009;33(10):1183–1190
  • Peters JC, Wyatt HR, Foster GD, Pan Z, Wojtanowski A, Vander Veur SS, Herring SJ, Brill C, Hill JO. The Effects of Water and Non-Nutritive Sweetened Beverages on Weight Loss During a 12-week Weight Loss Treatment Program. Obesity. June 2014;22(6):1415-1421
  • Piernas C, Tate DF, Wang X, Popkin BM. Does diet-beverage intake affect dietary consumption patterns? Results from the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Am J Clin Nutr. March 2013;97(3):604-61
  • Konstantina Argyri, Alexios Sotiropoulos, Eirini Psarou, Athanasia Papazafiropoulou, Antonios Zampelas, Maria Kapsokefalou. Dessert Formulation Using Sucralose and Dextrin Affects Favorably Postprandial Response to Glucose, Insulin, and C-Peptide in Type 2 Diabetic Patients. Rev Diabet Stud. 2013; 10(1):39-48
  • Wu T, Bound MJ, Standfield SD, Bellon M, Young RL, Jones KL, Horowitz M, Rayner CK. Artificial sweeteners have no effect on gastric emptying, glucagon-like peptide-1, or glycemia after oral glucose in healthy humans. Diab Care.2013;36:e202-e203
  • Espinosa I, Fogelfeld L. Tagatose: from a sweetener to a new diabetic medication? Expert Opin Investig Drugs.2010;19(2):285–294.

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