CC0
CC0

EXPERT REACTION: Sweeteners in high doses may raise type 2 diabetes risk

Embargoed until: Publicly released:

Artificial sweeteners can change the body’s response to glucose when consumed in large amounts, and could add to the risk of developing type 2 diabetes, according to an Australian trial in 27 healthy adults. The research is being presented at this year’s annual meeting of the European Association for the Study of Diabetes in Lisbon, Portugal.

Journal/conference: European Association for the Study of Diabetes (EASD) Annual Meeting

Organisation/s: The University of Adelaide

Media Release

Artificial sweeteners can change the body’s response to glucose when consumed in large amounts, and could add to the risk of developing type 2 diabetes (T2DM), says new research being presented at this year’s annual meeting of the European Association for the Study of Diabetes (EASD) in Lisbon, Portugal (11-15 Sept).

Previous studies have indicated that habitual consumption of large amounts of non-caloric artificial sweeteners (NAS) is associated with an increased risk of developing T2DM; however the underlying mechanisms for how this occurs are unknown.

This study was conducted by Associate Professor Richard Young of the Adelaide Medical School, University of Adelaide, Adelaide, Australia, as well as colleagues from other Adelaide-based research institutions, and aimed to investigate the effects of consuming large amounts of NAS on the body’s response to glucose.

The researchers recruited 27 healthy subjects who were given a quantity of two different NAS (sucralose and acesulfame-K) equivalent to drinking 1.5L of diet beverage per day, or an inactive placebo. These were consumed in the form of capsules taken three times a day before meals over the two-week period of the study. At the end of the two weeks, subjects had their response to glucose tested, examining glucose absorption, plasma glucose, and levels of insulin and gut peptides.

The team found that NAS supplementation caused an increase in measures of the body’s response to glucose, measured using a technique known as the incremental area under the curve (iAUC). This was greater for both glucose absorption and blood glucose, while the iAUC for the gut peptide GLP-1, which acts to limit the rise in blood glucose after meals, was reduced. None of these measures were altered in those subjects who were given a placebo.

The study determined that just 2 weeks of NAS supplementation was enough to enhance glucose absorption and increase the magnitude of the response of blood glucose as a result.

The authors conclude that “This study supports the concept that artificial sweeteners could reduce the body’s control of blood sugar levels and highlights the potential for exaggerated post-meal glucose levels in high habitual NAS users, which could predispose them to developing type 2 diabetes”.

Associate Professor Richard Young at Adelaide School of Medicine, University of Adelaide, Australia. As Prof Young is travelling long distance, please e-mail him first to arrange an interview. T) +61 4056 12753 E) richard.young@adelaide.edu.au

Alternative contact: Tony Kirby of Tony Kirby PR Ltd T) +44 7834 385827 E) tony@tonykirby.com

Notes to editors: This press release is based on abstract 193 Impact of artificial sweeteners on glycaemic control in healthy humans presented at this year’s European Association for the Study of Diabetes (EASD) Annual Meeting in Lisbon, Portugal. There is no full paper at this stage, but the authors are happy to answer your questions.

The authors declare no conflicts of interest.

As this is an oral presentation, there is no poster to view.

For full abstract, see: http://tonykirby.com/diabetes/abstractsweeteners.pdf

Expert Reaction

These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.

Dr Alan Barclay is an Honorary Associate at the University of Sydney

A small Australian study determined that administration of a blend of 92 mg of sucralose and 52 mg of Ace K in a capsule to 27 adults for 2 weeks increased the rate of glucose absorption from other foods/beverages in subsequent meals leading to a transient increase in blood glucose levels.

Intense sweeteners are diverse group of chemical substances that are hundreds of times sweeter than naturally occurring sweeteners like sugar(sucrose). Our food laws prohibit their addition to the food supply in pure form – they must be diluted to an intensity that is equivalent to the sweetness of the sugars they are replacing. In other words, only very small amounts of any of the intense sweeteners allowed in our food supply are found in our foods and beverages.

Our most recent sweetener survey determined that the average Australian consumed 11 mg of sucralose per day. The 90th centile of intake in consumers was 66 mg per day. Similarly, the average Australian consumed 33 mg of Ace K per day. The 90th centile of intake in consumers was 72 mg per day. So the dose of sucralose and Ace K given to each person in the trial was far more than what the average Australian consumes and it was in a pure undiluted form – not the way humans normally consume it. For sucralose, it was far more than what 90% of Australians consume.

So while the results of this short trial are interesting and warrant further investigation, we should not conclude that normal consumption of all intense sweeteners increases the risk of type 2 diabetes. The overall body of evidence indicates that when consumed in realistic amounts, intense sweeteners as a class are safe and an effective substitute for added sugars in foods and beverages.

Last updated: 04 Mar 2024 5:00pm
Declared conflicts of interest:
None declared.
Paul Zimmet is Professor of Diabetes at Monash and Honorary President of the International Diabetes Federation

While the authors suggest artificial sweeteners may have a role in type 2 diabetes causation, and it is an interesting attempt to define a mechanism, it is a very small study and we need long term studies in larger cohorts to establish how important this is. To my knowledge, these latter studies are either limited or not done.

This is just one of numerous artificial sweeteners and it should not be assumed that these findings apply to all sweeteners. Major diabetes organisations including the American Diabetes Organization have responsible guidelines for artificial sweetener usage.

Last updated: 14 Sep 2017 9:36am
Professor Zane Andrews is Deputy Head of the Metabolism, Diabetes and Obesity Program within the Monash Biomedical Discovery Institute at Monash University

People often choose artificially sweetened drinks as it's perceived they are better for you because they are calorie free. However, recent research is beginning to breakdown this perception. 

To produce their effects in the body, artificial sweeteners act on sweet taste receptors. One would commonly assume that these are in the mouth, and they are, but intriguingly they are also found in other parts of the body such as the intestines.

Studies in animal models show that intestinal sweet taste receptors are important to control blood glucose by manipulating glucose absorption into the blood stream and hormones influencing blood glucose. Of course, any imbalance in this system may increase blood glucose and predispose to type 2 diabetes.

This current study is novel because it examines humans for the first time. Specifically, it examines whether artificial sweeteners in humans affect intestinal glucose absorption into the blood and the blood levels of hormones affecting blood glucose.

The authors found that artificial sweeteners increase glucose absorption into the blood, and reduce blood levels of glucagon-like peptide 1, a hormone responsible for decreasing blood glucose after a meal. The net effect is that this acutely increases blood glucose, which supports the idea that artificial sweeteners in humans worsen blood glucose control. 

Therefore, persistent consumption of artificial sweeteners may predispose to type 2 diabetes.

This study is another piece of growing evidence that breaks down the perception that artificial sweeteners are better because they are calorie-free. 

Please note the study is unpublished and still to go through the peer review process.

Last updated: 13 Sep 2017 4:44pm

News for:

Australia
SA

Media contact details for this story are only visible to registered journalists.