How do artificial sweeteners affect insulin resistance in type-2 diabetes mellitus patients? Discover the potential implications and research insights.

The Relationship Between Artificial Sweeteners and Type 2 Diabetes

Artificial sweeteners have long been touted as a diabetes-friendly alternative to sugar, but emerging research suggests a more complex relationship between these sugar substitutes and the management of type 2 diabetes. While artificial sweeteners may not directly raise blood sugar levels, their impact on insulin resistance and overall metabolic health is a growing area of concern.

Artificial Sweeteners and Insulin Resistance

One of the key factors in the progression of type 2 diabetes is insulin resistance, where the body’s cells become less responsive to the insulin hormone. Studies have indicated that the consumption of artificial sweeteners may contribute to the development of insulin resistance, potentially exacerbating the condition for those with type 2 diabetes.

A 2021 review published in the journal Nutrients examined the existing evidence on the relationship between artificial sweeteners and insulin resistance. The review found that several studies have linked the consumption of artificial sweeteners, such as aspartame and saccharin, to increased insulin resistance and impaired glucose tolerance in both animal and human studies.

Potential Mechanisms Behind the Link

The exact mechanisms by which artificial sweeteners may impact insulin resistance are not fully understood, but researchers have proposed several possible explanations:

1. Disruption of gut microbiome: Artificial sweeteners have been shown to alter the composition and diversity of the gut microbiome, which plays a crucial role in metabolic regulation. Changes in the gut microbiome have been associated with the development of insulin resistance.
2. Activation of sweet taste receptors: The sweet taste receptors in the body, including those in the gut, may be activated by artificial sweeteners, leading to alterations in hormone secretion and metabolic responses.
3. Indirect effects on appetite and calorie intake: Some studies suggest that the use of artificial sweeteners may paradoxically increase appetite and calorie intake, which can contribute to weight gain and insulin resistance.

Implications for Diabetes Management

The potential link between artificial sweeteners and insulin resistance raises important questions about the long-term management of type 2 diabetes. While artificial sweeteners may offer a low-calorie alternative to sugar, their impact on metabolic health and insulin sensitivity should be carefully considered.

For individuals with type 2 diabetes, it may be prudent to approach the use of artificial sweeteners with caution and focus on a balanced, whole-food-based diet that emphasizes natural, low-glycemic-index carbohydrates. Consulting with a healthcare provider or registered dietitian can help determine the best dietary approach for managing type 2 diabetes and minimizing the risk of insulin resistance.

Ongoing Research and Future Directions

The relationship between artificial sweeteners and type 2 diabetes is an active area of research, with ongoing studies exploring the complex interplay between these sugar substitutes, insulin resistance, and overall metabolic health. As the scientific understanding continues to evolve, healthcare professionals and individuals with type 2 diabetes will need to stay informed about the latest evidence to make informed decisions about the use of artificial sweeteners in their diabetes management strategies.

Evaluating the Safety and Efficacy of Artificial Sweeteners

While the FDA has approved the use of various artificial sweeteners, the ongoing research on their potential metabolic effects highlights the importance of a nuanced approach to their use. Individuals with type 2 diabetes should carefully consider the potential risks and benefits of incorporating artificial sweeteners into their dietary regimen, in consultation with their healthcare providers.

Ultimately, the management of type 2 diabetes requires a comprehensive, personalized approach that takes into account the latest scientific evidence, individual needs, and the overall impact on metabolic health. By staying informed and working closely with healthcare professionals, individuals with type 2 diabetes can make informed decisions about the role of artificial sweeteners in their diabetes management plan.

Artificial Sweeteners :: Diabetes Education Online

Home » Living With Diabetes » Diet And Nutrition » Understanding Carbohydrates » Demystifying Sugar » Artificial Sweeteners

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Artificial sweeteners do not raise blood sugar levels.

When used instead of sugar, artificial sweeteners help you keep within your carbohydrate goals when planning meals.

Artificial sweeteners, or non-nutritive sweeteners offer the sweet taste of sugar, but have no carbohydrates or calories. Artificial sweeteners do not raise blood sugar levels. So when used instead of sugar, artificial sweeteners can help you keep within your carbohydrate goals when planning meals. And because artificial sweeteners have no calories, choosing foods made with artificial sweeteners may lower your calorie intake.

Look for manufactured foods and sweeteners for the table that contain one of these 5 sugar substitutes approved by the United States Food and Drug Administration:

• Aspartame (Brand Name: Equal)
• Sucralose (Brand Name: Splenda)
• Acesulfame-K (Brand Name: Sweet One)
• Saccharin (Brand Name: Sweet and Low, Sugar Twin)
• Neotame

A note to household chefs

Aspartame loses sweetness when cooked. Sucralose, acesulfame-K and saccharin can be used for baking. Look for special baking recipes for artificial sweeteners, as direct substitution for sugar might not give you the result you want. Or, try a combination of artificial sweetener and sugar in recipes to get your desired result while lowering the overall carbohydrate amount. Keep in mind that some artificial sweeteners can be sweeter than equal amounts of natural sugar. A little bit goes a long way.

What is Stevia?

This naturally sweet herb has been used in other countries for centuries. It is not FDA approved for use as a sweetener, but it can be purchased as a “dietary supplement” in many health food stores. Stevia comes in powder, liquid and tablet form. It doesn’t provide calories or impact blood glucose.

Are Artificial Sweeteners Safe?

The FDA has completed careful testing of all the artificial sweeteners. Artificial sweeteners have been shown to be safe to eat. Despite rumors of cancer causing effects of artificial sweeteners, research does not support that risk. All artificial sweeteners may be used by people with diabetes.

Food For Thought

Some foods made with artificial sweeteners may have more calories or fat than the original sugar-sweetened product. This may be the case with desserts and baked goods. Read food labels to compare products for serving sizes, calories and fat. Choosing a smaller portion of a sugar-sweetened product may be lower in calories than the artificially sweetened version!

View a printer-friendly Guide to Sweeteners.

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Which Sugar Substitutes Are Good for Diabetes? Stevia, Monk Fruit, Mo

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Despite sometimes being labeled as “diabetes-friendly,” artificial sweeteners may not be the best choice if you’re trying to monitor your blood glucose.

With a low to no calorie sugar count, artificial sweeteners may seem like a treat for people with diabetes. But recent research indicates that artificial sweeteners may actually be counterintuitive, especially if you’re looking to manage or prevent diabetes.

In fact, the increased consumption of these sugar substitutes may correlate to the increase of obesity and diabetes cases.

The good news is that there are sugar alternatives you can choose from, including:

• stevia or stevia products such as Truvia
• tagatose
• monk fruit extract
• coconut palm sugar
• date sugar
• sugar alcohols, such as erythritol or xylitol

You’ll still want to watch your intake for glucose management, but these options are far better than the products marketed as “sugar-free. ”

Stevia is a low-calorie sweetener that has antioxidant and antidiabetic properties. It’s been approved by the U.S. Food and Drug Administration (FDA).

Unlike artificial sweeteners and sugar, stevia can suppress your plasma glucose levels and significantly increase glucose tolerance. It’s also not an artificial sweetener, technically speaking. That’s because it’s made from the leaves of the steviaplant.

Stevia alsohas the ability to:

• increase insulin production
• increase insulin’s effect on cell membranes
• stabilize blood sugar levels
• counter the mechanics of type 2 diabetes and its complications

You can find steviaunder brand names such as:

• Pure Via
• Sun Crystals
• SweetLeaf
• Truvia

While steviais natural, these brands are usually highly processed and may contain other ingredients. For example, Truvia goes through 40 processing steps before it’s ready to be sold. It also contains the sugar alcohol erythritol.

Future research may shed more light on the impact of consuming these processed stevia sweeteners.

The best way to consume stevia is to grow the plant yourself and use the whole leaves to sweeten foods.

Shop: stevia

Tagatose is another naturally occurring sugar that researchers are studying. Preliminary studies show that tagatose:

• may be a potential antidiabetic and antiobesity medication
• can lower your blood sugar and insulin response
• interferes with the absorption of carbohydrates

A 2018 review of studies concluded tagatose is “promising as a sweetener without major adverse effects observed.”

But tagatose needs more studies for more definitive answers. Talk to your doctor before trying newer sweeteners such as tagatose.

Shop: tagatose

Monk fruit extract is another alternative that is gaining popularity. But no processed sweetener can beat using fresh whole fruit to sweeten foods.

Another excellent option is date sugar, made of whole dates that are dried and ground. It doesn’t provide fewer calories, but date sugar is made of the whole fruit with the fiber still intact.

You can also subtract fiber from total grams of carbohydrates, if you count carbs for meal planning. This will give you net carbs consumed. The more fibrous a food, the lower impact it will have on your blood sugar.

Shop: monk fruit extract or date sugar

Some artificial sweeteners say “sugar-free” or “diabetic-friendly,” but research suggests these sugars actually have the opposite of effect.

Your body responds to artificial sweeteners differently than it does regular sugar. Artificial sugar can interfere with your body’s learned taste. This can confuse your brain, which will send signals telling you to eat more, especially more sweet foods.

Artificial sweeteners can still raise your glucose levels

One 2016 study saw normal-weight individuals who ate more artificial sweeteners were more likely to have diabetes than people who were overweight or obese.

Another 2014 study found that these sugars, such as saccharin, can change your gut bacteria composition. This change can cause glucose intolerance, which is the first step towards metabolic syndrome and diabetes in adults.

For people who don’t develop a glucose intolerance, artificial sweeteners may help with weight-loss or diabetes control. But switching to this sugar replacement still requires long-term management and controlled intake.

if you’re thinking of replacing sugar regularly, talk to your doctor and dietitian about your concerns.

Artificial sweeteners may also contribute to weight gain

Obesity and being overweight is one of the top predictors for diabetes. While artificial sweeteners are FDA-approved, it doesn’t mean they’re healthy.

Marketing for food products can lead you to think non-caloric artificial sweeteners help with weight loss, but studies show the opposite.

That’s because artificial sweeteners:

• may lead to cravings, overeating and weight gain
• alter gut bacteria which is important for weight management

For people with diabetes looking to manage their weight or sugar intake, artificial sweeteners may not be a good substitute.

Being overweight or obese can also increase your risk factors for several other health issues such as high blood pressure, body pain, and stroke.

Safety rating for artificial sweeteners

The Center for Science in the Public Interest currently deems artificial sweeteners a product to “avoid.” Avoid means the product is unsafe or poorly tested and not worth any risk.

Sugar alcohols are naturally found in plants and berries. The types most often used in the food industry are synthetically created. You can find them in food products that are labeled as “sugar-free” or “no sugar added.”

Labels such as this are misleading because sugar alcohols are still carbohydrates. They can still raise your blood sugar, but not as much as regular sugar.

Common FDA-approved sugar alcohols are:

• erythritol
• xylitol
• sorbitol
• lactitol
• isomalt
• maltitol

Swerve is a newer consumer brand that contains erythritol. It’s available in many grocery stores. The brand Ideal contains both sucralose and xylitol.

Shop: erythritol, xylitol, sorbitol, isomalt, or maltitol

Different from artificial sweeteners

Sugar alcohols are often synthetic, similar to artificial sweeteners. But these two classifications of sugar alternatives aren’t the same. Sugar alcohols are different because they:

• can be metabolized without insulin
• are less sweet than artificial sweeteners and sugar
• can be partially digested in the intestine
• don’t have the aftertaste of artificial sweeteners

Research suggests that sugar alcohols can be a sufficient replacement for sugar. But reports also say that it won’t play a significant role in weight loss. You should treat sugar alcohols the same as sugar and limit your intake.

Sugar alcohols are also known to produce side effects such as gas, bloating, and abdominal discomfort. However, erythritol is usually better tolerated, if you’re concerned about these side effects.

Recent studies indicate that artificial sweeteners are no longer the healthy alternatives to sugar. In fact, they may increase a person’s risk for diabetes, glucose intolerance, and weight gain.

If you’re looking for a healthier alternative, try stevia. Based on research to date, this alternative sweetener is one of your better options. It’s known for its antidiabetic properties and ability to stabilize blood sugar levels.

You can get stevia in raw form, grow the plant yourself, or buy it under brand names such as Sweet Leaf and Truvia.

However, you should still limit your total added sugar intake rather than switching to sugar substitutes.

The more you consume any kind of added sweeteners, the more your palate is exposed to sweet tastes. Palate research shows that the food you prefer and crave is the food that you eat most often.

You’ll see the most benefit for managing your sugar cravings and diabetes when you reduce all forms of added sugar.

Artificial sweeteners increase risk of type 2 diabetes | Article

22nd of May 2017

Kotikovich Yu. S.

Keywords:

glucose,

artificial sweeteners,

type 2 diabetes,

sucralose

Specialties:

E ndocrinology

Summary

By changing the body’s susceptibility to glucose

In a new small study, scientists from the University of Adelaide, Australia, have shown that the use of artificial sweeteners alters the body’s sensitivity to glucose and increases the risk of developing type 2 diabetes. The results of this work were presented by experts at the annual meeting of the European Association for the Study of Diabetes (EASD), held in Lisbon, Portugal.

Previous studies have shown that high artificial sweetener habits can significantly increase the risk of type 2 diabetes. However, the biological mechanisms underlying the identified relationship remained unknown. In this study, led by Dr. Richard Young, researchers assessed the effect of sweeteners on the body’s response to glucose intake. To do this, they analyzed the condition of 27 healthy participants who received daily placebo or artificial sweeteners (sucralose or acesulfame-K) in an amount equivalent to their content in 1. 5 liters of diet soft drink. Participants took the drugs in the form of capsules 3 times a day for 2 weeks. At the end of the study, they assessed the body’s response to glucose, analyzing the degree of its absorption and concentration in the blood plasma, as well as measuring the level of insulin and peptides.

It turned out that the use of artificial sweeteners significantly changed the indicators of the body’s response to the introduction of glucose. The researchers evaluated the results using a method known as area under curve (AUC) analysis. This indicator increased for the level of glucose absorption and decreased for the concentration of the GLP-1 peptide, which inhibits the increase in glucose concentration after a meal. In participants who took placebo, the researchers did not notice any changes in carbohydrate metabolism.

As emphasized by the authors of the work, the data obtained indicate that the use of artificial sweeteners after 2 weeks leads to an increase in the level of glucose absorption, manifested by an increase in the concentration of glucose in the blood plasma. This supports the concept that artificial sweeteners may impair glycemic control, which may contribute to the development of type 2 diabetes.

• Diabetologia (2017) Small study suggests consuming large amounts of artificial sweeteners may increase the risk of developing type 2 diabetes. ScienceDaily, Sep. 13 (http://www.sciencedaily.com/releases/2017/09/170913193141.htm).

Julia Kotikovich

Artificial sweeteners and diabetes

By Dr. Mercola

According to the latest According to statistics, almost 40% of American adults, more than 18% of teenagers and almost 14% of children are now not only overweight, but obese, and processed foods and sweetened drinks are clearly driving factors.

Unfortunately, many people make the mistake of thinking that artificially sweetened foods are a healthy choice that cuts down on calories. This is not true at all.

Over the years, a growing body of research has shown that artificial sweeteners increase the risk of obesity and type 2 diabetes, perhaps even more so than sugar. A recent example is an animal study presented at the 2018 San Diego Experimental Biology Conference.

It examines how various sweeteners affect the use and storage of food in the body, and how they affect vascular function. Sugar and artificial sweeteners have been found to cause disturbances, albeit in different ways.

After a diet high in artificial sweeteners (aspartame or acesulfame potassium) or sugars (glucose or fructose) for three weeks, adverse effects were noted in all groups. All had increased blood lipids (fats), but the artificial sweeteners also accumulated in the animals’ blood, further damaging the lining of the blood vessels.

Newest Fad: Nutrient-Fortified Artificial Sweeteners

Despite evidence like this, the artificial sweetener market continues to thrive. Merisant launched a new calorie-free sweetener called Sugarly Sweet exclusively on Amazon at the end of January 2019, as well as a brand new line of vitamin and mineral fortified artificial sweeteners, according to Food Navigator.

Fortified sweeteners are sold under the Equal Plus brand and are available in three varieties: vitamin C and zinc, vitamins B3, B5 and B12, or vitamins C and E. The products are advertised as a “good source” of these nutrients, one sachet of which provides 10 percent of the recommended daily allowance for added vitamins and minerals.

Metabolic Effects of Zero Calorie Sweeteners

It is important to understand that while artificial sweeteners have no (or very few) calories, they are still metabolically active. As explained in the 2016 paper, Metabolic Effects of Non-Caloric Sweeteners, many studies have linked them to an increased risk of obesity, insulin resistance, type 2 diabetes, and metabolic syndrome. The article presents three mechanisms by which artificial sweeteners contribute to metabolic dysfunction:

1. They disrupt the conditioning that promotes glucose control and energy homeostasis.
2. They disrupt the gut microbiota and cause glucose intolerance
3. They interact with the sweet taste receptors expressed in the digestive system that are involved in glucose absorption and trigger insulin secretion.

In addition to the sweet taste buds on your tongue, there are also those in your gut that release signaling molecules into your bloodstream in response to sweet tastes, thereby forcing your pancreas to release insulin in preparation for the spike in glucose (that would happen if you ate sugar).

Artificial sweeteners are toxic to gut bacteria

Artificial sweeteners also have significantly different effects on the gut microbiome than sugar. While sugar is bad because it feeds health-damaging microbes, artificial sweeteners are even worse because they are toxic to gut bacteria in principle.

In a 2008 study, sucralose (Splenda) reduced gut bacteria by as much as 50 percent, specifically targeting those with important health benefits. Just seven small sachets of Splenda may be enough to negatively impact the gut microbiome.

In addition to the myriad side effects associated with disruptions to the gut microbiome, sucralose has also been associated with a wide range of other health effects. A selection of studies is provided in the article “Studies Reveal Shocking Side Effects of Splenda”, where you will also find a long list of studies demonstrating that artificial sweeteners cause weight gain and metabolic disturbances.

More recent studies have confirmed and expanded on these findings, showing that all currently approved artificial sweeteners disrupt the gut microbiome. An animal study published in the journal Molecules in October 2018 found that aspartame, sucralose, saccharin, neotame, advantame, and acesulfame potassium-K cause DNA damage and interfere with the normal and healthy activity of gut bacteria.

While all six types of artificial sweeteners have been found to have toxic effects on intestinal bacteria , there are individual differences in the type and amount of damage they produce:

• and genotoxic effects, meaning it is toxic to cells and damages the genetic information in the cell (which can cause mutations).
• Neotame caused a metabolic disorder in mice and also increased several fatty acids, lipids and cholesterol. Some gut genes are also decreased in number with this sweetener.
• Aspartame and Acesulfame Potassium-K – the latter commonly found in sports supplements cause DNA damage

Artificial sweeteners can cause muscle breakdown

that in addition to harming blood vessels and increasing the risk of obesity and type 2 diabetes, artificial sweeteners also cause muscle breakdown.

As lead author and Ph.D. Brian Gofman, assistant professor of biomedical engineering at Marquette University and the Medical College of Wisconsin, explained, “[Artificial] sweeteners trick the body.

And when your body isn’t getting the energy it needs because it needs some sugar to function properly, it potentially finds a source elsewhere.” Muscle is one such alternative source.

The neuroscience of food awards and how artificial sweeteners trick your body into eating more

An article published in the Yale Journal of Biology and Medicine in 2010 focused specifically on the neurobiology of sugar cravings and the effects of artificial sweeteners in the context of the neurobiology of reward food. As explained in this article:

“Food reward consists of two branches: sensory and post-ingestion… with mechanical satiety.

For moderately concentrated nutrients, rats have learned to prefer food associated with regular feeding, rather than “sham feeding”, in which incoming food flows out of the body through the gastric fistula.

However, the rats showed no preference if highly concentrated nutrients were used. The hypothalamus mediated reward after food ingestion. The hypothalamus secretes a variety of neuropeptides to regulate energy, osmotic balance, and feeding behavior…A growing body of evidence suggests that artificial sweeteners do not activate food reward pathways in the way that natural sweeteners do.”

“Diet” drinks are associated with an increased risk of stroke and heart attack

In related news, a recent observational study from the American Heart Association (AHA) found that, compared to drinking one or fewer “diet” drinks per week , two or more artificially sweetened drinks a day increase the risk of stroke, heart attack and early death in women over 50 by 23, 29 and 16 percent, respectively.

The risk is especially high for women with no history of heart disease, those who are obese and/or African American women. The study included more than 81,700 women from the Women’s Health Initiative Observational Study, a longitudinal health study of nearly 93,680 postmenopausal women aged 50 to 79.

The median follow-up was close to 12 years. According to the authors:

“Most of the participants (64.1 percent) were infrequent users (never or

In a multivariate analysis, those who consumed more PPIs compared to those who never or rarely … had a significantly higher probability of all endpoints (except hemorrhagic stroke), after multiple tests were performed.

Adjusted models showed that hazard ratios … were 1.23 for all strokes; 1.31 for ischemic stroke; 1.29 for coronary heart disease; and 1.16 for all causes of death.

In women with no history of cardiovascular disease or diabetes, high PPI intake was associated with a more than twofold increased risk of ischemic stroke with small artery occlusion. .. High PPI intake was associated with a significant increase in risk development of ischemic stroke in women with a body mass index ≥30 …”

In the accompanying editorial article, “Artificial sweeteners. Real Risks,” Hannah Gardener, Assistant Scientist in the Department of Neurology at the University of Miami, and Dr. Mitchell Elkind suggest drinking pure water instead of non-caloric sweetened drinks as the safest and healthiest low-calorie drink.

If you want a taste, just squeeze a fresh lemon or lime into mineral water. In cases where a little sweetener is needed in cooking, baking or drinks, choose consciously.

Healthy Sugar Substitutes

Two of the best sugar substitutes are Stevia and Lo Han Guo (also spelled Lo Han Guo). Stevia, a very sweet herb derived from the leaves of the stevia plant in South America, is sold as a supplement. It is completely safe in its natural form and can be used to sweeten most foods and drinks.

Lo Han Guo is similar to stevia, but this is my personal favorite.