Artificial sweeteners may have negative effect on glycemic control
by Kristen Monaco, Staff Writer, MedPage Today September 14, 2017

Action Points
• Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

LISBON — Non-caloric artificial sweeteners (NAS) may negatively impact glycemic control, a new study found.
Among healthy individuals, 2-week dietary supplementation with sucralose and acesulfame-K was associated with an increase in plasma glucose absorption, marked by 3-O-methyl glucose (iAUC 23%, P≤0.05), and blood glucose levels when compared with placebo (27%, P≤ 0.05), according to Richard Young, PhD, of the University of Adelaide in Australia, and colleagues.
Gut peptides were also altered after NAS consumption, marked by a 35% increase in iAUC versus those receiving placebo (P≤0.05), they reported at the European Association for the Study of Diabetes meeting.
“There’s always been interest in the type of behaviors that can increase the risk of developing type 2 diabetes,” Young stated during a press conference, citing prior studies which have reported a switch from sugar-sweetened beverages to NAS-sweetened beverages was not reflective of a lowered type 2 diabetes risk. “Glucose absorption had never been assessed in a longitudinal study of any nature, so this is the first data that suggests that glucose absorption is affected in healthy individuals.”
The research group assessed 27 healthy people without diabetes, and randomized them to receive a NAS-supplementation or cellulose placebo (n=13). The NAS group received the equivalent of 1.5 L of “diet” beverage for 14 days — 92 mg sucralose with 52 mg acesulfame-K — a combination that is commonly found in artificially sweetened beverages on the market today. Administered in capsule-form, the participants consumed the intervention three times per day, prior to meals.
All participants underwent an overnight fast, followed by an endoscopy with a 30-minute intraduodenal glucose infusion, and biopsy prior to and after capsule consumption.
Gut peptides other than GLP-1 did not report any attenuation following NAS intake, including GLP-2, insulin, and GIP responses between groups. However, after 40 minutes and 60 minutes after consumption, insulin and GLP-2 levels were slightly lower in the artificial sweetener group (37% for both vs baseline, P≤ 0.05).
The next step is to assess this effect in a cohort of people with type 2 diabetes, Young told MedPage Today. “One of the things that’s perhaps not well appreciated is that people that have type 2 diabetes consume a lot of artificially sweetened drinks. And this translates poorly into that group of people — they may be doing their overall blood sugar control a disservice, rather than not,” he stated, adding his group also plans to also assess how these artificial sweeteners affect the gut bacteria.

The study was funded by the National Health and Medical Research Council.
Young disclosed no relevant relationships with industry.
• Primary Source
European Society for the Study of Diabetes
Source Reference: Young R, et al “Impact of artificial sweeteners on glycemic control in healthy humans” EASD 2017; Abstract 193.