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Non-nutritive sweeteners for diabetes mellitus
Szimonetta Lohner1, Daniela Kuellenberg de Gaudry2, Ingrid Toews3
1Cochrane Hungary, Clinical Center of the University of Pécs, Medical School, University of Pécs, Pécs, Hungary.
The Cochrane Database of Systematic Reviews
|May 26, 2020
Summary
Non-nutritive sweeteners (NNS) use in diabetes shows inconclusive health outcomes. More research is needed to understand the effects of NNS on HbA1c, weight, and adverse events in people with diabetes.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Nutritional Science
Background:
- Non-nutritive sweeteners (NNS) are widely used by individuals with type 1 or type 2 diabetes to manage carbohydrate and energy intake.
- The health outcomes associated with NNS consumption in diabetic populations remain largely unknown.
Purpose of the Study:
- To assess the effects of non-nutritive sweeteners (NNS) on health outcomes in individuals with diabetes mellitus.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) with a minimum duration of four weeks.
- Searched multiple databases including CENTRAL, MEDLINE, Scopus, and ClinicalTrials.gov up to May 2019.
- Included RCTs comparing NNS with usual diet, placebo, water, other NNS, or nutritive sweeteners in individuals with type 1 or type 2 diabetes.
Main Results:
- Nine RCTs involving 979 participants were included; none were at low risk of bias across all domains.
- Comparisons with sugar, placebo, or nutritive sweeteners showed very low-certainty evidence for effects on HbA1c and body weight.
- Limited data on adverse events were reported, with no significant differences found between NNS and placebo groups.
Conclusions:
- Inconclusive evidence of very low certainty exists regarding the clinical benefits or harms of NNS on HbA1c, body weight, and adverse events in people with diabetes.
- There is a lack of data on the impact of NNS on quality of life, diabetes complications, mortality, and socioeconomic effects.
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