Artificial sweeteners linked to higher diabetes risk, study finds

Growing scientific evidence is raising concerns about the long-term health effects of artificial sweeteners.

Multiple studies now indicate that regular consumption may increase the risk of type 2 diabetes, contribute to weight gain, and disrupt metabolic health.

Artificial sweeteners are synthetic sugar substitutes designed to provide sweetness without the calories or carbohydrates found in regular sugar.

They were initially introduced to help reduce sugar intake, manage calorie consumption, support weight control, prevent diabetes, and protect dental health. Over time, they gained popularity in “diet” and “sugar-free” beverages and low-calorie foods, offering sweet flavours without the metabolic impact of sugar.

Type 2 diabetes

A 14-year study by Monash University, published in Diabetes & Metabolism, found that individuals who consumed artificially sweetened soft drinks daily had a 38 per cent higher risk of developing type 2 diabetes compared to those who rarely drank them. This was notably higher than the 23 per cent increased risk linked to regular sugar-sweetened beverages in the same study.

The study tracked over 36,000 Australian adults aged 40 to 69, monitoring their beverage habits and health outcomes. Researchers adjusted for factors like body mass index (BMI) and waist-to-hip ratio, and the elevated risk from artificially sweetened drinks persisted.

Participants reported how often they consumed regular soft drinks, fruit drinks, or artificially sweetened beverages. Over time, researchers tracked who developed type 2 diabetes and compared outcomes based on beverage intake.

The results showed a clear pattern: daily consumption of sugar-sweetened drinks was associated with a 23 per cent higher risk of diabetes, but this risk mostly disappeared after adjusting for body weight and belly fat. This implies sugary drinks likely increase diabetes risk primarily through weight gain.

Artificially sweetened drinks

Findings for artificially sweetened drinks were more concerning. Daily consumers had a 38 per cent higher risk of developing type 2 diabetes, and this risk remained even after adjusting for weight and fat. In other words, the risk from diet drinks wasn’t solely due to weight gain.

Researchers believe other mechanisms may be at play. Artificial sweeteners might alter the gut microbiome, affecting how the body processes sugar and insulin. They may also confuse the body’s natural response to sweetness, leading to cravings or impaired blood sugar control. Additionally, some people may overconsume food or drinks, believing diet beverages are “safe”, which could contribute to the risk.

To rule out reverse causality, researchers examined whether people already at risk for diabetes were simply choosing diet drinks more often. Even after accounting for this, the link between diet drink consumption and diabetes remained strong.

The study concluded that both sugary and diet drinks are associated with a higher risk of type 2 diabetes, but for different reasons. Sugary drinks increase risk primarily through weight gain, while diet drinks may disrupt metabolic processes more directly.

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Neither regular nor diet soft drinks are ideal for long-term health. The best choices for preventing diabetes and maintaining metabolic health are water, unsweetened tea, or coffee, with both sugary and diet drinks reserved for occasional consumption.

Insulin sensitivity

These findings add to a growing body of research suggesting that artificially sweetened beverages may not be metabolically neutral.

Meta-analyses of earlier studies have shown similar trends: higher intake of these drinks is linked to a 20-30 per cent increased risk of type 2 diabetes, though results vary.

The mechanisms remain unclear, but several theories exist. Artificial sweeteners may alter the gut microbiome, affect glucose metabolism and insulin sensitivity, or interfere with appetite regulation, where sweetness without calories disrupts normal responses and leads to compensatory eating.

It’s also possible that consumption of artificially sweetened drinks reflects broader lifestyle patterns. People who eat more processed foods or have poorer diets may also prefer these beverages, making it difficult to isolate the effects of sweeteners alone.

While switching from sugary drinks to diet versions may reduce sugar and calorie intake in the short term, long-term daily consumption is not risk-free. Both types of beverages appear linked to a higher risk of metabolic disease, and moderation remains essential.