Can Artificial Sweeteners Raise Blood Sugar?

Artificial sweeteners have been around for a long time and have grown in popularity due to their use by dieters and those who don't want extra pounds. Six artificial sweeteners have been approved by the U.S. Food and Drug Administration for human consumption in the U.S. Artificial sweeteners have also been recommended as sugar substitutes for people with diabetes or glucose intolerance (prediabetes). But research has begun to call into question the benefit of artificial sweeteners for those with diabetes or abnormalities in glucose metabolism. A study published in the Oct. 2014 issue of the highly regarded scientific journal Nature suggests that consuming artificial sweeteners can actually cause glucose intolerance by changing the makeup of the bacteria normally present in the digestive tract.

Because artificial sweeteners aren't digested, they pass through the gastrointestinal tract and come into direct contact with the bacteria that normally reside there. Investigators studied the effect that three artificial sweeteners have on these intestinal bacteria. Since changes in the intestinal microenvironment have been linked to diabetes and metabolic syndrome, the researchers wanted to learn whether or not the artificial sweeteners caused changes that could lead to impairment in glucose metabolism. They conducted experiments in which mice drank either normal water or water supplemented with three different kinds of artificial sweeteners (saccharin, sucralose, or aspartame). The mice in all three of the groups consuming artificial sweeteners developed glucose intolerance, with higher blood glucose levels than the mice drinking water alone. Further, the effect was also observed in mice that were fed a high-fat diet, indicating that the sweeteners had the effect in both the lean state and the high-fat state (mimicking overweight or obesity). They went on to conduct experiments that proved that the elevated glucose levels in the sweetener-consuming mice were directly related to changes in the intestinal bacterial composition.

Research into a definitive answer to that question is ongoing.

Next, the researchers looked at human subjects. They found that consumption of artificial sweeteners was linked to higher fasting glucose levels and higher levels of glycosylated hemoglobin (hemoglobin A1c) in non-diabetic people compared with nondiabetic people who did not consume the sweeteners. The study was controlled for body mass index, so the relationship was the same despite the weight of the individuals. These preliminary studies suggest that artificial sweeteners might actually have an opposite effect than intended, at least in certain people. Further studies of the intestinal bacteria and microenvironment will help clarify the role of these bacteria and potential alterations in their composition.

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