Diabetics Beware! Sugar-free may not Actually be Sugar-free!


sugar free

On the quest to eat less sugar, you may have been attracted to these little packages of artificial sweeteners. They are perceived to be an attractive way to lower sugar and calorie content in foods and are widely available across grocery store shelves and manufactured food products. Diabetics and even common men today are likely to use artificial products as their chosen and go-to sweeteners for food and beverages. Artificial sweeteners may be identified as those food additives that are intended to serve as effective sugar substitutes. They are prepared by chemically combining different molecules in laboratories. In contrast to sugar, artificial sweeteners do not offer any energy or calories to the body as they are not broken down by the digestive system. These sugar free products are manufactured to mimic the flavor of sugar but at times they may be sweeter than sugar (Sharma, A., Amarnath, S., Thulasimani, M. and Ramaswamy, S., 2016. Artificial sweeteners as a sugar substitute: Are they really safe?. Indian journal of pharmacology, 48(3), p.237)! It is because of this reason that using these sugar free products may be detrimental to the health of diabetics. For more insights on the implications of artificial sweeteners on diabetes patients, follow DocTube.

The FDA is known to regulate and approve artificial sweeteners, commonly known as sugar free or high-intensity sweeteners. It has approved the following six artificial sweeteners:

  • Saccharin
  • Sucralose
  • Aspartame
  • Neotame
  • Acesulfame potassium 
  • Advantame 
Artificial sweeteners are thus a kind of food additive that is created for providing sweetness without adding any extra calories and sugar. However, if research is to be believed, consuming these artificial sugar can actually be harmful. Some common side effects of using artificial sweeteners can include poor blood sugar control, weight gain as well as an unhealthy gut. It is always advisable to restrict your intake of artificial sweeteners as much as possible. Recent guidelines from the WHO have advised people against using these sugar-free sweeteners. Health experts say that such sugar substitutes do not offer any long-term health benefits and may cause adverse implications to the body's microbiome (Medicalnewstoday (2023).Why health officials recommend against non-sugar sweeteners. Available at (Accessed: 23 August 2023). It is therefore recommended to replace such sugary substances with foods that are naturally sweet such as unsweetened foods, beverages and fruits. In addition to these, there may also be adverse health implications due to its long-term use such as cardiovascular disease and Type 2 diabetes.

Health concerns related to sugar free sweeteners

1. Increased appetite

Research has suggested that these artificial sweeteners can activate reward pathways in a person’s brain that may in turn increase appetite. It has also been found that when compared to consuming water or sugar, regular consumption of aspartame is associated with higher sugar cravings, hunger and caloric intake.

2. Weight gain

Most of us falsely assume that artificial sweeteners help in weight management and weight loss as they contain no calories. However, it is important to note that there is evidence that has linked long-term consumption of diet soda to higher BMI in children and increased body fats in older adults (Brown, R.J., De Banate, M.A. and Rother, K.I., 2010. Artificial sweeteners: a systematic review of metabolic effects in youth. International Journal of Pediatric Obesity, 5(4), pp.305-312).

3. Poorly regulated blood sugar levels

Artificial sweeteners may not increase your blood sugar levels. However, they may increase your insulin levels in the blood. They have a sweet taste and this may make the pancreas mistake them for sugar. Research also suggests that there may be a link between long-term usage of artificial sweeteners and insulin resistance or Type 2 diabetes. On the other hand, these sugar-free products can also increase the overall frequency of reactive hypoglycemia or low blood sugar after eating (Wolever, T.M. and Miller, J.B., 1995. Sugars and blood glucose control. The American journal of clinical nutrition, 62(1), pp.212S-221S). This is due to the fact that such sweeteners can lead to an increase of insulin that may lower the blood sugar even though the body has not got any energy or calories from the sweetener. Thus, even if artificial sweeteners do not raise your blood sugar directly, they may still result in poorly controlled blood sugar levels.

4. Altered gut microbiome

Gut bacteria react differently to sugar free products than they do to real sugar. Sucralose and saccharin have been found to change the gut microbiome while also being linked to dysbiosis in humans (Suez, J., Korem, T., Zeevi, D., Zilberman-Schapira, G., Thaiss, C.A., Maza, O., Israeli, D., Zmora, N., Gilad, S., Weinberger, A. and Kuperman, Y., 2014. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 514(7521), pp.181-186). Dysbiosis refers to an imbalance in the gut microbial community. This may lead to irritability, bloating, thinning of the barrier surrounding the intestines, mood changes, migraines, autoimmune conditions and anxiety.

5. Higher risk for metabolic syndrome

Some research has suggested that the intake of sugar free products is linked to the development of metabolic syndrome. This refers to different risk factors that may increase your risk for major health problems like stroke, diabetes and heart disease.

High-Risk Groups

Although artificial sweeteners are considered unhealthy in general, certain people may be at a higher risk of complications and side effects when consuming these sugar free products and must therefore be extra careful of their intake. These may include the following groups of people:

  • People suffering from diabetes 
  • Pregnant and lactating women
  • Anyone with absorption problems and bowel disorders
  • A person who has had or is going to have a weight loss surgery
  • Children
  • People suffering from epilepsy and migraines

  What problems can artificial sweeteners cause in diabetics?  

Consumption of artificial sweeteners can lead to the release of insulin from the pancreas which may be mistaken for glucose due to its sweet taste. This, in turn, increases the insulin levels in the blood thereby leading to decreased receptor activity because of insulin resistance. This aggravates diabetes symptoms and may prove to be fatal.

  Do artificial sweeteners affect kidneys?  

Artificial sweeteners do not increase blood sugar levels but may have a negative effect on a person’s kidneys.


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