Diet soda and diabetes

Managing blood sugar levels is an everyday goal for people with type 1 and type 2 diabetes. While eating sugar doesn’t cause either type of diabetes, keeping tabs on carbohydrate and sugar intake is an important part of managing both types of diabetes. Eating healthfully can also reduce your risk for developing type 2 diabetes.
Being overweight or obese is linked to the development of type 2 diabetes. In fact, obesity is one of the leading causes of type 2 diabetes. According to the Centers for Disease Control and Prevention, more than one-third of American adults are considered obese. Obesity puts you at risk for diabetes, as well as other troublesome conditions. Eating processed foods that are high in sugar, unhealthy fats, and empty calories increases your risk of gaining too much weight.
Drinking sugary drinks is also a risk factor for developing type 2 diabetes. If you are working to keep your blood sugar in check or manage your weight, you might choose diet soda. Low in calories and sugar, diet sodas appear to be a good alternative to sugary drinks. Diet coke and A&W’s diet root beer, for example, claim to be entirely sugar-free. Unfortunately, even though they contain no actual sugar, they are loaded with artificial sweeteners and other unhealthy additives.

WHAT EXPERTS SAY
Research

At one time, there was much debate over the safety of artificial sweeteners. Many feared that these sweeteners caused certain types of cancer. Studies performed in the 1970s suggested that the artificial sweetener saccharin was linked to bladder cancer. Since that time, however, saccharin has been deemed safe. Both the National Cancer Institute and the U.S. Food and Drug Administration (FDA) consider the sweetener nontoxic. Aspartame, another common yet controversial sweetener, has also gained clearance for use as a sugar replacement.
The FDA regulates artificial sweeteners as food additives. It reviews and approves artificial sweeteners before they can be sold. Some foods are “generally recognized as safe” and don’t require FDA approval to be sold. However, aspartame and saccharin, commonly found in diet sodas, are both FDA reviewed and approved.
The American Diabetes Association (ADA) lists diet sodas among the drinks considered safe. The ADA recommends them as an alternative to non-diet varieties.

RISKS
What are the risks?

While diet soft drinks are safe, they are far from nutritious. In addition to diet soda, the ADA recommends water, unsweetened iced or hot tea, and sparkling or infused water. Even milk and 100 percent fruit juices, although they contain carbohydrates, can be wise choices when you consider the nutrients they provide. Be sure to limit fruit juices due to their high natural sugar content.
Carbonated colas also pose some risk. A 2000 study published in Archives of Pediatrics and Adolescent Medicine investigated the risks of colas in youth. The study found that drinking carbonated beverages was strongly associated with bone fractures in teenage girls. Although the same was not shown for boys, the study did raise concerns about long-term negative impacts of carbonated colas.
Diet sodas may also create issues specifically for people with diabetes. A study published in Nature showed that, in mice, artificial sweeteners can lead to a spike in insulin.
In the experiment, researchers discovered that artificial sweeteners can trigger sweet receptors in the stomach. This leads to an increase in insulin and lowered blood sugar. The stomach was essentially treating the artificial sweetener like real sugar, causing a spike in insulin. Researchers found this concerning but also said the spike in insulin wouldn’t likely cause clinical hypoglycemia, a risk for people on certain diabetes medications.

ASPARTAME AND DIABETES
Aspartame and diabetes

Aspartame is one of the most common artificial sweeteners. Brand examples include NutraSweet and Equal. Aspartame is a low-calorie sweetener that is 180 times sweeter than sugar and often used as a sugar substitute. Aspartame contains no calories or carbohydrates.
Other artificial sweeteners approved by the FDA include sucralose, Advantame, acesulfame potassium, and saccharin.
The research about aspartame and how it impacts those with diabetes is not completely clear. One 2016 study found that aspartame could be responsible for oxidative stress that causes disturbances in liver and kidney function in diabetic mice. A different 2016 study found that aspartame intake is associated with a greater glucose intolerance in obese individuals, which could increase the chance of diabetes. This effect may be due to the fact that aspartame has been shown to change the bacteria found in the gut.

PROS AND CONS
Pros and cons

When it comes to diet soda and diabetes, there are both pros and cons to consider.

Pros of drinking diet soda with diabetes include

  • It contains fewer carbohydrates than regular soda.
  • It curbs the sugar craving without a sugar overload.
  • You're consuming far fewer calories.

Cons of drinking diet soda with diabetes include

  • You’re consuming calories but gaining no nutritional benefit.
  • It’s full of unhealthy additives.
  • Long-term diet soda drinking is still associated with weight gain and other health risks.
  • Research shows an increased risk of diabetes and metabolic syndromewith both diet soda and regular soda intake.

ALTERNATIVE OPTIONS
Alternatives

While water is the top recommendation for hydration, most people prefer drinks with some flavor added in. Instead of reaching for a diet soda, however, there are several great options to choose from instead. Infused waters are a great alternative. You can add items like fruit (especially berries), cucumbers, lemon, and herbs (like basil and mint) into your water. Sparkling water is also a good option, as long as it isn’t artificially flavored or sweetened.
Milk is also an acceptable choice, though it’s best to stay away from sweetened milk (like chocolate milk), and keep track of carbohydrates, since cow, rice and soy milk all contain carbohydrates.
Unsweetened tea is another smart option. Whether you prefer hot or cold, you can choose from a large number of different flavors and types of tea.
Finally, when in doubt, try fruit-infused water. You can add items like fruit (especially berries), cucumbers, lemon, and herbs (like basil and mint) into your water. Sparkling water is also a good option, as long as it isn’t artificially flavored or sweetened.

TAKEAWAY
Takeaway

Whether it’s to lose weight or manage diabetes, becoming proactive about reducing sugar intake is a positive step. If you’re ready to make the leap toward better health, switching to diet soda may help you along the way.
Drinking a zero-calorie beverage may be a better option than the sugared variety, though choosing those with artificial sweeteners might not be the best choice. Be mindful of your eating habits as well as your preferred drinks. This will help you better manage your blood sugar levels.

When you have diabetes, it's easy to feel limited by what you can eat and drink. Although you might occasionally be tempted to stray from your healthy meal plan, you're best to avoid dietary temptations and consume only what your doctor deems appropriate. If you've been previously accustomed to drinking soda, diet alternatives should be safe for you.

The Safety of Diet Soda

The American Diabetes Association lists diet soda among the beverages that are safe for diabetics to consume. Diet soda is typically sweetened with one of five artificial sweeteners, including aspartame. These sweeteners do not contain calories, and the ADA reports that they will not cause a blood glucose reaction. Many common flavors of soda are available in diet versions, including cola, root beer, lemon-lime and orange.

Risks of Diet Soda

The safety of artificial sweeteners is highly contested, although the National Cancer Institute reports that no proof exists linking the Food and Drug Administration's approved artificial sweeteners to cancer. A greater risk in frequently consuming artificially sweetened soda is consuming unhealthy foods because you aren't drinking a high-calorie beverage. A study published in 2010 in the "Yale Journal of Biology and Medicine" that found those who drink heavy amounts of diet soda are more likely to be obese than those who don't drink diet soda, and obesity is a major risk factor for type-2 diabetes.

Watch Out for Caffeine

Even if drinking diet soda is safe for diabetics, you shouldn't make a habit of consuming this type of beverage. Diet soda has little nutritional value, and consuming a caffeinated flavor can harm your ability to sleep soundly. Excessive caffeine consumption can also lead to side effects, including anxiety and restlessness. Ceasing to consume caffeine can lead to symptoms such as headaches and irritability, however.

Other Drink Choices

Instead of frequently consuming diet soda, look for healthier alternatives that are still safe within the parameters of your diabetic diet. The ADA recommends drinking water, low-fat milk and 100 percent fruit juice. Although the latter two contain calories and carbs, consuming them in moderate amounts is often safe. The ADA suggests carefully counting the calories and carbs from milk or juice in your meal plan. For example, 1 cup of skim milk has 80 calories and 12 grams of carbs, while just 4 to 6 ounces of fruit juice contains at least 50 calories and 15 grams of carbs. Unsweetened coffee and tea are also acceptable. If you enjoy water's hydration benefits but aren't a fan of its taste, squeeze some lemon or lime juice into your glass.