Replacing table sugar with artificial sweetener safe for diabetics in small doses — Study

NEW DELHI — Replacing table sugar (sucrose) with a small quantity of natural and artificial non-nutritive sweeteners (NNSs) such as sucralose in daily beverages like coffee and tea may have no adverse effect on glycemic markers like glucose or HbA1c levels, according to a study. 

The study led by the Chennai-based Madras Diabetes Research Foundation (MDRF), showed that people who used sucralose in pellet, liquid, or powder form had a slight improvement in body weight (BW), waist circumference (WC), and body mass index (BMI).

“This can help cut down calories, and sugar intake and increase dietary compliance. Judicious use of NNS like sucralose within the permissible ADI (Acceptable daily intake), in daily beverages like tea and coffee appears to be safe,” said Dr V. Mohan, senior Diabetologist, Chairman of MDRF, who led the study.

The study, published in the journal Diabetes Therapy, intended to explore the effect of replacing table sugar (sucrose) with artificial sweetener sucralose in coffee/tea in Asian Indians.

The randomised controlled trial (RCT) examined 179 Indians with diabetes for 12 weeks who were divided into two groups: intervention and control.

In the intervention group, added sugar in coffee or tea was substituted with sucralose-based tabletop sweetener, while in the control group, participants continued to use Sucrose as before.

At the end of the 12-week study, no significant change in HbA1c levels was found between the groups. However, favourable changes were noted in the BMI, WC, and mean body weight. The mean weight loss in the intervention group was 0.3 kg, in parallel, BMI decreased by -0.1 kg/m², and WC decreased by -0.9 cm.

Last year, the World Health Organization (WHO) cautioned against using NNS to control body weight but clearly stated that the guidelines were mainly meant for people without diabetes.

However, the WHO warning raised concerns among healthcare stakeholders and the public regarding the use of NNS, even among those with diabetes.

Thus, the “study is very relevant to India as the dietary habits of Indians vary significantly when compared to the rest of the world. Typically, in India NNS is used to replace sugars in daily beverages like tea or coffee,” said Dr Mohan.

The use of added sugar in coffee and tea makes the beverages a potential daily source of sugar intake among Indians. Further, India’s overall carbohydrate consumption, particularly white rice or refined wheat, is also very high, adding to the risks of diabetes.

Dr Mohan noted that more studies are underway on the safety and efficacy of sucralose.