How Do Artificial Sweeteners Affect Blood Sugar and Insulin?

  • Medical Reviewer: Dany Paul Baby, MD
Reviewed on 6/21/2022

What are artificial sweeteners?

Artificial sweeteners offer the sweetness of sugar without the calories. In the short term, blood sugar levels will not rise due to the ingestion of artificial sweeteners and the sweetness of artificial sweeteners can trigger the cephalic phase in the release of insulin and cause an increase in insulin levels in the body.
Artificial sweeteners offer the sweetness of sugar without the calories. In the short term, blood sugar levels will not rise due to the ingestion of artificial sweeteners and the sweetness of artificial sweeteners can trigger the cephalic phase in the release of insulin and cause an increase in insulin levels in the body.

Sugar has become a common topic when people discuss health and nutrition. Reducing sugar in the diet can help in weight loss and overall improvement of your health. The use of natural products can sometimes substitute for sugar. Artificial sweeteners are another way to get sugar out of the diet. However, artificial sweeteners may not be as healthy as previously thought. 

Also known as sugar substitutes, artificial sweeteners offer the sweetness of sugar without the calories. Most are several times sweeter than sugar. For this reason, it does not take much to season food. Foods made with artificial sweeteners may have fewer calories because of their use instead of sugar. 

People use artificial sweeteners to avoid sugar, hoping to maintain flavor with fewer calories. The scientific community is constantly studying the health benefits and safety of the consumption of artificial sweeteners. They are metabolized differently by the body due to their chemical differences. The difference in how artificial sweeteners affect the body's metabolic rate has conflicted with findings related to how they affect glucose normalizing, body weight control, and biological methods.

What are the different types of artificial sweeteners?

The most common artificial sweeteners are saccharin, aspartame, acesulfame potassium, and sucralose.

Saccharine: Saccharin is available as an acid bound to calcium or sodium. The most common bond is with sodium salt due to its stability and solubility. Saccharin is over 300 times sweeter than sugar. The body does not metabolize it, so the FDA considers it safe. When it is eaten, most of it is absorbed into the blood. It is eliminated via the urinary and bowel system, so it rarely makes it to the stomach to affect the microbiological environment

Aspartame: This sweetener is about 200 times sweeter than sugar. Unlike some of its counterparts, aspartame has four calories per gram. But because of its sweetening abilities, it only takes a small amount to get the desired flavor. When eaten, it is broken down by the small intestine into many components, including methanol. The liver metabolizes methanol. Aspartame does not remain in the body and never reaches the colon. It is used during protein synthesis. 

Acesulfame Potassium: Acesulfame potassium is a powder 200 times sweeter than sugar. It is very sweet, and due to its long persistence, it is used in popular products such as sodas. It is bonded with potassium but does not affect the body's potassium levels because the body does not metabolize the combined molecule. With 24 hours of intake, it is excreted mainly by the kidneys. 

Sucralose: Sucralose is very similar to sugar. There are enough chemical changes to its structure to keep it calorie-free in the body. Digestive enzymes are unable to recognize and digest it. Though it is made from sugar, it is 6000 times sweeter. It passes through the GI system unchanged and is almost completely eliminated via bowel movements. 

What raises insulin and blood glucose levels?

Our body maintains a system of feedback mechanisms that keep blood sugar levels In  homeostasis. When we eat carbohydrates like bread, cakes, and pasta, our blood sugar levels go up. Carbohydrates break down into sugar during the digestive process and enter the bloodstream. This increases the levels of blood sugar. The body's response to this is to increase insulin production. Small levels of insulin are released before sugar enters the bloodstream. Production is triggered by the smell, sight, and taste of food; this is known as the cephalic phase of insulin release. 

How do artificial sweeteners affect blood sugar?

In the short term, blood sugar levels will not rise due to the ingestion of artificial sweeteners. Long-term effects in humans are unknown currently. Most artificial sweeteners are considered "free" because they contain 20 calories or less and minimal amounts of carbohydrates. They don't count as carbs or calories in a diabetes exchange. It is important to remember that foods with artificial sweeteners can still affect blood sugar levels due to other ingredients.

How do artificial sweeteners affect insulin levels?

The sweetness of artificial sweeteners can trigger the cephalic phase in the release of insulin and cause an increase in insulin levels in the body. Though there are no human studies, regular use has the potential to alter bacteria in the gut and make cells more resistant to naturally produced insulin, which in turn can increase insulin and sugar levels. 

Over the past decade, the incidence of diabetes has increased. This is primarily due to sedentary habits and eating habits. This includes the use of artificial sweeteners, which are broadly replacing sugar. Ingestion of artificial sweeteners causes an increase in insulin levels prematurely and eventually leads to decreased receptor activity due to  insulin resistance

Increased drinking of sodas sweetened with artificial sweeteners has also increased the incidence of type 2 diabetes, further suggesting insulin resistance with time. Besides possibly affecting body weight, these sweeteners also affect glycemic control due to reduced glucose absorption. This does not, however, alter glucose homeostasis. 

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Are artificial sweeteners suitable for people with diabetes?

Both the American Diabetes Association and the American Heart Association have approved the use of artificial sweeteners instead of sugar to help with obesity, diabetes, metabolic syndrome, and risk factors for heart disease. It is not a magic bullet, but the proper use of artificial sweeteners can help reduce excess calories in the diet. This lowers your overall calorie intake. Calorie reductions help maintain a healthy body weight, which reduces risk factors for diabetes and heart disease.

Should you stop using artificial sweeteners?

Artificial sweeteners can be good alternatives to sugar because they do not add calories to the diet. Only a small amount is needed as compared to sugar. According to the National Cancer Institute, there is no evidence that artificial sweeteners cause cancer or other serious health problems. The  FDA has deemed them safe for consumption, and ultimately they have more health benefits than sugar. 

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References
SOURCES:

Frontiers in Nutrition: "The Impact of Artificial Sweeteners on Body Weight Control and Glucose Homeostasis."

Mayo Clinic: "Artificial sweeteners: Any effect on blood sugar?", "Artificial sweeteners and other sugar substitutes."

National Center for Biotechnology Information: "Effect of artificial sweeteners on insulin resistance among type-2 diabetes mellitus patients."

PLOS ONE: "Cephalic phase of insulin secretion in response to a meal is unrelated to family history of type 2 diabetes."

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