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Type 2 Diabetes Diet Drinks

By Maura Shenker ; Updated August 14, 2017

If you have diabetes, you probably know that it's best to avoid sugary drinks like regular soda, sweet tea and fruit punch. A 12-ounce serving of regular soda contains around 150 calories and 40 grams of sugar. Diet drinks may be a better choice, with no sugar and few, if any, calories. But perhaps you are reluctant, having seen news reports warning of possible dangers of diet drinks. As of 2016, however, the American Diabetes Association includes diet drinks as a beverage option for people with diabetes.

Difference Between Regular and Diet Drinks

If you have diabetes, it can sometimes be hard to deal with a sweet tooth as sugary drinks will raise your blood sugar. A 12-ounce serving of regular soda may contain as much as 10 teaspoons of sugar. A better way to satisfy your sweet craving might be a diet soda. While some people prefer the taste of diet drinks, others just enjoy soda and want to avoid the sugar and calories of a sugar-sweetened drink. Instead of sugar, diet soda contains one or more artificial sweeteners, such as sucralose, acesulfame potassium and aspartame. These sweeteners are used instead of sugar, and drinks made with these sweeteners contain no carbohydrates, so they do not raise your blood sugars.

Diet Drinks, Insulin and Blood Glucose

The possible influence of artificial sweeteners on blood sugar and insulin levels is controversial, and at least some research studies have yielded conflicting results. For example, a February 2016 "Obesity" article detailed the results of a 12-month weight-loss study involving 303 people without diabetes who were overweight or obese. All participants received the same weight-loss counseling but were randomly split into groups, drinking either 24 ounces of water or an artificially sweetened drink daily. The researchers found that artificial sweeteners did not change blood sugar levels, and people consuming the artificially sweetened drinks lost more weight.

However, an April 2015 research article in the journal "Gut Microbes" provided evidence that artificial sweeteners can alter blood sugar metabolism and lead to elevated blood sugar levels in mice, possibly by changing the composition of the natural bacteria in the intestines. While additional research is needed, an October 2015 "Archives of Public Health" review article evaluating the results of the research to date notes that most studies show artificial sweeteners do not have a significant effect on blood sugar or insulin levels in people with or without diabetes.

Diet Drinks and Possible Type 2 Diabetes Risk

A possible association between diet drinks and the risk of developing type 2 diabetes (T2DM) is another controversial topic, with some conflicting study results. The authors of a July 2015 "British Medical Journal" pooled and analyzed the results of studies examining possible associations between development of T2DM and consumption of sugar-sweetened beverages, artificially sweetened beverages and fruit juice. Consumption of sugar-sweetened drinks caused the greatest level of increased T2DM risk. But artificially sweetened beverage and fruit juice consumption were also associated with some increased risk. The authors noted that the association between artificially sweetened drinks and fruit juice and increased T2DM risk may have been due to factors other than consumption of the beverages themselves.

However, an October 2015 "Archives of Public Health" review article reported mixed results from single studies. Four studies found no increased T2DM risk associated with consuming artificially sweetened beverages, but 3 reported finding an association. Additional, well-designed research is needed to clarify this important issue.

Next Steps

Whether diet drinks are potentially helpful, harmful or neither for people with diabetes remains a hotly debated issue, and research is ongoing. However, artificial sweeteners used in diet drinks are generally recognized as safe by the U.S. Food and Drug Administration. A July 2012 joint scientific statement from the American Heart Association and the American Diabetes Association noted that when used judiciously, artificial sweeteners may be helpful in reducing sugar and calorie consumption, thereby promoting weight loss or weight control. These effects could be potentially help in managing T2DM.

If you have concerns about consuming diet drinks, talk with your doctor or registered dietitian. Coffee or unsweetened tea and water -- perhaps flavored with a twist of lemon or lime juice -- are other possible alternatives.

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