Could sucralose sweeteners cause diabetes-like disorders?

Sucralose is an artificial sweetener that gives a sweet taste to foods and beverages without increasing calorie intake. Several studies have already shown that sucralose consumption is associated with impaired glucose and insulin metabolism in the human body because it disrupts the balance of the gut microbiome.

Researchers in Mexico have now conducted a clinical trial in young and healthy adults to find out what the impact of the consumption of long-term sweetener on the microbiome. They found that sucralose can produce alterations similar to the development of type 2 diabetes.

The work was carried out by researchers from the General Hospital of Mexico, the National Institute of Genomic Medicine, the Faculty of Medicine, the National Autonomous University of Mexico (UNAM), the Center for Scientific Research and Higher Education in Ensenada, and the Faculty of Public Health and Nutrition of the Autonomous University of Nuevo León .

After learning about the results of the study in Mexico, Segundo Seclen, an endocrinologist from Peru and president-elect of the Latin American Diabetes Association, said in a dialogue with Infobae: “Evidence shows that sweeteners alter the intestinal microbiota and turn it into a low-intensity inflammatory factor that disrupts glucose metabolism and increases insulin resistance. In summary, the risk of diabetes increases in its consumption, especially in people with risk factors for diabetes such as abdominal obesity, hypertension, dyslipidemia, among others.”

“We conducted a clinical trial in healthy young adults to investigate the effect of long-term sucralose ingestion on the intestinal abundance of four bacterial species representative of the phyls Actinobacteria, Bacteroidetes and Firmicutes as a primary outcome. As a secondary result, we explored whether sucralose-induced dysbiosis was potentially related to alterations in glucose and insulin levels during an oral glucose load,” the researchers wrote in the published paper.

Sucralose is recommended for patients with diabetes, as it maintains the sweet taste without increasing calories or glycemic peaks. But, paradoxically, frequent use of sucralose in healthy people can increase blood glucose and insulin levels. The study was led by Dr. Galileo Escobedo, a researcher at the Experimental Medicine Unit of the UNAM and the General Hospital of Mexico.

The gut microbiota, which could be considered an additional organ that weighs about two kilograms in a 70-kilo adult, is the collection of thousands of bacteria of different species that live in our gut and contribute “to our health or our disease”.

The clinical trial was conducted in two groups of men and women. For 10 weeks, one was given 48 milligrams of sucralose daily in the water and the other, the control group, a placebo (water only). The dose of sucralose administered “equals a half-liter juice or four cookies”. This is the amount that represents an average, moderate consumption, although there are people who consume much more of this sweetener on a daily basis.

At the beginning and end of the sucralose exposure, Escobedo and colleagues measured glucose, insulin and leptin levels, as well as sequencing and PCR procedures to determine the microbiota profile in response to sweetener intake.

The study, which was published in the specialized journal Microorganisms, showed that sucralose causes intestinal dysbiosis, that is, a “dramatic” alteration in the balance or proportion of intestinal bacteria that it has an individual. To begin with, at the same time as the Clostridium coccoides bacterium increases, associated with “spikes in glucose and insulin in the blood and a tendency to develop type 2 diabetes”, the population of Lactobacillus acidophilus, bacteria that are good for metabolic health and are even contained in some dairy foods.

In addition, this alteration in microbiota bacteria is associated with a tendency to intestinal inflammation and increased recurrence of digestive disorders. It is known, Escobedo recalled, in a press release, that if glycemic peaks persist for a long time, they damage nerves and blood vessels, which is beginning to be seen in subjects who do not yet have diabetes, but who will develop it within five or 10 years.

Something very similar, although to a lesser extent, is observed with sucralose: “as if its consumption increases the tendency to develop metabolic disorders that occur during diabetes”. Although diabetes is a disease with a set of alterations already established, these same alterations are observed, separately, with the consumption of sucralose.

The Escobedo team demonstrated that even with this moderate amount of sucralose (some people consume more in cookies, orange juice and sweetening their coffee with sweetener with sucralose) “there are impressive effects on intestinal bacteria: it annihilates some and promotes harmful others, associated with metabolic health disorders and digestive”, according to the official statement.

Because of the high consumption of sucralose in the population, and that it may be associated with the development of diabetes-like disorders such as hyperinsulinemia, hyperglycemia, intolerance to carbohydrates and digestive disorders, Dr. Escobedo recommended patients with diabetes who need to consume it for health reasons, it is advisable to do so under medical supervision.

He warned that poorly controlled diabetes (high blood sugar levels) causes micro- and macro vascular abnormalities that result in damage to nerves and blood vessels and can lead to blindness, loss of limbs, feeling very painful or complete loss of sensation, and even elevated cardiovascular risk that can lead to a heart attack.

Meanwhile, for people with a healthy lifestyle and especially children, “it is recommended to avoid consuming artificial sweeteners, drinking water and sweetening foods with small amounts of sugar, in order not to induce attachment to sweet taste in girls and boys, who tomorrow can become patients with type 2 diabetes,” the researchers recommended in the statement.

When asked by Infobae, Dr. Silvio Schraier, deputy director of the specialization program in nutrition at Fundación Barceló and member of the Argentine Diabetes Society, said another opinion: “The study carried out in Mexico has limitations. It was done with a small sample of people and the consumption of sucralose was compared with water. Apparently, those who took sucralose had increased insulin secretion, a logical change. At the moment, sucralose consumption cannot yet be associated with the development of diabetes.”

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