Diabetic? Why You Should Avoid Diet Drinks

by Mary Shomon Patient Advocate

If you have diabetes, you may think it's healthier to choose a diet drink or an artificial sweetener. It’s time to rethink your choices. Diet drinks and artificial sweeteners pose many health risks to people with diabetes. Let's take a look at the latest research.

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Risk: Vision Loss

A 2018 study found that drinking only four or more cans of a diet soft drink per week more than doubles your risk of proliferative diabetic retinopathy (PDR). PDR is an eye-related complication of diabetes. In PDR, abnormal blood vessels develop in the eye and increase your risk of vision loss and blindness.

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Risk: Impaired Glucose Tolerance

Drinking diet soda every day is associated with a 36 percent increased risk of metabolic syndrome and glucose intolerance. These conditions make your body less effective at releasing and responding to insulin. That means it’s harder to manage your blood sugar.

Man checking his blood glucose levels.
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Risk: Increased Blood Sugar Levels

Like many people with diabetes, you may believe that artificial sweeteners can't raise your blood sugar. But some studies have shown that the artificial sweetener aspartame actually increases blood sugar and insulin levels at similar rates to regular sugar. More research is needed to look at whether other artificial sweeteners have the same effect.

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Risk: Eating More Calories

Controlling weight is already an issue for many people with diabetes. A 2014 study reported that people who were overweight and drank diet sodas ate between 90 and 200 more calories from food per day. The theory is that you don't get enough reward from artificial sweeteners, which leads to overeating calorie-rich and sweet foods.

Overweight man measuring his waistline.
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Risk: More Belly Fat

Belly fat contributes to insulin resistance. It can also make blood sugar management harder. Research shows that daily or even occasional diet soda drinkers gain nearly three times as much belly fat as non-drinkers.

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Risk: Stroke and Heart Disease

Patients with diabetes already face an increased risk of stroke and heart disease. Artificial sweeteners deal an added blow. An American Heart Association/American Stroke Association study found that drinking two or more artificially sweetened beverages per day increases the risk of stroke by 23 percent, and heart disease by 29 percent.

Risk: Depression

Depression is already more common in people with diabetes. Diet drinks make it worse. Research has found that drinking four or more cans of diet soda per day makes you 30 percent more likely to be diagnosed with depression.

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Risk: Dementia

Having diabetes is a risk factor for dementia. Now, research shows that drinking at least one diet soda per day is linked to three times the risk of developing dementia.

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Risk: Gut Bacteria Imbalances

A healthy balance of gut bacteria is essential to metabolic and immune health. Research shows that drinking diet soda changes the composition and behavior of your intestinal bacteria. Bacterial imbalances can contribute to metabolic syndrome, glucose intolerance, and inflammation. These conditions make diabetes treatment harder.

Diabetic man injecting insulin into his stomach.
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Risk: Insulin Resistance and Type 2 Diabetes

Even if you have type 1 diabetes, insulin resistance can make your treatment more difficult. A British Journal of Nutrition study found that people who drink diet sodas raise their risk of insulin resistance and type 2 diabetes by about 13 percent for each 12-ounce can they drink each day.

What About Stevia?

The four most commonly used artificial sweeteners – and the ones most often used to sweeten in diet drinks – are aspartame (Equal, NutraSweet), sucralose (Splenda), saccharin (Sweet 'N Low), and acesulfame K. While research has focused primarily on these chemical sweeteners, some experts theorize that as a non-caloric sweetener, stevia may share many of the same risks and downsides.

Mary Shomon
Meet Our Writer
Mary Shomon

Mary Shomon is a patient advocate and New York Times bestselling author who empowers readers with information on thyroid and autoimmune disease, diabetes, weight loss and hormonal health from an integrative perspective. Mary has been a leading force advocating for more effective, patient-centered hormonal healthcare. Mary also co-stars in PBS’ Healthy Hormones TV series. Mary also serves on HealthCentral’s Health Advocates Advisory Board.