What is the evidence regarding the use of nonnutritive sweeteners such as saccharin, aspartame, acesulfame potassium, sucralose, neotame and stevia in women with GDM?
While there are recognizable benefits of the use of nonnutritive sweeteners with the maintenance of blood glucose control, to date there is limited evidence to support the use or nonuse of nonnutritive sweetners (NNS) in pregnancy, and even less evidence addressing this issue specifically in gestational diabetes mellitus (GDM). The FDA has approved aspartame, acesulfame potassium, sucralose, saccharin and neotame for general use, while stevia has not been approved. The use of FDA-approved nonnutritive sweeteners during pregnancy is acceptable with the exception of aspartame for pregnant women with hyperphenylalanine in the blood and phenylketonuria. The American Medical Association suggests avoiding saccharin during pregnancy due to possible slow fetal clearance.
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.