DM: Nutritive Sweeteners (2014)

Intervention
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of nutritive sweeteners, independent of weight loss, on insulin levels (exogenous/endogenous)?
- Conclusion
  Limited research regarding the consumption of nutritive sweeteners (such as isomaltulose and sucrose) as a replacement for carbohydrate, when maintaining consistent carbohydrate intake and an isocaloric diet, reported no significant effect on exogenous or endogenous insulin levels in adults with diabetes.
  
  Additional long-term studies are needed to ascertain an impact of consuming nutritive sweeteners on insulin levels in adults with diabetes.
- Grade: III
  - 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.
- Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of nutritive sweeteners, independent of weight loss, on insulin levels (exogenous or endogenous)?
- Search Plan and Results: DM: Nutritive Sweeteners 2013
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of nutritive sweeteners, independent of weight loss, on glycemia (A1C or glucose)?
- Conclusion
  Studies regarding the consumption of nutritive sweeteners (such as isomaltulose and sucrose) as a replacement for carbohydrate, when maintaining consistent carbohydrate intake and an isocaloric diet, reported no significant effect on A1C. However, research regarding the impact of consuming nutritive sweeteners on fasting blood glucose reports mixed results.
- Grade: II
  - 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.
- Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of nutritive sweeteners, independent of weight loss, on glycemia (A1C and glucose)?
- Search Plan and Results: DM: Nutritive Sweeteners 2013
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of nutritive sweeteners, independent of weight loss, on CVD risk factors (lipids or blood pressure)?
- Conclusion
  Studies regarding the consumption of nutritive sweeteners (such as isomaltulose and sucrose) as a replacement for carbohydrate, when maintaining consistent carbohydrate intake and an isocaloric diet, reported no significant effect on HDL-cholesterol levels in adults with diabetes. However, research regarding the impact of consuming nutritive sweeteners on total cholesterol, LDL-cholesterol and triglycerides reports mixed results.
  
  Subjects did not have or were not described as having any disorders of lipid metabolism or hypertension and none of the studies reported on blood pressure. Additional long-term studies are needed to ascertain an impact of consuming nutritive sweeteners on lipid profile and blood pressure in adults with diabetes, especially those with disorders of lipid metabolism and hypertension.
- Grade: III
  - 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.
- Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of nutritive sweeteners, independent of weight loss, on CVD risk factors (lipids and blood pressure)?
- Search Plan and Results: DM: Nutritive Sweeteners 2013