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DM: FDA-Approved Non-Nutritive Sweeteners (2014)

Intervention
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts and types of FDA-approved non-nutritive sweeteners (stevia, sucralose, saccharin, acesulfame K, aspartame and neotame) on glycemia (A1C or glucose)?
- Conclusion
  Limited research reports no significant impact of consuming FDA-approved non-nutritive sweeteners [such as aspartame, stevia (steviol glycosides) and sucralose], independent of weight loss, on A1C and fasting glucose levels in adults with diabetes.
  
  No studies were identified that reported on the effects of saccharin, acesulfame K and neotame consumption among subjects with diabetes. Additional long-term studies are needed regarding the impact of consuming FDA-approved non-nutritive sweeteners on glycemia 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 and types of FDA-approved non-nutritive sweeteners (stevia, sucralose, saccharin, acesulfame K, aspartame and neotame) on glycemia (A1C and glucose)?
- Search Plan and Results: DM: Non-Nutritive Sweeteners 2013
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts and types of FDA-approved non-nutritive sweeteners (stevia, sucralose, saccharin, acesulfame K, aspartame and neotame) on insulin levels (exogenous/endogenous)?
- Conclusion
  One study reports no significant impact of consuming FDA-approved non-nutritive sweeteners [such as stevia (steviol glycosides)], independent of weight loss, on endogenous insulin levels in adults with type 2 diabetes.
  
  No studies were identified in subjects with type 1 diabetes or that reported on exogenous insulin levels. No studies were identified that reported on the effects of sucralose, saccharin, acesulfame K, aspartame and neotame consumption among subjects with diabetes. Additional long-term studies are needed regarding the impact of consuming FDA-approved non-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 and types of FDA-approved non-nutritive sweeteners (stevia, sucralose, saccharin, acesulfame K, aspartame, and neotame) on insulin levels (exogenous/endogenous)?
- Search Plan and Results: DM: Non-Nutritive Sweeteners 2013
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts and types of FDA-approved non-nutritive sweeteners (stevia, sucralose, saccharin, acesulfame K, aspartame and neotame) on CVD risk factors (lipids or blood pressure)?
- Conclusion
  One study reports no significant impact of consuming FDA-approved non-nutritive sweeteners [such as stevia (steviol glycosides)], independent of weight loss, on lipid profile and blood pressure in adults with type 2 diabetes.
  
  No studies were identified in subjects with type 1 diabetes. No studies were identified that reported on the effects of sucralose, saccharin, acesulfame K, aspartame and neotame consumption among subjects with diabetes. Subjects were not described as having any disorders of lipid metabolism, but only subjects with controlled hypertension were included. Additional long-term studies are needed regarding the impact of consuming FDA-approved non-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 and types of FDA-approved non-nutritive sweeteners (stevia, sucralose, saccharin, acesulfame K, aspartame and neotame) on CVD risk factors (lipids and blood pressure)?
- Search Plan and Results: DM: Non-Nutritive Sweeteners 2013