Abstract

ROLE OF ARTIFICIAL SWEETENERS IN DIABETES MANAGEMENT: EFFICACY, SAFETY AND EMERGING EVIDENCE

Zehra Husaini*, Sahil Srivastava, Mohammad Shawwal

ABSTRACT

Diabetes mellitus is a growing metabolic health challenge in which dietary choices play an important role in maintaining glycemic control and reducing long-term complications. Artificial sweeteners, also referred to as non-nutritive sweeteners, have gained considerable attention as alternatives to conventional sugars because they provide intense sweetness with little or no energy and generally cause a minimal immediate rise in blood glucose. This has led to their increasing use in foods and beverages intended for individuals with diabetes and those seeking better weight and calorie control. However, their role in diabetes management is more complex than simply replacing sugar with a low-calorie alternative. This review examines the current evidence regarding the efficacy, safety, and potential metabolic effects of artificial sweeteners,with emphasis on glycemic control, body weight, insulin sensitivity, and overall metabolic health. The review also explores emerging evidence suggesting that certain sweeteners may interact with the gut microbiota and influence glucose metabolism, highlighting the possibility of individual variations in metabolic response. Although controlled studies indicate that replacing added sugars with non-nutritive sweeteners may help reduce energy and carbohydrate intake, evidence regarding their long-term effects on diabetes-related outcomes remains inconsistent. Therefore, artificial sweeteners may have a potential role as an adjunct to dietary management rather than as a stand-alone strategy for diabetes control. A better understanding of dose, duration, individual response, and specific sweetener type is essential for establishing evidence-based recommendations. Future research should focus on long-term clinical studies and personalized nutritional approaches to clarify whether artificial sweeteners are merely sugar substitutes or active modulators of metabolic health.

Keywords: Artificial sweeteners; Non-nutritive sweeteners; Diabetes mellitus; Insulin sensitivity; Gut microbiota; Metabolic health; Sugar substitutes.