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. 2020 Oct 6;13:775–785. doi: 10.2147/IJGM.S274760

Table 1.

Clinical Trials Investigating the Effect of AS Consumption on Glucose Homoeostasis

Authors and Year Study Design Population and Age Parameters Findings
Anton et al14
2010		 Single-blind randomized crossover study 19 participants with normal weight and 12 obese subjects
(18–49 years)

  • Glucose

  • Insulin

  • Insulinogenic index

  • Reduction in blood glucose and insulin levels with stevia consumption compared to sucrose

  • Lower blood glucose levels with aspartame consumption at 20 min compared to sucrose

  • Higher insulinogenic index with aspartame consumption at 1 hour
Ma et al41
2010		 Single-blind randomized crossover study 10 healthy normal weight subjects
(25–29 years)

  • Glucose

  • GLP-1

 Intraduodenal infusion of sucralose did not change glucose intestinal absorption or GLP-1 secretion compared to control infusion
Brown et al42
2011		 Double-blind randomized crossover study 8 healthy normal weight women
(19–24 years)

  • Glucose

  • Insulin

  • Glucagon

  • Ghrelin

 No significant changes were described with sucralose consumption compared to water
Ford et al43
2011		 Single-blind randomized crossover study 8 healthy normal weight subjects
(22–27 years)

  • Glucose

  • Insulin

  • GLP-1

  • PYY

 Sucralose consumption did not change any variables compared to water
Steinert et al44
2011		 Randomized crossover study (no blinding) 12 healthy normal weight subjects
(22–24 years)

  • Glucose

  • Insulin

  • GLP-1

  • PYY

  • Ghrelin

 No significant differences were observed in any of the parameters following consumption of aspartame, acesulfame-k, or sucralose compared to water
Wu et al45
2012		 Single-blind randomized crossover study 10 healthy obese subjects
(25–33 years)

  • Glucose

  • Insulin

  • GLP-1

  • GIP

 Sucralose consumption had no effects on any parameters
Maersk et al16
2012		 Randomized crossover study (no blinding) 24 healthy obese subjects
(20–50 years)

  • Glucose

  • Insulin

  • GLP-1

  • GIP

  • Ghrelin

 Aspartame consumption did not change any variables
Brown et al11
2012		 Randomized crossover study (no blinding) 44 subjects divided into 3 groups: 25 healthy controls, 10 with T2D, and 9 with type 1 diabetes
(12–25 years)

  • Glucose

  • GLP-1

  • GIP

  • PYY

  • C-peptide

  • Diet soda consumption before a glucose load increased GLP-1 secretion in healthy and type 1 diabetic individuals compared to carbonated water

  • No changes in other parameters
Stellingwerff
et al46
2013		 Double-blind randomized crossover study 23 healthy normal weight men
(22–36 years)

  • Glucose

  • Insulin

 Sucralose consumption immediately before exercise had no effects on glucose and insulin concentrations during exercise
Pepino et al10
2013		 Randomized crossover study (no blinding) 17 healthy obese
(34–36 years)

  • Glucose

  • Insulin

  • Insulin sensitivity

  • Insulin clearance

  • glucagon

  • GLP-1

  • GIP

  • C-peptide

  • Sucralose consumption showed higher glucose, insulin, and C-peptide concentration, with a reduction in insulin sensitivity and insulin clearance

  • No differences were found in GIP, GLP-1, and glucagon
Olalde-Mendoza et al15
2013		 Randomized study (no blinding) 80 obese individuals with T2D
(40–58 years)

  • Capillary glucose

 Diet soda consumption had no effects on capillary glucose concentrations
Bryant et al47
2014		 Randomized crossover study (no blinding) 10 normal weight subjects
(18–24 years)

  • Glucose

 Consumption of saccharine, aspartame, or acesulfame-k in combination with glucose did not change blood glucose concentrations compared to glucose alone
Temizkan et al9
2015		 Single-blind randomized crossover design 8 newly diagnosed type 2 diabetic patients (51.5±9.2 years) and 8 healthy obese subjects (45.0±4.1 years)

  • Glucose

  • Insulin

  • GLP-1

  • C-peptide

  • Sucralose consumption was associated with lower glucose and higher GLP-1 concentrations compared to water consumption in healthy individuals

  • No differences in sucralose or aspartame on insulin and C-peptide
Boyle et al48
2016		 Single-blind randomized crossover design 40 healthy normal weight and obese subjects
(50–65 years)

  • Capillary glucose

  • Interstitial glucose

 Sucralose consumption had no effects on capillary or interstitial glucose concentrations
Dhillon et al49
2017		 Single-blind randomized crossover design 64 obese subjects
(18–50 years)

  • Glucose

  • Cephalic phase insulin response

  • Significant changes in blood glucose concentration with sucralose consumption compared to control

  • Significant cephalic phase insulin response following sucralose consumption
Tey et al50
2018		 Single-blind randomized crossover study 32 healthy normal weight men
(21–50 years)

  • Postprandial glucose

  • Consumption of low-calorie sweeteners was associated with a lower postprandial glucose concentration compared to high-calorie sweeteners
Crézé et al51
2018		 Randomized crossover study (no blinding) 18 healthy normal weight subjects
(age not provided)

  • Glucose

  • Insulin

  • Ghrelin

  • Consumption of artificial sweetened beverages was associated with lower plasma glucose and insulin concentration compared to sucrose-sweetened beverages

  • Plasma ghrelin showed higher values in artificially sweetened beverages compared to sucrose-sweetened beverages
Farhat et al52
2019		 Single-blind randomized crossover study 30 healthy normal weight and obese subjects
(16–36 years)

  • Postprandial glucose

  • Stevia consumption had no effect on postprandial glucose
Gómez-Arauz et al53
2019		 Randomized placebo-controlled trial 45 participants divided into 2 groups: 20 controls (21.55±2.18 years) and 25 who ingested sucralose (22±2.99 years)

  • Glucose

  • Insulin

  • Sucralose consumption showed higher serum insulin levels at 30, 45, and 180 min following oral glucose tolerance test.

  • No differences were observed for blood glucose levels
Nichol et al54
2020		 Randomized crossover study (no blinding) 10 healthy normal weight and 11 healthy obese subjects
(23–33 years)

  • Glucose

  • Insulin

  • C-peptide

  • GIP

  • Sucralose consumption elevated plasma glucose by 30±10% in lean and obese subjects compared to water

  • Insulin levels reduced within 20–40 min of the oral glucose tolerance test in lean subjects and increased within 90–120 min in obese subjects

  • C-peptide and GIP did not show significant differences
Bueno-Hernández et al55
2020		 Randomized double-blind placebo-controlled trial 137 subjects divided into 3 groups: a) subjects receiving water as controls, b) subjects receiving 48 mg sucralose, and c) subjects receiving 96 mg sucralose

  • Glucose

  • insulin

 Sucralose intake for 10 weeks resulted in:

  • higher insulin concentrations at 0, 30, 105 and 120 min following oral glucose tolerance test in the group receiving 48 mg sucralose

  • higher blood glucose at −15, 0, and 120 min in the group receiving 48 mg sucralose

  • higher area under the curve (AUC) of insulin in groups receiving 48 and 96 mg sucralose