TABLE 2.

Findings from Key Studies of the Effects of LNCS on Glycemic Management (Glucose Metabolism)

Glucose Metabolism Study	Study Design/Population	Findings
Jensen et al., 2020 (29)	• 8-year prospective trial • n = 1,142 adults with diabetes	• Eighty percent of participants reported regularly consuming LNCS soda (39%) or using LNCS to sweeten their beverages (41%). • No statistically significant associations of reported LNCS use consumption with fasting insulin or fasting glucose were observed.
Toora et al., 2018 (30)	• Single-arm, placebo-controlled trial • Healthy males/females • n = 30	• The mean glucose level 1 h after intake of glucose was 80.42 ± 8.97 mg/dL, and that of LNCS ranged from 74.42 ± 8.34 to 83.19 ± 5.62 mg/dL. • A statistically significant decrease (P <0.001) compared with glucose intake was shown in the difference in blood glucose level between the two samples. • These findings showed a slight increase in the blood glucose level after the intake of LNCS; however, the increase was significantly less compared with the glucose consumption.
Nichol et al., 2018 (31)	• Systematic review of 29 RCTs • Normoglycemic adults and individuals with diabetes • n = 741	• LNCS consumption was not found to increase blood glucose level, and its concentration gradually declined over the course of observation after LNCS consumption. • The glycemic impact of LNCS consumption did not differ by type of LNCS but to some extent varied by participants’ age, body weight, and diabetes status.
Grotz et al., 2017 (32)	• 12-week RCT • Normoglycemic males • n = 47	• A1C, glucose, insulin, and C-peptide levels remained within normal ranges throughout the study. • The findings support that sucralose has no effect on glycemic control. These results confirmed findings from an earlier study in type 2 diabetes (36) that showed no significant differences between sucralose and placebo groups in blood glucose control before, during, or after treatment or when analyzed over the 3-month study period.
Campos et al., 2015 (33)	• 12-week RCT • Healthy males/females • n = 31	• In subjects who were overweight or obese and had a high intake of sugar-sweetened beverages, replacement with LNCS beverages significantly decreased intrahepatocellular (IHCL) concentrations over a 12‐week period. The decrease in hepatic fat was most significant in subjects with IHCL >60 mmol/L than in subjects with low IHCL concentrations.
Ma et al., 2009 (34)	• Single-blind, randomized order • Healthy males/females • n = 10	• No differences in blood glucose, plasma glucagon-like peptide 1, or serum 3‐O‐methylglucose concentrations between sucralose and control infusions were observed. • The findings showed that sucralose does not appear to modify the rate of glucose absorption or the glycemic or incretin response to intraduodenal glucose infusion when given acutely in healthy human subjects.
Grotz et al., 2003 (35)	• 17-week RCT • People with type 2 diabetes • n = 136	• No significant differences were observed between the sucralose and placebo groups in A1C, fasting plasma glucose, or fasting serum C-peptide changes from baseline. There were no clinically meaningful differences between the groups in any safety measure. • These findings demonstrated that, similar to cellulose, sucralose consumption for 3 months at doses of 7.5 mg/kg/day, which is approximately three times the estimated maximum intake, had no effect on glucose homeostasis in individuals with type 2 diabetes.