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Several scientific studies support the use of sucralose as a safe strategy for carbohydrate management in patients with diabetes.

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US Endocrinology. Johnston C, Stevens B, et al.

This paper reviews recent research which supports the ways in which low-calorie sweeteners and products sweetened with them can be an important tool for people at risk of or with pre-diabetes or diabetes. This review, written by researchers at Baylor University School of Medicine, covers topics of concern commonly raised about the use of low calorie sweeteners including: appetite, weight gain and insulin and hormonal responses. The authors provide evidenced-based research findings that mitigate these concerns. The authors conclude that low calories sweeteners and products sweetened with them can assist people in reducing added sugars and carbohydrate intake and may facilitate weight management. In addition, low calorie sweeteners can offer people with diabetes greater flexibility in meal planning to achieve their health goals while allowing for dietary preferences.

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Wu T, Bound MJ, Standfield SD, Bellon M, Young RL, Jones KL, Horowitz M, Rayner CK. Artificial sweeteners have no effect on gastric emptying, glucagon-like peptide-1, or glycemia after oral glucose in healthy humans. Diabetes Care, 2013. 36: e202-e203.

This randomized, single-blind study was designed to test the effect of sucralose and/or acesulfame potassium (AceK) in four different drinks, including water, on blood glucose, plasma insulin and GLP-1 concentrations in 10 healthy males. Ten minutes after consuming one of the four beverages, a 75 g oral glucose load was administered. Glucose, insulin and GLP-1 blood levels were measured before and for 4 hours post ingestion in all subjects. The results showed that neither sucralose alone, nor when combined with AceK, had any acute effect on gastric emptying, GLP-1, or glycemic responses.

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Mezitis NHE, Maggio CA, Koch P, Quddoos A, Allison DB, Pi-Sunyer FX. Glycemic effect of a single high oral dose of the novel sweetener sucralose in patients with diabetes.
Diabetes Care. 1996;19(9):1004-1005.

This randomized, double-blind, placebo-controlled, crossover study was designed to assess the effect of a single oral high dose of sucralose on short-term glycemic control in patients with insulin-dependent diabetes mellitus (T1DM) or non-insulin-dependent diabetes mellitus (T2DM). The researchers conclude that the results support the conclusion that sucralose consumption does not adversely affect short-term blood glucose control in patients with diabetes.

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to glucose, insulin, and C-peptide in Type 2 diabetic patients

Argyri K, Sotiropoulos A, et al: Dessert Formulation Using Sucralose and Dextrin Affects Favorably Postprandial Response to Glucose, Insulin, and C-Peptide in Type 2 Diabetic Patients. Review of Diabetic Studies.

Using 70 patients with type 2 diabetes as subjects, this study compared the effects of seven desserts containing sucralose and the soluble fiber dextrin to the effects of the same desserts containing sucrose on glycemic, C-peptide, and insulin response. Participants were divided into seven groups of ten and, on three occasions after an overnight fast, each participant received either a meal (bread and cheese); or a meal and dessert made with sucralose and dextrin; or a meal and dessert made with sugar. Differences in glucose, insulin, and C-peptide were evaluated at five different points in time after each meal. Among the desserts used in the study were cake, pastry cream, strawberry jelly, chocolate, and napoleons. The results showed that the participants who ate cake, strawberry jelly or pastry cream made with sucralose and dextrin had lower after-meal glucose and insulin levels than after eating the same desserts made with sugar. Similar effects on glucose, insulin, and C-peptide levels at specific time points were reported for the milk dessert, napoleon and chocolate made with sucralose. Crème caramel showed no effect.

The researchers concluded that the results show that the desserts made with sucralose and soluble fiber did not raise after-meal levels of glucose, insulin or C-peptide in comparison with meal consumption alone or the increase was lower than the increase observed after consumption of the meal with the dessert made with sucrose. The researchers noted that, since this was a short-term study, further research is appropriate.

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Grotz VL, Henry RR, McGill JB, et al. Lack of effect of sucralose on glucose homeostasis in subjects with type 2 diabetes. J Am Diet Assoc. 2003;103(12):1607-1612.

This double-blind, randomized, placebo-controlled, parallel-group, multicenter study evaluated the effects of high daily doses of sucralose in patients with type 2 diabetes over a period of 3 months. The study demonstrated that "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" and "was as well-tolerated by the study subjects as was the placebo...In sum, sucralose-sweetened foods and beverages may be useful tools in the dietary management of individuals with, or at risk of, diabetes, a disease that has increased significantly with the recent epidemic increase in obesity."

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Brown AW, Bohan Brown MM, Onken KL, Beitz DC. Short-term consumption of sucralose, a nonnutritive sweetener, is similar to water with regard to select markers of hunger signaling and short-term glucose homeostasis in women. Nutr Res. 2011;31(12): 882-888.

Study abstract: "Nonnutritive sweeteners have been used to lower the energy density of foods with the intention of affecting weight loss or weight maintenance. However, some epidemiological and animal evidence indicates an association between weight gain or insulin resistance and artificial sweetener consumption. In the present study, we hypothesized that the nonnutritive sweetener sucralose, a trichlorinated sucrose molecule, would elicit responses similar to water but different from sucrose and sucrose combined with sucralose on subjective and hormonal indications of hunger and short-term glucose homeostasis. Eight female volunteers (body mass index, 22.16 ± 1.71 kg/m(2); age, 21.75 ± 2.25 years) consumed sucrose and/or sucralose in water in a factorial design. Blood samples were taken at fasting and 30 and 60 minutes after treatment followed by a standardized breakfast across treatments, and blood samples were taken 30, 60, 90, and 120 minutes after breakfast. Plasma was analyzed for glucose, insulin, glucagon, triacylglycerols (TAG), and acylated ghrelin. Perceptions of hunger and other subjective measurements were assessed before each blood sample. No differences were detected in subjective responses, circulating triacylglycerol, or glucagon concentrations among treatments over time. Significant differences were observed in insulin, glucose, and acylated ghrelin concentrations over time only between sucrose-containing treatments and non-sucrose-containing treatments regardless of sucralose consumption. Therefore, sucralose may be a relatively inert nonnutritive sweetener with regard to hunger signaling and short-term glucose homeostasis."

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Clinical studies have shown that SPLENDA® Brand Sweetener (sucralose) does not affect blood glucose levels, insulin, or HbA1c. A 2003 study, published in Journal of the American Dietetic Association, documents the results of a 5-center clinical trial in persons with Type 2 diabetes who consumed approximately 3 times the maximum estimated mean daily sucralose intake for 3 months without effect on blood sugar levels, HbA1c, or on C-peptide (the gold standard biomarker for insulin).

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