Do Artificial Sweeteners Cause Insulin Resistance?

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🩺ABOUT DR. BREWER
Dr. Brewer started as an Emergency Doctor. After seeing too many preventable heart attacks, he went to Johns Hopkins to learn Preventive Medicine. While there, he went on the run the post-graduate training program (residency) in Preventive Medicine. From there, he made a career of practicing and managing preventive medicine and primary care clinics. His later role in this area was Chief Medical Officer for Premise, which has close to 1,000 primary care/prevention clinics. He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, and stroke prevention clinic.

At PrevMed, we focus on heart attack, stroke, and cognitive decline. We serve patients who have already experienced an event as well as those who have not developed a diagnosis or event. Dr. Brewer provides services via telemedicine. We find a lot of undiagnosed prediabetes or insulin resistance. Treating unrecognized risk factors like prediabetes allows reduction of risk and prevention of disease.

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[andrewphillips]

Can you direct me to the study you mentioned in this video that gave you pause for concern? The one that had to do with patients drinking either sucralose or water and then subjected to a glucose tolerance test.

[billb]

FWIW, I worked off of my carbohydrate addiction. It took several years to complete. I still put stevia and either erythritol or allulose in my morning fiber+baker's chocolate+coffee mix. It would be difficult to choke down without some sweetener.
I have zero other cravings, so I think it is not hurting me when used this way (once a day).

[stevec]

In Jan. of 2021 after 5 months on keto my HOMA-IR had a score of 0.36 and a year later it was 1.1, 3 times higher than the year before. To this day I have never overtly cheated on keto, such as having a candy bar or an order of fries or adding sugar to anything. However, I had not been shy about using keto approved artificial sweeteners to make desserts. In this past year I have gained 10 pounds & have noticed that my fasting glucose levels, even after 16 hours would be above 100 & for the most part would stay above 100 for the day. I have just started to severely cut back on my use of artificial sweeteners and today my fasting glucose was 93 and 2 hours after eating it was 111, so I think I'll continue this way of restricting my use of artificial sweeteners and see what happens.

[TheYangnyin]

There are so many different artificial sweeteners.. I would expect different effects from different chemicals.

[lukula]

Been carnivore for about 16 months, male and in my 70's. Have had a life long sugar addiction which I've been able to at least control most of the time. (Holidays and 
Halloween were the most dangerous by far). And have had my share of health issues.
With all the many health improvements since starting this change in eating, (some
deemed impossible by the "experts"), the sugar cravings, though greatly reduced, are 
still lurking in my "primal mind". I've pretty much accepted that this issue will follow 
me to the end. At 5'11" and in the low 180lbs, and now working again as a carpenter.
I'm not too concerned. I've learned to distrust almost all institutionalized data and
consider most of it to be agenda and profit driven. Sadly, there's no money in a 
healthy society. And addiction is the primary vehicle to provide lots of illness.

[Red]

I get confused on defining artificial sweetener types. Allulose comes directly from fructose is one example. Splenda is made from sugar directly. It seems that manufacturing companies do not consider dextrose etc are sugars. My method for truth is to sample my blood with glucose meter after drinking two coffees with a couple spoons of the sweetener in an hour. Nothing to eat and pre and post meter readings are the only methods to determine IR impact. Does anyone disagree?

[ygobsht]

Artificial sweeteners do in fact induce a small rise in insulin levels. Regular use of artificial sweeteners changes the gut microbiome and this could make our cells resistant to the insulin we produce, leading to increased blood sugar and insulin levels.

[rodolfocoelhodesouza]

I may remember that the insulin level does not always correlate with the blood glucose level. If you drink soda with sugar, it will add glucose to the blood and trigger a high insulin increase. If you drink soda with sweetener, it does not add glucose to the blood, however the brain may acknowledge the sweet taste and trigger a smaller insulin response. However, as in this second case there is not glucose to be managed by the insulin, the insulin level in the blood will stay slightly higher. Therefore the problem is: which is worst, the load of glucose or the small insulin increase. Well, to be completely safe, avoid both. Otherwise, it seems that sweeteners have caused much less damage to me than sugar. Also because glucose is not the only problem, we should not forget the effect of fructose on the liver.

[eleccalengr]

My engineering hypothesis tells me that the effect of sweeteners increases proportional to age.

[theAndromedaStrainiscoming]

When I come across this topic, it's usually framed as artificial sweeteners don't raise blood sugar, but their sweetness tricks your body's sensors into producing more insulin. For a Type II diabetic, they, I believe by definition, are producing too much insulin, so this is bad. Whether this turns out to be the main cause of insulin resistance isn't really the issue here. I was reading an article in a diabetes site today about how Type 1 diabetics are known for there predilection for drinking Diet Coke because, as the article stated, it doesn't raise your blood sugars. Overproduction of insulin isn't an issue for this group. I also don't think all artificial sweeteners are created equal. I also am uncomfortable labelling sugar a "natural sweetener" as it is so destructive. The word natural seems to create this air of superiority on foods, which I don't think should be the case here. Allulose is a better sweetener than sucrose.

[Hanover-ekjy]

It almost sounds like it’s better to drink regular soda???

[billb]

It appears that YouTube censored my previous comment (again) because it included a reference link.
The point of my message was that it has been suggested that the problem with artificial sweeteners is that they interfere with the gut microbiome. That hypothesis is consistent with both observations of "no insulin response" and "increased insulin resistance".

The next question is, "Do all sweeteners do this? What about Stevia, Monk Fruit, and Allulose? What about erythritol?". In other words, is the issue more with chemical-based sweeteners?

[Hanover-ekjy]

Mayo Clinic=Sugar substitutes don't affect your blood sugar level. In fact, most artificial sweeteners are considered "free foods." Free foods contain less than 20 calories and 5 grams or less of carbohydrates, and they don't count as calories or carbohydrates on a diabetes exchange.

[samohahaideri]

Great subject, also they are neglected the psychological good effect which is more important to patients in comparison to to how much Insulin is going up.
Thank you Dr

[southside]

Hello
Question.??? If soft plaque could cause clots. HOW TO remove HARD PLAQUE in steps

My LDL HDL. TRIGL are all over 270 😭
Please help in steps

[gail]

Is organic Stevia included the group? Thanks!!

[Red]

@dr brewer. A little off topic, I neither enjoy salmon nor sardines. I consume 4g vascepa daily. Isn’t that enough for the omega 3s?

[sootedninjas]

@Ford Brewer MD MPH xylitol & Monk Fruit Are they considered artificial sweetener? what is a definition of artificial sweetener?

[tensecondbuickgn]

My biggest question is do artificial sweeteners trigger an insulin response? Or are they truly zero calories? If you're on an intermittent fasting diet like me, this is powerful information because I use Mio water flavor.

[PFLEONARDI]

Dr. Brewer, Great video as usual! I had a good chuckle about being over 10lbs at birth brings on diabetes. Over 70 years ago I was born 2lbs 8oz and no incubator in that hospital. My father was in shape (21 years old, athletic + just out of boot camp for Korea deployment). I gave up on diet pop unless it has stevia or monk fruit years ago due to a chiropractor friend’s advice. So why would all my brothers and sisters become diabetics(mostly T2)? Is it due to the Standard American Diet? Is it genetics?