THE CONSUMPTION of artificial sweeteners could be linked Type 2 diabetes, a new study shows.
The global longitudinal meta-analysis, which pooled data from over 720,00 adults over an average of 10 years, found a significant association between higher intake of artificial sweetener and the development of Type 2 diabetes.
Researchers searched English and Chinese-language databases for prospective studies examining artificial sweetener consumption and Type 2 diabetes risk, identifying six eligible cohort studies published between 2009 and 2025.
Together, these studies followed adults in the USA, Europe, and Japan for an average of 10.1 years, ranging from 5 years up to 20 years, accumulating over 7.2 million person-years of data.
Amongst the participant sample, there were 38,445 new diabetes cases within this time. Using a random-effects model, researchers calculated pooled hazard ratios comparing adults with higher artificial sweetener intake to those with low or no consumption.
Consistent Trend Across Cohorts
The results showed that participants with higher artificial sweetener intake were significantly more likely to develop Type 2 diabetes than those with low or no intake.
Those who consumed more artificial sweeteners faced roughly a 31% greater relative risk of developing the condition over time. All six studies indicated an upwards correlation between consumption and risk, although the strength of the association varied from a 11% increased risk in the largest most recent US study to a 69% increased risk in a French cohort.
The researchers noted substantial variation between the included studies, reflecting differences in study populations, sweetener types assessed, and follow-up periods.
Despite this, the association held up under a leave-one-out sensitivity analysis in which each study was individually removed to check whether any single study was driving the result. No evidence of significant publication bias was detected.
Despite the clear and recognisable trend, the researchers rated the overall certainty of this evidence as low, citing the small number of studies and the limitations of their observational design.
However, the authors argue that these findings carry meaningful public health implications as artificial sweeteners are frequently recommended, including in clinical settings, as a straightforward way to cut sugar and calorie intake without the presumed downsides of sugar itself.
The researchers also noted that their findings may shed light on the effects of long-term exposure to artificial sweeteners given that many previous short-term clinical trials generally found no link between sweeteners and diabetes risk.
They stop short of claiming a causal link but conclude that the potential adverse metabolic effects of artificial sweeteners should be factored into public health policy and clinical dietary recommendations going forward, rather than treating them as an automatically safer alternative to sugar.
Lu S et al. The longitudinal association between artificial sweetener intake and the risk of type 2 diabetes among adults aged 18 years and older: a systematic review and meta-analysis. Front. Nutr. 2026 13:1886458.
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