Association of artificially sweetened and sugar-sweetened soft drinks with β-cell function, insulin sensitivity, and type 2 diabetes: the Maastricht Study

Purpose Artificially sweetened and sugar-sweetened beverage consumptions have both been reported to be associated with type 2 diabetes mellitus (T2D) risk. The aim of the current study was to investigate the potential underlying associations with dynamic pancreatic beta-cell function (BCF) and insulin sensitivity. Methods We evaluated cross-sectional associations in 2240 individuals (mean +/- SD age 59.6 +/- 8.18, 49.4% male, 21.9% T2D) participating in a diabetes-enriched population-based cohort. Artificially sweetened and sugar-sweetened soft drinks and juice consumption were assessed by a food-frequency questionnaire. Glucose metabolism status, insulin sensitivity, and BCF were measured by a seven-point oral glucose tolerance test. Regression analyses were performed to assess associations of artificially and sugar-sweetened beverage consumption with measures of glucose homeostasis. Associations were adjusted for potential confounders, and additionally with and without total energy intake and BMI, as these variables could be mediators. Results Moderate consumption of artificially sweetened soft drink was associated with lower beta-cell glucose sensitivity [standardized beta (95% CI), - 0.06 (- 0.11, - 0.02)], total insulin secretion [beta - 0.06 (- 0.10, - 0.02)], and with lower beta-cell rate sensitivity [odds ratio (95% CI), 1.29 (1.03, 1.62)] compared to abstainers. Daily artificially sweetened soft drink consumption was associated with lower beta-cell glucose sensitivity [beta - 0.05 (- 0.09, 0.00)], and total insulin secretion [beta - 0.05 - 0.09, - 0.01)] compared to abstainers. Conclusions Moderate and daily consumption of artificially sweetened soft drinks was associated with lower BCF, but not with insulin sensitivity. No evidence was found for associations of sugar-sweetened soft drink and juice consumption with BCF or insulin sensitivity in this middle-aged population. Prospective studies are warranted to further investigate the associations of artificially and sugar-sweetened beverage consumption with non-fasting insulin sensitivity and multiple BCF aspects.