Researchers in Sweden have found a relationship between sugary drink intake and the risk of developing type 2 diabetes. This echoes previous research supporting an ‘insulin resistance’ pathway of disease development. These findings are significant in preventing type 2 diabetes, a disease highly associated with heart disease, brain disease and several cancers. It might just be that cutting down on your Coke or Pepsi may increase your life.
Diabetes is a disease of sugar metabolism. Excess sugar in the blood causes a number of effects, including damage to large blood vessels (increasing risk of stroke, heart attacks and foot ulcers,) and damage to smaller blood vessels (increasing apparent risk of Alzheimer’s dementia and others.) There are also links to multiple cancers. The evidence is mounting; diabetes is a killer.
There are many different forms, the most simple being type 1+ 2 (although these names are debated.) ‘Type 1’ diabetes is reasoned to result from ‘autoimmune destruction’ of ‘insulin producing cells’ in the pancreas. Insulin helps metabolise sugar and deliver it to cells, so its removal means sugar hangs around to do damage. ‘Type 2’ diabetes is argued to result from ‘increased resistance to insulin’ as well as ‘reduced insulin production’. After a long life of heavy sugar use, insulin is rarer and less effective. Either way, the sugar has a free ride.
This most recent study of over 2500 patients has shown that the higher your sugar intake through soft drinks, the higher your ‘relative’ risk* of developing type 2 diabetes. This makes sense, as more sugar means greater strain on your bodies systems, which are worn out quicker. ‘ I think it is time to try to limit the consumption of sugar-sweetened beverages’ – said research lead Dr Josefin Lofvenborg of Karolinska Insitutet**.
The study also highlighted an increased risk of the development of a variant type of diabetes, Latent Autoimmune diabetes of the Adult (LADA.)
LADA itself is characterized as a ‘mixture of type 1 + 2 diabetes’, with the presence of autoimmune destruction of insulin producing cells, increased insulin resistance and reduced total insulin. It is estimated that up to 25% of young people with diagnosed type 2 diabetes may in fact have LADA, suggesting a commonality between causes. With respect to the above study, the cause is not directly clear but well observed.
Historical research into the relationship between diet drinks and type 2 diabetes have been less conclusive, with some evidence to suggest an increased risk perhaps secondary to ‘switching’ between sugar to non-sugar alternatives. The authors of the study state clearly that any link between diabetes and artificial sweeteners requires further work:
‘One could speculate that some people may have swapped from sugary to diet soft drinks in an attempt to prevent further weight gain or to lose weight. If that would be the case, it would mean that we are observing the effect of previous intake of sugary drinks rather than the effect of artificially sweetened beverages’ said Dr Josefin Lofvenborg,
It is clear. To reduce your risk of developing type 2 diabetes, cut out the sugar. This may mean switching to diet drinks or water, but it certainly means taking a more mindful approach to diet.
*A little extra
It is important to clarify that increased ‘relative risk’ is not the same as ‘absolute risk’. These terms are often confused or conflated in news to achieve a greater emotional response to findings. Absolute risk is the definite risk of something happening (i.e. your chance of having a heart attack.) Relative risk is the chance of something happening contingent on the existence of something else (your chance of having a heart attack whilst being diabetic compared to not) The ratio between the absolute and relative risk is usually more telling and paints a more ‘realistic picture’.
**A little thankyou
Thankyou to Dr Josefin Lofvenborg for her kindness and clarity in helping me to form this work. Best of luck to her in her next fascinating realm of work. She has also found that coffee protects against diabetes, so I can now justify my habit. To read more of her work visit here:
Any opinions above are the author’s alone. Guidance is based on the best available evidence at the time of writing. All data is based on externally validated studies unless expressed otherwise. Novel data is representative of sample surveyed. Online recommendation is no substitute for seeing your own doctor and should not be taken as medical advice.
Dr Ben Janaway is a medical doctor and healthcare writer. He writes regularly for patient.co.uk and other national news sources. He also runs his own blog on issues surrounding healthcare, as well as sharing patient stories. Contact Dr Janaway at www.twitter.com/drjanaway with stories or for discussion.
For commissions please contact: https://uk.linkedin.com/in/benjamin-janaway-0882ab66
Sources and further reading
- Greenwood, DC et al (2014) Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies’ BR J Nutria epub 2014
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