Sweetened beverages increase the risk of autoimmune diabetes
Lifestyle factors influence the risk of autoimmune diabetes. Researchers from IMM show that sweetened beverages consumption may be as strong of a risk factor for LADA – an autoimmune form of adult onset diabetes – as it is for type 2 diabetes. These novel results were recently published in European Journal of Endocrinology. The findings have received much attention worldwide, not the least in the United Kingdom due to the ongoing debate about the planned sugar-tax on soft drinks.
Consumption of sugar-sweetened beverages has been linked to increased risk of type 2 diabetes in several studies. This study finds an elevated risk also for LADA. Those consuming more than two glasses (á 200mL) of sweetened beverages per day had twice the risk of developing LADA compared to non-consumers. The risk of LADA increased on average by 15% for each daily glass of sweetened beverage, and there was no difference between sugar-sweetened and diet beverages.
Potential underlying mechanisms of how sugar-sweetened beverages may influence diabetes risk include excess energy intake resulting in increased likelihood of obesity, or induced insulin resistance as a consequence of increased insulin demand and stressed beta cells (insulin-producing cells).
Hypotheses for artificially sweetened beverages and diabetes risk include stimulated appetite leading to increased energy intake, or alterations in gut microbiota leading to impaired glucose metabolism. However, the authors speculate that some people may have switched from sugary to diet drinks in an attempt to prevent further weight gain or to lose weight, and that this could be an alternative explanation for the results regarding artificially sweetened beverages.
Josefin Edwall Löfvenborg, nutritionist and PhD student at Institute of Environmental Medicine (IMM):
Consuming large amounts of sweetened beverages, especially sugary drinks, may increase the risk of both type 2 diabetes and LADA. The excess risk is seen even after adjustments for overweight and lifestyle factors. But more studies are needed before any conclusions can be drawn about artificially sweetened beverages.
The findings are based on data from the ESTRID Study including almost 1500 cases of diabetes. ESTRID is an ongoing study, collected at IMM in collaboration with researchers at Lund and Uppsala University. The study was financed by the Swedish Research Council (VR), the Swedish Research Council for Health, Working Life and Welfare (FORTE), AFA Insurance, and the Swedish Diabetes Association.
Josefin E Löfvenborg, Tomas Andersson, Per-Ola Carlsson, Mozhgan Dorkhan, Leif Groop, Mats Martinell, Tiinamaija Tuomi, Alicja Wolk, Sofia Carlsson.
European Journal of Endocrinology, online 21 October 2016, doi: 10.1530/EJE-16-0376