Diabetes mellitus is a chronic metabolic disease mainly attributable to unhealthy, untimely food habits and lack of physical activity. Good glycemic control is one of chief aspects of preventing complications related to diabetes. This has led to shift in replacing sugar with artificial sweeteners amongst diabetic population. Past studies have indicated that there is lack of awareness of type and long-term side effects of artificial sweeteners among people with diabetes. This study was thus conducted to assess awareness and knowledge of usage of artificial sweeteners among adults with type 2 diabetes mellitus. The study population involved 200 adults (≥18 years) with type 2 diabetes in Kashmir valley. Results revealed that patients didn’t know the content of artificial sweetener they consumed, and were also unaware of health benefits and health hazards of artificial sweeteners. The study findings highlight high rate of unawareness amongst subjects regarding the side effects of long-term consumption of artificial sweeteners.

1. F. T. Lange, M. Scheurer, and H.-J. Brauch, “Artificial sweeteners—a recently recognized class of emerging environmental contaminants: a review,” Analytical and bioanalytical chemistry, vol. 403, no. 9, pp. 2503–2518, 2012.
2. D. Benton, “Can artificial sweeteners help control body weight and prevent obesity?” Nutrition research reviews, vol. 18, no. 1, pp. 63–76, 2005.
3. C. Fitch and K. S. Keim, “Position of the academy of nutrition and dietetics: use of nutritive and nonnutritive sweeteners,” Journal of the Academy of Nutrition and Dietetics, vol. 112, no. 5, pp. 739–758, 2012.
4. C. R. Whitehouse, J. Boullata, and L. A. McCauley, “The potential toxicity of artificial sweeteners,” Aaohn Journal, vol. 56, no. 6, pp. 251–259, 2008.
5. A. Shil, L. M. Ladeira Faria, C. A. Walker, and H. Chichger, “The artificial sweetener neotame negatively regulates the intestinal epithelium directly through t1r3-signaling and indirectly through pathogenic changes to model gut bacteria,” Frontiers in Nutrition, vol. 11, p. 1366409, 2024.
6. P. Prabhakaran Sobhana, R. Nagaraju, R. Naik, V. Roy, and D. Shakappa, “Assessment of knowledge and intake of artificial sweeteners among type ii diabetic individuals and perspectives of registered dieticians in india,” International Journal of Health and Allied Sciences, vol. 12, no. 4, p. 5, 2023.
7. K. Singh, R. Shivashankar, M. Gandral, L. Aravind, and N. Tandon, “Diabetes management in asia,” in The Diabetes Textbook: Clinical Principles, Patient Management and Public Health Issues. Springer, 2023, pp. 273–283.
8. P. Jaiswal, S. S. Sachdev, D. Kalra, and T. J. Chettiankandy, “Assessment of the use of low-calorie sweeteners amongst indian population and their awareness about their adverse effects.”
9. M. Karajibani, H. Eslahi, F. Montazerifar, F. Razaghee, and A. Dashipour, “Knowledge, attitude, and practices (kaps) of type 2 diabetes patients regarding the consumption of artificial sweeteners in zahedan, iran: a cross-sectional study,” Hospital Practices and Research, vol. 5, no. 3, pp. 105–111, 2020.
10. J. R. MR RN, “Knowledge, attitude and practice of diabetic patients regarding the use of artificial sweetners as substitute to sugar,” Natl J Integrated Res Med, 2018.
11. K. Iizuka, “Is the use of artificial sweeteners beneficial for patients with diabetes mellitus? the advantages and disadvantages of artificial sweeteners. nutrients 2022, 14, 4446,” 2022.
12. V. Markus et al., “Inhibitory effects of artificial sweeteners on bacterial quorum sensing,” International journal of molecular sciences, vol. 22, no. 18, p. 9863, 2021.
13. S. A. Hanin, V. V. Priya, and R. Gayathri, “Awareness of health effects of aspartame among diabetic patients.” Drug Invention Today, vol. 10, no. 7, 2018.
14. K. R. Tandel, “Sugar substitutes: Health controversy over perceived benefits,” Journal of Pharmacology and Pharmacotherapeutics, vol. 2, no. 4, pp. 236–243, 2011.
15. I. M. Gowdar, B. K. Aljuaid, A. I. Almasaad, M. A. Bamuqadm, T. A. Alfaifi, and A. A. Alhoti, “Awareness and knowledge about sugar substitutes among population in riyadh region,” Journal of Pharmacy and Bioallied Sciences, vol. 13, no. Suppl 1, pp. S263–S267, 2021.

S. Jan and S. Ali, “Awareness and Knowledge of Artificial Sweeteners Among Diabetic Patients in Kashmir”, International Journal of Health and Medical Sciences, vol. 10, pp.13-19, 2024. Doi: https://dx.doi.org/10.20469/ijhms.10.30002