Effects of the non-nutritive sweeteners sucralose and stevia in people with type 1 and type 2

INTRODUCTION: The global increase in the prevalence of diabetes has sparked a growing interest in alternative therapies, including the use of non-nutritive sweeteners (NNS) as a substitute for sucrose. In the Chilean market, sucralose and stevia are the most widely used. OBJECTIVE: To describe the effects of stevia and sucralose intake on metabolic outcomes and appetite-satiety in individuals with type 1 (DM1) and type 2 (DM2) diabetes, considering the available evidence. METHODS: Descriptive review. A search was conducted on PubMed, WoS, and Scopus using the following terms and keywords: "stevia rebaudiana," "blood glucose," "insulin," "metabolic processes," "sucralose," "diabetes type 1 and 2," "appetite," or "satiety." The analysis of selected studies was discretionary. RESULTS: Evidence regarding glycemic and insulin response is variable, with some studies suggesting benefits in insulin sensitivity and others reporting null effects. Additionally, it was identified that the effects of NNS on sweet taste receptors and the hormonal response of incretins play a key role in glucose homeostasis. Regarding appetite-satiety, NNS may not have the same satiating power as sucrose, potentially stimulating appetite and excessive consumption. It is crucial to highlight that the heterogeneity in the methodology of reviewed studies, including sample size, duration, dose, and route of administration of sweeteners, complicates drawing firm conclusions. CONCLUSION: Although the ingestion of stevia and sucralose has demonstrated beneficial effects on carbohydrate metabolism, there is a pressing need for further research to better understand the metabolic effects and their impact on appetite-satiety, especially in the adult and pediatric diabetic population.