Recently, Amy Campbell wrote a great comprehensive review of artificial sweeteners. For 19 years, Amy managed the Clinical Education Programs at the renowned Joslin Diabetes Center. She is also a Certified Diabetes Educator, Registered Dietitian, and Licensed Dietitian Nutritionist. We were so pleased to have Amy join our Twitter chat on November 18, 2014, to discuss the science and safety of artificial sweeteners. Joining Amy for the chat was our host, Jewels Doskicz who tweets at @she_sugar.

To start our chat, Amy established the basics of what is an artificial sweetener?
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She added that examples of artificial sweeteners include aspartame, acesulfame-K, sucralose and saccharin and shared this great resource filled with facts about low-calorie sweeteners.

We started with what can be a polarizing question: Why do you think people with diabetes should/shouldn't use artificial sweeteners?
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Amy @amypcampbell started us off with an important insight: "A1: Artificial sweeteners have been shown in some studies to help people with diabetes lose weight. #DCDE"

@kay_aneal added: "Q1) You SHOULD use them because less carb counting and they taste the same as real sugar for the most part! #DCDE"

@katepecina had this to share: "A1 _Artificial sweeteners don't leave you craving for more as sugar does. #DCDE"

Of course, there are also concerns expressed about artificial sweeteners, such as these:
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And Amy shared that "A1: One concern about using artificially sweetened items is the potential to compensate by eating more calories from another source #DCDE"

Question 2

Following up on some of the concerns was a question about recent research that has been published regarding artificial sweeteners.
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It was great to have Hope Warshaw, CDE (@hopewarshaw) join our chat and share her thoughts on this important question: "Lots of misinfo, misconception about low cal sweeteners. #DCDE"

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@brizeater weighed in about some of the concerning new research by saying: "Q2. So far latest info on sweeteners hasn't totally changed my use, but I do find myself using stevia products more & the others less. #DCDE"

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@brizeater followed up with this comment about aspartame: "@HumnPincushion I haven't died of aspartame yet, so I think we're good.. #DCDE"

Question 3

Next we wanted to get a sense of whether or not people with diabetes had a favorite artificial sweetener. Truvia vs. spenda vs. aspartame vs. acesulfame-K.

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To kick off the answer, our host @She_sugar shared this humorous sweetener flowchart:
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And @amypcampbell added to our question: "A3: Anyone tried monk fruit extract yet? #DCDE"

@humnpincushion shared his favorites: "A3. Aspartame and splenda because I'm addicted to diet soda like its going out of style, some Splenda and stevia in baking#dcde"

@she_sugar explained that she choses unrefined sugars over artificial sweeteners: "Q3. I prefer unrefined sugars such as: coconut sugar, dates, honey, molasses, applesauce and sucanat accounting for their carbs #DCDE"

@mommaherring68 shared a great idea for working around wanting something sweet to drink:
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Then the conversation drifted to the relationship between artificial sweeteners and sugar alcohols.
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Question 4

Do you see a connection between use of artificial sweeteners and your health? We wanted to find out what our Twitter friends thought about that question.
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Rose (@rosie_tomato) shared the uncertainty that many feel: "Q4. I really don't know - sometimes I worry about some of the things in the press, but for now it beats BGs in the 3-400s #dcde"

Amy shared this important fact: "A4: Per the National Cancer Institute, there's no sound evidence that artificial sweeteners cause cancer or other health problems.#DCDE"

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To the concern that artificial sweeteners can affect the microbial balance in our gut, Amy pointed out: "Q4: The gut microbial study was done primarily in rodents - not necessarily applicable to humans! #DCDE"

@kimdiabetic also shared: "@amypcampbell And the study on humans was a small sample size. #DCDE"

Question 5

For question 5, we wanted to know what people with diabetes reach for when they are craving a sweet treat.
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@rosie_tomato confessed her guilty pleasure is m&ms.
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@neeljadeja also confessed to reaching for non-artificially sweetened treats: "Q5. Reese's cup, white chocolate is my fave. Cheesecake. Hershey's anything. Skittles. Cake. cake. cake. Did you want me to lie? #dcde"

But then @kylecluff reminded us that the key is self-control and portion control.
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And @t2dremission offered a great suggestion as well: "Q5 I keep unsweetened baking chocolate to melt into a.m. coffee. Occasionally I'll nibble on one in the evening—not too late (reflux). #dcde"

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A great closing thought from Amy: "Remember: you have choices in terms of what you eat and drink. You can use artificial sweeteners or not. Lots of options out there! #DCDE"

@neeljadeja: "Closing- You guys sharing what you go thru makes it easier for me to go thru it too. So thankyou. All of you. #dcde"

@jennimaizel summed up the motivation we have for building and running Diabetic Connect online community at all: "Closing: It is always so useful to hear other PWD/CDE's thoughts! Definitely learned new things. #DCDE"

And as a final summary to what people with diabetes think about artificial sweeteners, @brizeater said it well:
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Be sure to join us next Tuesday, November 25th for our Thanksgiving chat. We'll be sharing all our best ideas and recipes for enjoying Thanksgiving when you have diabetes. It will be great. Please plan ahead to be able to share your recipes. You can read more about the chat by clicking here.