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Diet soda consumption associated with increased risk of diabetic retinopathy
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Researchers found that patients with diabetes who consumed more than four cans per week of a diet soft drink had a more-than-twofold risk of having proliferative diabetic retinopathy.
A total of 609 adult participants with diabetes (73 with type 1, 510 with type 2) were recruited to explore the association between regular and diet soft drink consumption and diabetic retinopathy (DR) and macular edema.
A total of 285 participants consumed diet soft drinks, and 190 consumed regular soft drinks. One hundred twenty-seven and 129 individuals provided no information on diet and regular soft drink consumption, respectively.
A total of 230 adults had no DR, 36 had mild nonproliferative DR, 154 had moderate nonproliferative DR (NPDR), 28 had severe NPDR, and 146 had proliferative DR.
They found that regular soft drink consumption was not associated with DR or diabetic macular edema (DME).
When compared to no consumption, consuming high amounts of diet soft drink (more than four cans per week) was significantly associated with increased odds of having PDR, according to researchers.
Diet soft drink consumption was not associated with presence or severity of DME. Similarly, regular soft drink consumption was not significantly associated with presence or severity of DR or presence or severity of DME.
“These findings support the overall body of evidence suggesting that regular and frequent consumption of artificially sweetened beverages may have detrimental vascular outcomes,” researchers wrote. – by Abigail Sutton
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Brad Sutton, OD, FAAO
It is becoming increasingly clear that regular consumption of artificially sweetened diet soft drinks is just simply bad for us. Of course, routine consumption of regular soft drinks with sugar is not a good idea either. Unfortunately, many people believe that they are being “healthy” when they substitute diet sodas for their sugar-laden counterparts; however, both have been shown to substantially increase the risk of multiple forms of cardiovascular disease.
But what about complications specific to diabetic eye disease? While they have limitations, the results of the research presented in this article are nonetheless sobering. Study participants who consumed over four diet soft drinks per week more than doubled their risk of developing proliferative diabetic retinopathy (PDR). It is interesting that no increased risk of DME was discovered, just an increase in PDR.
On first glance, it is also very surprising that there was no association between routine consumption of regular soft drinks and the presence of either PDR or DME. So, are regular soft drinks actually better than diet? Probably not. There were so few patients who reported drinking more than four regular soft drinks per week, just six people, that the authors had to include anyone who drank any number of regular sodas each week, even as few as one. This may have influenced the findings and masked a potential association.
At any rate, we can feel confident in telling our patients that drinking sodas routinely, even if just a few each week, can be reasonably expected to have negative consequences.
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