Both sugar and artificially sweetened beverage intake has been linked with type 2 diabetes risk.

We found both sugar-sweetened and artificially sweetened beverage intakes are associated with increased risk of type 2 diabetes in an Australian population. Sensitivity analysis to rule out reverse causality also confirmed the findings.

The findings of this study highlight the need for a firm policy intended to curb the adverse health effects of sugar and artificially sweetened beverages in Australia.

Globally, sugar intake from sugar-sweetened beverages (SSBs) exceeds the daily recommended limits for intake levels of free sugar. Artificially sweetened beverages (ASBs), widely used to replace SSBs, are increasingly linked to adverse health outcomes. Hence, we assessed the association of sweetened beverage intake (SSBs and ASBs) with the risk of type 2 diabetes (T2DM).

Data from the Melbourne Collaborative Cohort Study (MCCS) on 36,608 individuals aged 40 to 69 years were used. Self-reported data on diabetes were collected. The frequency of SSBs and ASBs consumption was categorized as: never or < 1 time/month; 1–3 per month; 1–6 times per week; ≥1 time / day. The association of sweetened beverage intake with the incidence of T2DM was assessed using modified Poisson regression, adjusted for lifestyle, obesity, socioeconomic, and other confounders.

Intakes of SSBs and ASBs were associated with an increased risk of T2DM. A high intake (≥ 1 time/day) compared to a low intake (never or < 1 time / month) was associated with increased risk of T2DM for SSB intake (incidence risk ratio (IRR) = 1.23; 95 % CI: 1.05–1.45; P for trend = 0.006) and for ASB intake (IRR = 1.38; 95 % CI: 1.18–1.61; P for trend < 0.001). Further adjustment for body mass index (BMI) and waist-to hip ratio (WHR) eliminated the association for SSBs, but not ASBs intake.

Both sugar and artificially sweetened beverages were linked to an increased risk of T2DM. The findings highlight the need for public health measures to control the intake of sweetened beverages.

Artificially sweetened beverages

Carbonated beverages

Cohort studies

Non-nutritive sweeteners

Sugar-sweetened beverages

Type 2 diabetes

© 2025 The Authors. Published by Elsevier Masson SAS.