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      Sugar intake from sweetened beverages and diabetes: A narrative review

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          Abstract

          Type 2 diabetes mellitus (T2DM) is one of the fastest growing public health concerns around the world. Sugar-sweetened beverage (SSB) consumption has been proven to be associated with adverse health consequences in the diabetic population. Reducing SSB consumption, body weight control, healthy diets, and increased physical activity have been suggested as strategies to improve diabetes prevention and management. This literature review provides an overview of: (1) The association between SSB consumption and the risk of T2DM; (2) Types of SSB consumption and T2DM; (3) The effect of obesity and inflammation on the association between SSB consumption and risk of T2DM; and (4) SSB consumption in T2DM patients. There is still work to be done to determine how SSB consumption is related to T2DM, but the current research on identifying the association between SSB consumption and T2DM is promising, with the most promising studies confirming the connection between SSBs, T2DM risk, and diabetes management. Future studies should explore more effective SSB related diabetes prevention and management interventions.

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          Type 2 diabetes as an inflammatory disease.

          Marc Y. Donath, Steven Shoelson (2011)
          Components of the immune system are altered in obesity and type 2 diabetes (T2D), with the most apparent changes occurring in adipose tissue, the liver, pancreatic islets, the vasculature and circulating leukocytes. These immunological changes include altered levels of specific cytokines and chemokines, changes in the number and activation state of various leukocyte populations and increased apoptosis and tissue fibrosis. Together, these changes suggest that inflammation participates in the pathogenesis of T2D. Preliminary results from clinical trials with salicylates and interleukin-1 antagonists support this notion and have opened the door for immunomodulatory strategies for the treatment of T2D that simultaneously lower blood glucose levels and potentially reduce the severity and prevalence of the associated complications of this disease.
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            Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes

            Vasanti Malik, Barry M. Popkin, George Bray … (2010)
            OBJECTIVE Consumption of sugar-sweetened beverages (SSBs), which include soft drinks, fruit drinks, iced tea, and energy and vitamin water drinks has risen across the globe. Regular consumption of SSBs has been associated with weight gain and risk of overweight and obesity, but the role of SSBs in the development of related chronic metabolic diseases, such as metabolic syndrome and type 2 diabetes, has not been quantitatively reviewed. RESEARCH DESIGN AND METHODS We searched the MEDLINE database up to May 2010 for prospective cohort studies of SSB intake and risk of metabolic syndrome and type 2 diabetes. We identified 11 studies (three for metabolic syndrome and eight for type 2 diabetes) for inclusion in a random-effects meta-analysis comparing SSB intake in the highest to lowest quantiles in relation to risk of metabolic syndrome and type 2 diabetes. RESULTS Based on data from these studies, including 310,819 participants and 15,043 cases of type 2 diabetes, individuals in the highest quantile of SSB intake (most often 1–2 servings/day) had a 26% greater risk of developing type 2 diabetes than those in the lowest quantile (none or <1 serving/month) (relative risk [RR] 1.26 [95% CI 1.12–1.41]). Among studies evaluating metabolic syndrome, including 19,431 participants and 5,803 cases, the pooled RR was 1.20 [1.02–1.42]. CONCLUSIONS In addition to weight gain, higher consumption of SSBs is associated with development of metabolic syndrome and type 2 diabetes. These data provide empirical evidence that intake of SSBs should be limited to reduce obesity-related risk of chronic metabolic diseases.
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              Inflammatory Markers and Risk of Type 2 Diabetes

              Xia Wang, Wei Bao, Jun-Jun Liu … (2012)
              OBJECTIVE There has been growing evidence that inflammatory markers play a role in the development of type 2 diabetes. We aimed to systematically review prospective studies on the associations of elevated levels of interleukin-6 (IL-6) and C-reactive protein (CRP) with increased risk of type 2 diabetes by conducting a meta-analysis. RESEARCH DESIGN AND METHODS A systematic search of the PubMed, EMBASE, ISI Web of Knowledge, and Cochrane Library databases up until 10 February 2012 was conducted to retrieve prospective studies matched to search terms. We used generalized least-squares trend estimation to assess dose-response relationships. The summary risk estimates were pooled using either fixed-effects or random-effects models to incorporate between-study variation. RESULTS The meta-analysis, including 10 prospective studies, with a total of 19,709 participants and 4,480 cases, detected a significant dose-response association of IL-6 levels with type 2 diabetes risk (relative risk [RR] 1.31 [95% CI 1.17–1.46]). For CRP, the meta-analysis involving 22 cohorts, with a total of 40,735 participants and 5,753 cases, showed that elevated CRP levels were significantly associated with increased risk of type 2 diabetes (1.26 [1.16–1.37]), with the absence of publication bias. Sensitivity and subgroup analyses further supported the associations. CONCLUSIONS This meta-analysis provides further evidence that elevated levels of IL-6 and CRP are significantly associated with increased risk of type 2 diabetes.
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                Author and article information

                Contributors
                Tung-Sung Tseng
                Wei-Ting Lin
                Gabrielle V Gonzalez
                Yu-Hsiang Kao
                Lei-Shih Chen
                Hui-Yi Lin
                Journal
                Journal ID (nlm-ta): World J Diabetes
                Journal ID (publisher-id): WJD
                Title: World Journal of Diabetes
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 1948-9358
                Publication date (Print): 15 September 2021
                Publication date (Electronic): 15 September 2021
                Volume: 12
                Issue: 9
                Pages: 1530-1538
                Affiliations
                Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United States. ttseng@ 123456lsuhsc.edu
                Department of Global Community Health and Behavioral Sciences, School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA 70112, United States
                Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United States
                Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United States
                Department of Health and Kinesiology, Texas A&M University, College Station, TX 77843, United States
                Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United States
                Author notes

                Author contributions: Tseng TS reviewed and drafted the first manuscript; Lin WT, and Gonzalez GV contributed to the study conception and literature review; Kao YH checked the review quality and results; Tseng TS, Lin HY and Chen LS contributed to the content analysis and the interpretation of the study; all authors contributed to edit and revise the manuscript critically and approve the final version of the article to be published.

                Corresponding author: Tung-Sung Tseng, MSc, PhD, Associate Professor, Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, 2020 Gravier Street, Room 213, New Orleans, LA 70112, United States. ttseng@ 123456lsuhsc.edu

                Article
                Other ID: jWJD.v12.i9.pg1530
                DOI: 10.4239/wjd.v12.i9.1530
                PMC ID: 8472506
                PubMed ID: 34630905
                SO-VID: 2c53f53e-d7c1-40cb-9cc8-5779b069a530
                Copyright © ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/

                History
                Date received : 27 January 2021
                Date revision received : 5 May 2021
                Date accepted : 3 August 2021
                Categories
                Subject: Minireviews

                Keywords: sugar-sweetened beverages,type 2 diabetes mellitus,inflammation,obesity,diabetes management
                Data availability:
                Keywords: sugar-sweetened beverages, type 2 diabetes mellitus, inflammation, obesity, diabetes management

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