From healthcentral.com
New research suggests that drinking water instead of diet drinks is linked to healthier blood sugar levels—and more weight loss, too
Living with type 2 diabetes (T2D) can sometimes feel overwhelming, but it’s important to remember that simple lifestyle changes can have a big impact on health and your ability to manage the condition. For instance, new research just revealed that replacing diet drinks with water not only can help women with T2D lose weight—it can also significantly increase the chances of achieving diabetes remission.
A Simple Switch With Dramatic Benefits
The study, which was presented at the June 2025 scientific meeting of the American Diabetes Association, involved 81 women with type 2 diabetes and a body mass index (BMI) that classified them as either overweight or obese, who regularly drank diet beverages. They were randomly assigned to either continue drinking diet drinks or to replace those beverages with water five times a week after lunch. After 18 months, the water group had lost about 4.5 more pounds than the diet drink group (15 pounds vs. 10.7 pounds).
What’s more, 90% of the water group had achieved diabetes remission, which is defined by experts as being able to maintain normal blood sugar levels for three months without being on medication. That’s compared to 45% of the diet drink group who achieved remission. “The water group also showed significant improvements in BMI, fasting and postprandial [after eating] glucose, insulin levels, insulin resistance (HOMA-IR), and triglycerides,” says one of the primary investigators, Hamid R. Farshchi, M.D., Ph.D., the CEO of D2Type, a digital diabetes health support company, and a former associate professor at the University of Nottingham’s School of Life Sciences in the U.K.
Understanding the Potential Ripple Effect of Artificial Sweeteners
To many, these findings will be surprising. After all, diet beverages are widely considered to be a less harmful alternative to full-sugar options like sodas and sports drinks. And while swapping full-sugar drinks with diet alternatives might be a good first step on the road to diabetes management, Dr. Farshchi says that the artificial sweeteners in diet drinks, including aspartame, sucralose, and acesulfame K, carry their own downsides. “Observational studies have linked regular consumption of these sweeteners with increased risk of T2D,” he says. This may be due to “weight gain, and impaired metabolic regulation, potentially due to disrupted satiety signalling, altered gut microbiota, and learned sweet preferences.”
In other words, despite an absence of calories, sugar substitutes may thwart weight loss in other ways. “Artificial sweeteners usually trigger a sweet taste without delivering calories, which may disrupt the body’s ability to regulate appetite and glucose metabolism,” elaborates Sarah Fishman, M.D., Ph.D., a diabetes and weight loss specialist with Premier Endocrinology in New York City, who was not involved in the study. “This can impair insulin sensitivity over time in some individuals, and people with type 2 diabetes already have impaired insulin sensitivity.” She adds that the effects artificial sweeteners have on gut bacteria might contribute to glucose intolerance and inflammation, and notes that even calorie- and sugar-free sweet-tasting drinks might increase cravings for actual sugar and carbs, encouraging people to overeat.
All this helps explain why research in the journal Diabetes and Metabolism indicates that people who drink a single artificially sweetened beverage per day may increase their risk of diabetes by up to 38%, “sometimes more than sugar-sweetened alternatives,” Dr. Farshchi says.
Why Opting for Water Is Helpful With T2D
Water eliminates the artificial sweetener problem—plus it carries its own benefits for those with T2D. “Proper hydration supports kidney function, cardiovascular health, and overall metabolic regulation,” Dr. Farshchi says.
“When you’re well-hydrated, your kidneys can flush out excess sugar more effectively. Research also indicates that dehydration can increase blood sugar levels by up to 30%, a significant impact,” says Whitney Stuart, R.D.N., a dietitian and diabetes educator and the owner of Whitness Nutrition in Dallas, who was not involved in the study. Water can also increase satiety, which can aid with weight loss, adds Dr. Fishman.
Such benefits may contribute to how the water group fared so much better than the diet drink group in Dr. Farshchi’s research—but the findings surprised even him. “We expected water replacement would help, but this trial was designed to evaluate the long-term effects. The magnitude of the difference in remission rates, particularly the twofold increase in the water group, exceeded our expectations,” he says.
Weighing Your Hydration Options
While drinks sweetened with small amounts of stevia may be less likely to cause issues, notes Stuart, she says in general people should plan to avoid artificially sweetened drinks and foods (such as “light” yogurts and sugar-free snacks and desserts) as much as possible. “They can be helpful occasionally, but eating them too often might keep your sweet tooth alive and make it harder to stick to a healthy, balanced diet that’s not as dramatically sweet,” she says.
Also beware diet energy drinks, which contain a double whammy of artificial sweeteners and caffeine, which has been linked to blood sugar fluctuations in those with T2D, Dr. Fishman says.
One final note: It is possible to drink too much water. “While increasing water intake is beneficial, it should be done in moderation based on individual needs, depending on body size, activity level, and medical conditions,” Dr. Farshchi says. Water intoxication can cause sodium levels in the body to drop too low, leading to nausea, fatigue, and in certain extreme cases even death. About nine cups a day for women and 13 cups for men is a ballpark estimate by the Academy of Nutrition and Dietetics, but your doctor can help give specific recommendations.
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