The relationship between diet soda soft drinks, artificial sweeteners, and diabetic retinopathy: A cross-sectional study

Background The relationship between diabetic retinopathy and diet-drink (soft soda), non-nutritive sweeteners have not been fully determined. We here attempted to determine it. Aims The study aimed to assess the association between soda soft drinks, non-nutritive sweeteners, and diabetic retinopathy. Methods A cross-sectional descriptive study was conducted at a diabetes center in Tabuk city, Saudi Arabia from September 2019 to April 2020: 174 patients with type 2 diabetes mellitus (DM) were interviewed using a structured questionnaire: demographic data, the DM duration, the lifestyles (exercise, smoking, and diet), and the medications. The weekly amount of diet soda and daily consumption of non-nutritive sweeteners were assessed. These were analysed with association with retinopathy. Results The glycated haemoglobin per cent was 8.50 +/- 1.60, the diet soda and artificial sweeteners consumptions were 1.18 +/- 1.57 cans/week and 0.89 +/- 1.26 sachets/day, respectively. No association was found between artificial sweeteners, diet soda, and diabetic retinopathy (Wald, 1.251, and 0.213, P-values, 0.263, and 0.644, 95 per cent CI, 0.583-7.204, and 0.190-2.793 respectively). Retinopathy incidence was associated with the DM duration (Wald, 8.095, P-value, 0.004, and 95 per cent CI, 0.766-0.952). Conclusion Diet soda and non-nutritive sweeteners were not associated with diabetic retinopathy, irrespective of gender or body mass index. Diabetic retinopathy was associated with the duration of DM after its first diagnosis.