Diet Sugar-Free Carbonated Soda Beverage, Non-Caloric Flavors Consumption, and Diabetic Retinopathy: Any Linkage

PURPOSE: Assessing diabetic retinopathy (DR) risk factors and daily nutrition habits are vital for prevention. This study aims to evaluate the relationship between diet soda cans, non-nutritive sweetener consumption, and diabetic retinopathy. PATIENTS AND METHODS: A cross-sectional study was conducted among 200 patients attending a diabetes center in Tabuk City, Saudi Arabia, from September 2019 to July 2020. A structured questionnaire was used to collect patients’ demographic factors, and DR risk factors including the use of diet soda, non-nutritive sweeteners, and exercise habits. Dilated fundus eye examination was done to detect any diabetic retinopathy. A blood sample was taken for measuring glycated hemoglobin to assess the degree of glycemic control. RESULTS: The participant's age was 50.74 ±13.51 years, and the duration since the diagnosis of diabetes was 9.99 ±6.97 years, body mass index was 27.28 ±4.68, and HbA1c %, 8.50 ±1.61), the patients used to consume 1.31 ±1.57 diet soda cans/week, and 1.06±1.39 artificial sweeteners/sachet/day. DR was found in 33%. Diet sugar-free carbonated soda beverage was associated with poor glycemic control and retinopathy, while non-caloric flavor consumption was associated with obesity (P-value<0.05). No association was evident regarding other factors (P-value>0.05). CONCLUSION: Diet sugar-free carbonated soda beverage was associated with higher HbA1c and retinopathy, while non-caloric flavor consumption was associated with obesity. No association was evident regarding other factors. Further larger multicenter studies are needed.