Aspartame Creates Diabetic And Obesity
From Dr. Betty Martini, D.Hum
Dr. Woodrow Monte in "While Science
Sleeps: A Sweetener Kills" said on
page 10, "Recently, during a study of over six thousand individuals
performed in six widely dispersed clinics in the United States, it was revealed
that the consumption of at least one 12 ounce can of diet soda a day for four
years was associated with a statistically significant sixty-seven percent
increased risk of type II diabetes."
Diabetics abstaining from aspartame see so
many of their medical problems disappearing that were caused by this
poison. Then they say, "so what do I use now as a
sweetener?" I had this conversation with Mike Sylver many years ago
who grew herbs in the
Patients with diabetes mellitus and "potential" diabetes currently consume large amounts of aspartame products with the enthusiastic approval of their physicians and dietitians. A popular aspartame tabletop sweetener containing less than one gram of carbohydrate and four calories per packet is widely recommended as a "free exchange." Multicolored ads for other aspartame products focusing on diabetes appear in professional journals and lay publications.
Observations involving 118 diabetic aspartame reactors (10 percent) in this series suggest the need for caution. They indicate that aspartame may adversely influence the control of diabetes, precipitate clinical diabetes, and aggravate or simulate complications referable to the eyes, kidneys, and peripheral nerves.
Such concern is reinforced by a report from The Centers for Disease Control indicating a dramatic rise of diabetes among the adult population - from 6.5 percent in 1998 to 6.9 percent in 1999. Moreover, it involved almost every demographic category (race; age groups). The CDC projected that the number of Americans so afflicted will increase from 16 million to 22 million in 2025.
The initial 60 diabetics who completed the questionnaire fell into the following categories (Roberts 1990).
ACB - aspartame cola beverage
ASD - aspartame soft drink
ATS - aspartame tabletop sweetener
Group A - 18 patients with untreated diabetes who developed high fasting blood glucose concentrations (greater than 140 mg %)
Group B - 25 patients on insulin and diet
Group C - 17 patients on oral drugs and diet
The following clinical encounters deserve attention, and will be amplified in the ensuing discussion.
· Aspartame reactors being treated with insulin or an oral drug sometimes could not decide if they were experiencing a reaction to insulin or to aspartame.
· Several insulin-dependent diabetics seemed more prone to aspartame-induced convulsions- both grand mal (see Case III-24) and petit mal (see Case III-25).
· Insulin resistance and diabetic control tended to improve promptly after avoiding aspartame products.
· Questions arose about missed or doubled dosages of insulin or oral drugs due to aspartame-induced confusion (Chapter VI).
· A few of my diabetic patients (not included in this series) had abstained from aspartame before I queried them about its use because they already had concluded that it aggravated their condition.
· Aspartame addiction (Chapter VII - G) compounded the problem when diabetics used these products to get their "sugar fix."
A. PRECIPITATION OF CLINICAL DIABETES
Several patients whom the author had followed for years evidenced a prior diabetic response ("decreased glucose tolerance") by glucose tolerance testing - that is, their blood glucose concentrations after drinking a glucose load exceeded 200 mg percent. On an appropriate diet, the fasting blood sugar (FBS) concentrations remained normal (115 mg percent or less) or only slightly elevated. Their subsequent elevated values (hyperglycemia), along with weakness and other symptoms of diabetes, proved puzzling until it was ascertained they used aspartame products. Clinical and biochemical improvements occurred when such products were stopped.
In addition, some patients with longstanding reactive hypoglycemia were founded to have fasting hyperglycemia for the first time after consuming aspartame (see Case XIII-2 and XIII-3). Their FBS values then normalized after abstinence.
Three aspartame reactors developed diabetes after attacks of apparent aspartame induced pancreatitis (Chapter IX-D). Case XIII-4 illustrates this sequence.
Representative Case Reports
A 47-year-old man with hemochromatosis or iron storage disease had been attended several years. (This condition is also known as "bronze diabetes" because iron deposits in the pancreas can damage the islet cells that produce insulin.) When seen in July 1986, his FBS had risen to 159 mg percent. On direct inquiry, he stated that he had been drinking considerable aspartame sodas. The FBS declined to 97 mg percent three weeks after abstinence.
A 75-year-old woman had documented reactive hypoglycemia; her blood glucose declined to 45 mg percent during a prior glucose tolerance test. She presented in September 1986 with recurrent conjunctivitis over the past 1-1/2 years. Three ophthalmologists prescribed local antibiotics without benefit.
This patient had been consuming large amounts of pudding and other products containing aspartame. The FBS was now 143 mg percent. The hemoglobin A,C concentration (an indicator of sustained blood glucose elevations) was 14.3 (normal 4-6). After stopping aspartame, her FBS progressively dropped to 119 mg percent within one month. Concomitantly, the hemoglobin A,C decreased to 6.1.
A 78-year-old man had been treated since 1958 for reactive hypoglycemia associated with a prior gastrectomy. He had developed an unexplained arthoropathy involving the right elbow that was not gout. (The uric acid concentration was normal.) This attack subsided within several days of conservative therapy. His FBS was found to be repeatedly elevated - 156 mg percent on 8/3/87, and 16 mg percent on 8/10/87. A mid afternoon blood glucose concentration on 8/10/87, however, was only 65 mg percent. When asked about aspartame use, he stated that he recently had been consuming large amounts of diet root beer and diet cola. These were discontinued and replaced by his customary interval snacks. A repeat FBS one week later was 118 mg percent.
A 62-year-old beautician began drinking aspartame soft drinks and pre-sweetened tea to lose weight. She subsequently experienced severe abdominal pain "under the rib cage on the left side." It became so intense that she pressed both fists against the abdominal wall seeking relief. Bicarbonate of soda afforded no benefit. There also was intense nausea, severe abdominal bloat, and blood in the stools.
Two months after the onset of aspartame use, a physician found her FBS to be 435 mg percent. It had been normal (100 mg percent) one year previously. She craved sweet cider while consuming aspartame.
A diagnosis of pancreatitis was made. The patient continued to suffer these symptoms while receiving cimetidine ("Tagamet") and an antacid in the hospital. She then deduced that her problems might be related to aspartame in her "diabetic diet," and demanded it be discontinued. Thereafter, "my hurting left and my sugar was regulated."
This patient had a history of asthma, hypoglycemia attacks, and allergy to penicillin. Her children also were aspartame reactors - a daughter suffering abdominal distention and eye-ear problems, and her son aspartame-induced headaches.
B. LOSS OF DIABETES CONTROL WHILE ON INSULIN THERAPY
Twenty-three diabetic patients among the first 551 aspartame reactors had been controlled for considerable periods on diet and one or several doses of insulin daily. Subsequently, they were found to have a persistent increase of the blood glucose concentration (by home glucose monitoring) in the absence of intercurrent infection or other problems conducive to loss of control. Inquiries about aspartame revealed a moderate or large intake of diet sodas and foods. Shortly after avoiding aspartame products, their glucose concentrations generally declined, enabling a reduction in dosage of insulin.
The vicious cycle of poor diabetic control with superimposed aspartame-associated infection and resistance to insulin was described in Chapter IX-H.
The experience of couples in whom both spouses were diabetic proved impressive. Cases XIII-16 and XIII-17 illustrate such an "aspartame diet."
Comparable problems in controlling diabetes surfaced in the form of questions sent syndicated medical columnists. For example, a diabetic asked Dr. Neil Solomon if there was a relationship between starting to drink diet soft drinks and difficulty in controlling his blood sugar(The Miami Herald October 8, 1986, p. D-2).
Insulin-dependent diabetic patients may have another superimposed problem of biotechnology: the increase of side effects from genetically-engineered recombinant human insulin. They include arthritic complaints, weight gain, and reduced hypoglycemia awareness.
Representative Case Reports
A 61-year-old woman required hospitalization for readjustment of her insulin dosage due to the loss of diabetes control even though she adhered carefully to a "diabetic diet" and other measures. She also had been experiencing intense dizziness, headache and progressive loss of memory. Considerable aspartame product were being used as part of the recommended diet.
The patient then discovered her intolerance for aspartame products.
"A nurse told me about listening to you on radio station WWMR-FM, and gave me the gist of your comments on aspartame and its side effects. My diabetes is under better control since I have completely stopped using anything with aspartame. I am feeling better. The dizziness is gone. The headaches are fewer, and I think my memory is keener than it was even thought it has only been three weeks."
A think young woman with insulin-dependent diabetes described the severe exacerbation of her visual and neuropathic symptoms, along with loss of diabetes control, while consuming aspartame products. Her insulin requirement had increased to 110 units daily. When she avoided aspartame, the visual and neuropathic symptoms disappeared, and the insulin dosage could be decreased to 12 units daily.
A 59-year-old diabetic man had required 20 units of an intermediate-acting insulin daily for many years. His insulin requirements more than doubled when "my sugar ran out of control" after consuming three liters of diet cola daily.
A 12-year-old diabetic boy required multiple hospitalizations while consuming considerable aspartame. He was twice admitted in diabetic coma. The physicians at a university hospital encountered considerable difficulty in stabilizing his insulin dosage during the periods aspartame were taken.
A 46-year-old interior designer had maintained good control of insulin-dependent diabetic for three decades. He then consumed several aspartame soft drinks and up to five packets of an ATS daily. "At that point, my diabetes went haywire, and I had terrible insulin reactions." Control of diabetes reverted to its previous status within one week after stopping aspartame products.
A 45-year-old obese woman required hospitalization for uncontrolled diabetes. She improved on an appropriate diet and split doses of insulin, with virtual normalization of her fasting and random blood glucose values over several weeks. Prior to that time, she had not consumed aspartame products.
In a subsequent visit, the patient complained of extreme sleepiness, fatigue, depression and intense sweats. Her FBS concentrations now ranged up to 160 mg percent, and the blood pressure had risen to 180/112. When asked about aspartame use, she stated that she began drinking considerable amounts of diet sodas on the advice of a dietitian. Five days after stopping all aspartame products, without any change in insulin dosage, the FBS values averaged 130 mg percent and the afternoon glucose values ranged from 90-120 mg percent. Concomitantly, her blood pressure declined to 155/90.
This 80-year-old active diabetic had been controlled on diet and tolbutamide (Orinase) for several years. She then was shifted to insulin because of elevate blood glucose concentrations that persistently exceeded 200 mg percent. The dosage of insulin had to be increased over the ensuing eleven months from 12 units to 28 units. Her FBS on 8/14/86 was 230 mg percent. She also experienced severe headaches.
This patient happened to hear my discussion about aspartame disease, and stopped using it. The headaches promptly disappeared. Her FBS declined to 101 mg percent within two weeks, at which point the insulin dosage was reduced.
An elderly diabetic woman had been doing well on 10-12 unit NPH insulin before breakfast, and 6-8 units NPH before her evening meal. The FBS progressively rose to 209-214 mg percent over the next five months, notwithstanding several increases of the insulin dosage. No infection or other contributory factor could be uncovered. Within five days after discontinuing aspartame, her FBS declined to 110 mg percent, and the insulin dosage reverted to her prior requirements.
A 48-year-old insulin-dependent diabetic began using aspartame products to avoid sugar. She reported, "It increased my blood sugar, making it necessary to take an extra shot of insulin to counteract it." Associated nausea and extreme irritability interfered with her performance as a teacher. She had a longstanding allergy to penicillin. Her daughter also experienced severe nausea and dizziness after ingesting aspartame.
An insulin-dependent diabetic described her problems with aspartame in these terms:
"When using this sweetener, I have increased blood sugar, and more difficulty controlling the diabetes. It also caused a more rapid heartbeat. I am fighting to get this sweetener out of everything! There is not a diabetic 'treat' I can have because they are loaded with this sweetener. That includes diet pop."
A 67-year old insulin-dependent diabetic woman presented with severe headache, leg pains, and lightheadedness. These complaints disappeared after avoiding aspartame for three weeks. The previously unexplained rise of her FBS (from 130-165 mg percent to 313-331 mg percent) declined to 131 mg percent. The blood glucose concentration after breakfast now did not exceed 191 mg percent.
A husband shifted to diet colas when diabetes was diagnosed, and "got used to the taste" in the transition from regular cola. Symptomatic retinopathy with retinal bleeding subsequently developed. He also suffered severe joint pain, and non-healing of a sore. Learning about aspartame disease, he discontinued such products. "Within a month, the numbness in my hands was gone, the sore on my right index finger healed (and has not come back), and my joints don't hurt anymore."
The diabetic wife of Case XIII-16 had been unable to maintain her blood glucose level below 200 mg percent for several years despite exercise and trying to lose weight. Observing the beneficial effect of aspartame avoidance in her husband, she also abstained. Within two weeks, she lost fifteen pounds, coupled with a decline of her blood glucose to 152 mg percent.
C. POOR CONTROL ON ORAL DRUGS FOR DIABETES
More than a score of non-insulin-dependent diabetics who were being treated with oral hypoglycemic drugs unexpectedly manifested high morning and afternoon blood glucose concentrations while consuming aspartame drugs.
Representative Case Reports
A 67-year-old diabetic woman had been maintained relatively well on diet and tolazamide (Tolinase). Her blood glucose concentrations increased during August 1986 - the morning values ranging from 180-247 mg percent, and the afternoon values up to 248 mg percent. During this period, she was taking two to three diet colas and other aspartame products daily. Fungal involvement of a thumb (reflecting loss of diabetic control) also developed.
The patient then stopped aspartame. She felt much improved one week later. The nail infection already had begun to improve. Her serial FBS values were now 108, 106, and 108 and 82 mg percent. The pre-supper values were 198, 64, 94, and 82 mg percent.
A prominent engineer sent the following letter to Aspartame Victims and Their Friends.
"I am a Type II (adult onset) diabetic. I am normally able to keep my blood sugar under reasonable control with the use of oral medication.
"When an aspartame tabletop sweetener first appeared on the market, I purchased the pre-prepared packets to use in place of the saccharin sweetener I had been using. I had concern about saccharin due to its reported carcinogenic effects.
"Very shortly after beginning aspartame, my blood sugar jumped to 268, then to 351, 321, and 333 over a period of 18 days. Suspecting that this sweetener might be the cause of the rapid rise in blood sugar, I discontinued its use. My blood sugar dropped back to 200 in six days. I am still controlling it within an acceptable range three years later.
"The doctor to whom I was going to at the time of this surge ridiculed the idea that such a small amount of aspartame could trigger this dramatic effect in my blood sugar. I changed doctors shortly thereafter. I am personally convinced that the usage of aspartame was the cause of my high blood sugars.
"I have definite knowledge of one Type I diabetic on insulin who was using the same tabletop sweetener and monitoring his blood sugar. When he visited his doctor, the test (as run by the laboratory) showed his blood sugar to be out of control.
"I try to avoid aspartame in any form, and am very disturbed by its presence in so many products."
A 51-year old stockbroker began consuming one can of diet cola and two packets of an ATS daily after diabetes was diagnosed. Even though he conscientiously followed a diet and took tolbutamide, there was difficulty in controlling his blood glucose concentrations. He also developed marked ringing in the left ear, "distorted vision" in the left eye (attributed to "macular degeneration of unexplained cause"), severe drowsiness, memory loss, and a marked personality change.
A 48-year-old truck driver saw the author in consultation for poorly controlled diabetes, intense neuropathic discomfort of the feet and left hand, and progressive blurring of vision. The latter had been attributed to "some oozing in the right eye." His FBS on tolbutamide was 278 mg percent; a random blood glucose was 178 mg percent. The total serum cholesterol (normal, over 35 mg percent), and the triglyceride level 1,468 mg percent (normal, up to 160 mg percent).
The patient was drinking four diet sodas daily. He had not ingested alcohol for several years. Striking improvement of vision was noted within less than one week after stopping aspartame, especially the absence of a blur while driving. His FBS declined to 146-163 mg percent within one week. Concomitantly, the blood pressure decreased from 150/100 to 134/84. There was subsequent improvement of the neuropathic symptoms, and a lowering of his cholesterol to 192 mg percent, and triglyceride to 273 mg percent.
D. REACTIONS TO INSLUIN AND ORAL DRUGS
Many diabetics noted a greater tendency to insulin reactions/hypoglycemia while using aspartame products.
Several diabetic patients unequivocally attributed more frequent and severe insulin reactions to the use of aspartame. A contributory factor in some may have been marked confusion and memory loss (Chapter VI-C), causing them to repeat doses of insulin or to forget their interval feedings.
Representative Case Reports
A 41-year old housewife developed insulin-dependent diabetes at the age of 22. Its control had become a problem the previous five years because of frequent and severe insulin reactions. Her husband at times had to force-feed her. This posed a considerable challenge inasmuch as aggression and "complete obstinance" characterized her attacks. Concomitant problems included weight gain, bloat, fluid retention, marked personality changes, and a striking loss of short-term memory.
She consumed considerable amount of aspartame products - including sodas (averaging two liters daily), hot drinks, chewing gum, mints, and diet hot chocolate.
A 36-year-old woman with insulin-dependent diabetes (25 years) initially had denied any contributory role of aspartame products because she left that the negative allegations were "reactionary." Moreover, a dietitian told her they were "perfectly safe." As a result, "I just went wild eating it in everything." She wrote
"My blood pressure went from difficult to horrible. My appetite was running rampant. I was waking up with 500 blood sugars, and also going to lows of 35-40. No one could figure out what was wrong with me. I didn't want to have sex with y husband. I even began having hot flashes. I had some minor tingling, which I always passed off as 'just one of those diabetic things.' I was gaining weight, feeling uncoordinated and spacey, and felt like hell.
"I then remembered the correspondence about aspartame, and decided to give it up as a trial. The next day, my blood sugars were perfect, as they have been now for almost two weeks. It is uncanny. I am so beside myself with glee I can hardly stand it. My insulin dosage has gone from 37 units to 17 units daily. I have, simply put, been reborn."
A 37-year old woman was diagnosed as having diabetes seven years previously. She then began using aspartame products. There was a strong family history of diabetes.
The patient experienced many unexplained symptoms. Her family physician and endocrinologist initially attributed them to her diabetes medication. They included confusion, loss of memory, anxiety attacks, unexplained chest pains, headache, dizziness, joint pains, weight loss, and drastic declines of the blood glucose concentration... at times with loss of consciousness. Her family had to stay with her constantly, and feed her frequently. She wrote, "Without warning, I was fine one minute, and the next minute the room would be spinning and I was looking for a place to lay down. It was like being in a dream or fog. I even had to leave work."
She stopped all aspartame products when a friend sent her an article about aspartame disease. Dramatic improvement ensued. "I had to leave work due to blood sugar levels dropping. My loved ones haven't had to feed me or be with me. I haven't had to drive in a mental fog. I haven't had nearly as many headaches, joint aches or dizzy spells."
A businessman expressed appreciation for being informed about the probable role of aspartame disease relative to his problems with diabetes and memory loss.
"I am a diabetic who consumes large amounts of sugar-free beverages containing aspartame. For about three months, I have been experiencing a loss of memory the following ways:
a. About five days per week I will forget if I ate lunch that day. When I get home in the evening, I will be ravished, but I don't know if or what I ate. This is dangerous for a diabetic on insulin who should be eating three meals on time to balance the insulin dosage.
b. I will see people I've known for years, but cannot remember their names."
A 21-year-old insulin-dependent teacher suffered more frequent insulin reactions (both at work and at home) while consuming 15 or more cans of aspartame colas daily. He stated, "When we cut down on aspartame, I stopped having so many reactions."
Type II diabetic patients who did not receive insulin by injection also experienced more frequent and sever hypoglycemic attacks while consuming aspartame products.
Representative Case Report
A diabetic woman had been controlled on diet and tolazamide. During the two years she consumed aspartame, her FBS values decreased. She then suffered grand mal seizures and transient paralysis on one side. Swelling of the mouth and tongue also occurred on two occasions after taking aspartame. Her condition stabilized on the prior regimen after avoiding aspartame, with no recurrence of the seizures or mouth reactions.
E. REAL OR SIMLUATED DIABETES COMPLICATIONS
Diabetic patients who react to aspartame products face an additional major problem: the aggravation or simulation of diabetes complications - namely, neuropathy, retinopathy, and nephropathy (kidney involvement). In turn, failure to recognize aspartame disease invites needless or hazardous treatments, including eye (laser) surgery.
The role of aspartame disease relative to visual impairment (Chapter IV), headache (Chapter V), dizziness (Chapter VI-B), limb pain (Chapter VI-H), diarrhea (Chapter IX-D) became evident when these symptoms abated after aspartame products were discontinued.
· Cases IV-25 to IV-29 reported striking and prompt improvement of blurred vision and eye pain after stopping aspartame.
· Case I-29 had prompt improvement of severe difficulty in focusing after abstinence from aspartame, proving she did not have a suspected symptomatic retinopathy.
· A diabetic who drank four liters of aspartame sodas daily complained of severe changes in vision. An ophthalmologist reassured him that there was no demonstrable retinopathy. After reading about blindness in an aspartame reactor, he stopped such products... with marked improvement.
· 75-year-old physician (reported by Barbara Mullarkey in the Wednesday Journal of Oak Park & River Forest March 26, 1986, p. 37) had enjoyed regular sexual activity. Within 10 days of using an ATS for recently diagnosed diabetes, he noted " a complete and total loss of libido." This might have been ascribed to diabetic neuropathy except for the fact that his vigorous sex life returned within six weeks after avoiding aspartame.
· A diabetic woman developed agonizing pains "from my knees to y ankles which I was not able to handle." They began shortly after drinking two cans of an aspartame beverage. Other symptoms included "large sores over my head, face and back, plus I was on the verge of fainting and sick all the time." At the insistence of an physician-daughter, four specialists saw her for a presumed diabetic neuropathy. The provoking cause could not be determined. The patient then "took it upon myself to cut out the soft drinks. I was immediately normal with the exception of my leg pain."
· Case IV-1, a 66-year-old diabetic man, had been controlled with diet and an oral hypoglycemia drug. He then experienced temporary "loss of vision" and pain in both eyes, as well as "dry eyes" requiring the frequent use of artificial tears. Other complaints included severe drowsiness, decreased hearing in both ears, itching, and "red blotches." These features subsided after stopping aspartame, but promptly recurred during one re-challenge. He abstained from these products thereafter because "I was afraid I'd go blind."
Aggravation of Diabetic Complications
Repeated reference was made in previous chapters to the aggravation or simulation of diabetic retinopathy (Chapter IV) and diabetic neuropathy (Chapter VI-E) in aspartame disease. Mention of this subject on talk shows predictably evoked calls from diabetic patients about the onset of severe complications when they began using aspartame products after having been in "good control."
The metabolic stress superimposed upon diabetes by aspartame disease can be intensified when kidney failure coexists, as in Case XIII-21. (See Introduction to Section 3).
The aggravation or simulation of neurologic complications by aspartame was considered in Chapter VI and elsewhere. Suspicion about the diagnosis of multiple sclerosis in a diabetic consuming considerable aspartame is paramount. Terms such as "diabetic dementia" and "diabetic encephalopathy" should raise suspicion about aspartame disease in the case of patients who consume these products. The variety of other misdiagnoses included "polyradiculoneuropathy" and the Guillain-Barre syndrome.
Hemochromatosis (iron storage disease; bronze diabetes) might be aggravated in its pre-cirrhotic state by aspartame through the stimulation of insulin (Chapter XIV). This association is suggested by Case XIII-I. In addition to hyperinsulinemia, other evidences of insulin resistance include obesity, elevated lipids, and abnormal glucose tolerance. The primary action of transferrin receptors to the cell surface where extracellular iron uptake is mediated (Ferrannini 2000).
Representative Case Reports
A 50-year-old surgeon with diabetes began consuming considerable amounts of diet sodas. He had to give up surgery and driving when his vision deteriorated to 20/100 in both eyes. Laser therapy was administered to one eye. Once he discontinued diet drinks, his vision improved to 20/30 and 20/40, and his blood sugar values were generally normal.
During an interview on Philadelphia Station WWDB, the mother of a 20-year-old diabetic woman called. She stated that a hemorrhage in one eye of her daughter had caused virtual blindness notwithstanding careful control of diabetes with insulin, and severe impairment was beginning in the other eye. This mother had pleaded with her to reduce or stop the considerable use of diet sodas, but to no avail. She then wrote
"My suspicions that aspartame might be responsible for losing her sight in the left eye were raised. I realize that most people, including many physicians I have spoken to, will blame this on her diabetes. But they have also admitted to me that her problem as a diabetic who is very well controlled under the care of a diabetologist, and with regular visits (every six months) to an eye surgeon, is very unusual.
"It all happened so quickly. We are suffering from shock even though it has been almost a year since she lost all central vision. One reason for our panic is that now she is experiencing blurring, etc. in her right eye. I was even afraid to mention any suspicion about aspartame to the family or friends as I thought they would think me grasping at straws or just a 'hysterical' mother."
This case, reported to Dr. Richard J. Wurtman of Massachusetts Institute of Technology, is part of the public record.
The patient had longstanding diabetes with renal failure. A kidney transplant was unsuccessful, necessitating hemodialysis. She subsequently died at the age of 37.
Four months prior to her death, she began consuming increasingly large amounts of aspartame-sweetened tea and lemonade. Her mother tried to dissuade her from doing so after reading about aspartame reactions. The patient, however, insisted that "it was safe because the F.D.A. had approved it." Within two months, she experienced severe muscle spasms, slurred speech, difficulty in swallowing, inability to control the limb muscles, and seizures.
The attending physician stated that he did not know enough "to make a judgment" about the possible contributory role of aspartame. The parents thereupon went to the hospital library, and found an article by Dr. Wurtman on aspartame-induced seizures which they handed to the physician. The mother subsequently wrote, "I honestly believe that the aspartame may have been the cause of her seizures. Surely any one with kidney failure would be at high risk."
Increased Triglyceride and Cholesterol Concentrations
Elevated blood triglyceride and cholesterol concentrations are commonly found in patients with diabetes. Indeed, they may serve as clues to this underlying metabolic disturbance.
A large literature exists concerning the impaired ability of diabetics with insulin resistance to metabolize a glucose load - as reflected by their increased insulin concentrations after meals, and associated triglyceride elevation.
Aspartame can evoke or aggravate hypertriglyceridemia and hypercholesterolemia, as in Case XIII-20. The problem may be compounded when high-fiber laxatives containing aspartame are recommended because they reduced blood cholesterol levels in short-term studies.
Case II-2 evidenced clinical diabetes for the first time after more than two decades under the author's care. She recently began drinking large amounts of aspartame beverages. Concomitantly, her triglyceride levels rose to 1,284 mg percent and 1,616 mg percent (normal, up to 160 mg percent) and her serum cholesterol to 354 and 349 mg percent (normal, up to 225 mg percent).
These metabolic aberrations could be viewed as reflections of compensatory, albeit inefficient, mechanisms whereby the body attempts to provide basic energy needs for vital organs (Roberts 1964, 1967b, 1964c, 1971b). The superimposed adverse effects of aspartame are discussed in Section 5.
Many diabetic patients conducted "self-experiments" with aspartame products, and independently confirmed my observations.
A woman with Type I diabetes decided to "experiment with the use of aspartame from time to time to satisfy my own curiosity about its effects on my body." She stated "Invariably, if I use aspartame - just one or two diet sodas per day and a few sticks of aspartame gum - my former symptoms of aspartame poisoning return with a vengeance. My blood sugars go haywire. Only one tiny unit of insulin would drop my blood sugar over 100 points in under half a hour, sending me into a series of hypoglycemic reactions. Rebound into high blood sugars followed. The tingling along my spine and under my breast bone, which had disappeared after I gave up aspartame, returned. And my menstrual periods, which had been very irregular prior to giving up aspartame but came every 28 days for three days like clockwork after giving up aspartame, came on two weeks early, then three weeks early, two days after re-introducing aspartame into my diet."
Public Health Ramifications
The Center for Disease Control and Prevention reported a striking 33 percent rise in the incidence of diabetes nationally between 1990 and 1998. While various factors were incriminated (most notably overweight, stress, fast foods and less exercise), the possible contributory role of aspartame products was apparently not considered.
Consumption of Aspartame and Sugar by Diabetics
FDA Commissioner Dr. Frank E. Young testified as to the United States Committee on Labor and Human Resources on Nov. 3, 1987 that 60 percent of diabetics were using aspartame products, compared to 35 percent of the total sample population. Yet, Farkas and Forbes (1965) concluded there was "...no basis for generalizing on the effect that the use of non-caloric sweeteners has or will have on adherence to a carbohydrate-restricted diet by patients with diabetes in the age range of 40 to 70 years."
There has been a paradoxical rise in the consumption of all sugar products over the past two decades, concomitant with the dramatic increased use of artificial sweeteners. The Department of Agriculture noted that the per capita consumption of sugar in 1985 was 130 pounds compared to 118 pounds in 1975. (The consumption of artificial sweeteners, including aspartame and saccharin, rose from 6.2 pound in 1975 to 17.0 pounds in 1985). Many diabetics add aspartame to coffee or tea, which they then proceed to take with cake, pie, or ice cream.
The excessive use of aspartame products helps explain the proneness of women with insulin-dependent diabetes mellitus (IDDM) to bulimia (Stancin 1989). Such behavior involves self-induced vomiting, the taking of laxatives, diuretics and enemas, and even the intentional reduction of insulin in order to lose weight (Chapter IX-B).
The problems considered in this chapter have potential legal ramifications. Special mention is made of pregnant women, children, older persons, epileptics, and other high-risk groups. Several examples are cited.
· An insulin-dependent diabetic who suffered seizures after using an ATS sued the manufacturer for alleged breach of an "implied warranty" that these sweeteners were "fit for ordinary use" (The Grand Rapids Press March 6, 1986, p. C-6).
· Aspartame-related hypoglycemia may have caused or contributed to the "dead-in-bed syndrome" in diabetics with hypoglycemia unawareness.
Diabetes: A Brief Overview
Diabetes mellitus is a chronic disease in which there is insufficient insulin - total or relative (resistance to insulin action) - for deriving adequate energy from ingested food. It tends to be familial.
There are more than ten million diabetics in the United States, but less than half have been formally diagnosed. Most (85 percent) do not require insulin, and are termed "Type II." Paradoxically, many persons in this category, especially when overweight, release considerable insulin after taking sugar or a meal, and then experience reactive hypoglycemia ("low blood sugar attacks"). I have used the term diabetogenic hyperinsulinism (see Introduction and Chapter XIV) to describe this transitional phase (Roberts 1964, 196, 1966, 1967, 1968, 1971b, 1973). The remaining 15 percent are referred t as having "Type I" insulin-dependent or juvenile-type diabetes.
Most diabetics desire sweets. This may represent an inborn characteristic, an acquired habit, or both.
· A survey of 500 diabetic patients conducted in West Germany (cited by Horwitz 1983) revealed that only 84 could abstain from sweets.
· A comparable situation exists among juvenile diabetics. Court (1976) found that 72 percent of mothers used artificial sweeteners in preparing the meals of their diabetic children to achieve compliance.
The hazards of aspartame for diabetics require further clarification in light of statistics concerning premature mortality. The years of potential life lost (YPLL) increased only for the categories of diabetes mellitus and chronic obstructive pulmonary disease in the Morbidity and Mortality Weekly Report (December 1986 Supplement).
Mechanisms of Aspartame's Diabetognic Potential
The adverse metabolic, hormonal, toxic, and other undesirable effects of aspartame and its components are detailed in Section 5. Many could contribute to the aggravation of diabetes and its complications. They encompass the wasting of insulin, impaired insulin-stimulated glucose transport, increased growth hormone and glucagon release after phenylalanine administration, other effects of its amino acids (see below), and additional pharmacologic activities. Another mechanism whereby aspartame-induced stimulation of insulin could aggravate diabetes involves the generation of insulin receptor antibodies capable of blocking the access of insulin to liver receptors (Dozio 2001).
With reference to aspartame-induced insomnia (Chapter VI-F), sleep debt has a detrimental impact on carbohydrate metabolism and endocrine function - including decreased glucose tolerance, and altered thyrotropin and cortisol concentrations (Spiegel 1999).
Some of the scientific observations that pertain to the effects of aspartame and its amino acid components on insulin release, other hormones, and metabolism are briefly reviewed.
· Phenylalanine and aspartic acid might enter the brain of diabetics more readily due to altered permeability of the blood-brain barrier. They could then aggravate fetal development during gestational diabetes in conjunction with elevated sorbitol concentrations because of increased polyol metabolism (Eriksson 1986) - conducive to eye and neurologic complications
· Limited insulin reserves could be further depleted by pancreatitis (Chapter IX) or phenylalanine-induced pancreatitis stimulation (Chapter XXIV). This and other amino acids, as well as protein, increase insulin and blood glucose levels. Years ago, Conn and Newburgh (1936) demonstrated comparable elevations of the blood sugar in diabetic patients consuming either dextrose or beefsteak.
· Schusdiziaria et al (1981) reported that digested gluten elicited a more rapid and significantly greater rise in postprandial (after a meal) peripheral vein insulin and glucagon levels than undigested gluten.
· Wahren et al (1972) found accelerated splanchnic uptake of amino acids in diabetic patients (24 hours after withdrawal of insulin), compared to healthy controls. This increase was most notable for phenylalanine, glycine, serine, threonine, methionine, and tyrosine.
· Atawa et all (1990) noted the high frequency of aspartic acid at 57 of the HLA -DQ Beta-chain in Japanese patients with insulin-dependent diabetes mellitus.
· Another influence of phenylalanine and its analogs on glucose and insulin metabolism involves the binding and activation of glucose-dependent insulinotropic polypeptide (GIP) receptors by the photoactivable p-benzyl-L-phenylalanine (Yip 1999). GIP, an important regulator of insulin receptor of the insulin receptor as well as insulin action on target issues.
Sardesai et al (1987) concluded on the basis of experimental data that aspartame may adversely influence the control of diabetics. They found that a single dose of aspartame administered to both normal and streptozotozin-induced diabetic rats increased liver tryptophan oxygenase by 12 percent. Furthermore, aspartame decreased blood and brain tryptophan, and increased serum glucose and glucagon in the diabetic animals. The chronic administration of aspartame to both groups also resulted in increased tryptophan oxynase activity, hyperglycemia, and a further rise of glucose in the diabetic animals.
The subject of hypoglycemia reactions in aspartame disease and the mechanisms involved will be considered in Chapter XIV.
Excessive insulin may be released by aspartame through a reflex mechanism involving the cephalic phase of insulin release. This is exaggeration of normal physiology relative to anticipating the arrival of food. It could result in hypoglycemic symptoms, or aggravation of diabetes mellitus when the binding of more insulin at cell membranes creates "insulin resistance."
Severe caloric restriction and other forms of metabolic stress in noninsulin-dependent diabetics increases the release of endorphins and enkephalins. These endogenous peptides with opiate-like activity have been shown to have important glucose-regulating effects in humans - notably, significant increases in plasma insulin and glucose concentrations (Giugliano 1987). Such effects can also lead to clinical hypoglycemia and insulin resistance.
Diabetic patients who receive increased doses of insulin for "tight control," as occurred while using aspartame, are at greater potential risk for the adverse cerebral consequence of hypoglycemia. This problem is compounded by reduced release of counter regulatory hormones (epinephrine; growth hormone; cortisol; glucagon) in response to severe hypoglycemia. These altered counter regulatory hormonal thresholds in well controlled Type II diabetics, even at normal blood glucose concentrations (Spyer 2000), can further compound complications by aspartame-induced hyperinsulinemia.
· Widom and Simonson (1990) demonstrated that diabetic patients may develop cognitive impairment before the onset of symptoms attributable to the release of epinephrine and norepinephrine.
· Amiel et al (1991) reported a threefold increase in the incidence of both severe and asymptomatic hypoglycemia among diabetic patients treated intensively with insulin. Furthermore, they are more likely to develop EEG abnormalities during hypoglycemia.
Criticism of Related Research (see Chapter XXVIII)
The administration of aspartame as capsules to evaluate its effect on diabetic control, rather than "real world" products, is relevant. This introduces the deficiency of not invoking the cephalic phase of insulin release associated with the taste of sweet (see above). If insulin production is already strained, such suerimposed stimulation could result in a state termed "high-output failure of insulinogenesis" (Roberts 1964 ,1965).
Professional Confusion and Disagreement (see Chapter XXVIII)
Many physicians and other health care professionals disagree with the author's concerns about aspartame use by diabetics.
· Filer and Stegink (1989) reviewed aspartame metabolism in diabetic subjects, and concluded "aspartame may be safely ingested at projected levels of use." (These investigators received considerable corporate support).
· John D. Fernstrom, Ph.D. (1987) opined that the "pros" of aspartame in improving the quality of life for "millions of diabetics in the population" far outweigh "any imagined cons" of this and related products. He argued against wasting effort by "being obsessive about something that isn't really there."
· Dr. F. Xavier Pi-Sunyer, a physician-representative of the American Diabetes Association, reaffirmed this organization's approval of the safety of aspartame - both for diabetics and the general population in testimony given in an U.S. Senate hearing on Nov 3, 1987. He asserted that there had been no significant input from physicians concerning problems in managing diabetics related to aspartame use. Moreover, he expressed concern over the unwarranted anxiety created by this hearing, and objected to spending any more money for research "already done."
Furthermore, most physicians accept the assertion by diabetologists that aspartame is harmless for diabetics.
· Horwitz and Bauer-Nehrling (1983) concluded that there is "no evidence of alteration of diabetic control because of aspartame ingestion."
· Visek (1984) stated that aspartame does not interfere with the basic treatment of diabetic patients.
· Stern et all (1976) followed 43 non-insulin-dependent diabetics at two centers. They were given either two capsules of aspartame three times daily with meals, or a comparable placebo, for 90 days. These investigators stated that "diabetic control was unaffected by the chronic administration of these substances."
The author's interpretation of the fasting blood sugar (FBS) concentrations in the subgroups of patients treated and followed at the Jewish Hospital and Medical Center of Brooklyn, based on the published data, differs from this assessment The FBS values at one, five, nine, and 14 weeks for the 9-10 patients given aspartame were 115.7, 116.2, 136.5, and 134.9 mg percent, respectively. The FBS values for the placebo group (ranging in number from 10 to 11) at one, five, nine, and 14 weeks were 88.9, 107.2, 117.7, and 95.5 mg percent, respectively. The P values at one, five, nine, and 14 weeks were 0.10, >0.50, >0.40, and >0.10, respectively.
· Nehrling et al (1985) gave aspartame and an identical-looking placebo containing corn starch to insulin-dependent and non-insulin-dependent diabetics in a randomized, double-blind study over an 18-week period. Three capsules were taken with each meal (total of 9 capsules daily). They concluded that adverse reactions were n more common with aspartame. These investigators, however, did not compare the corn starch with an inert non-carbohydrate placebo (e.g. alanine). Moreover, one subject developed severe diarrhea while receiving aspartame. (It disappeared when the aspartame was discontinued, and recurred after re-challenge).
· The inclusion of monosodium glutamate (MSG) in presumed placebos raises another problem.
The author asserted in many publications and written testimony to Congress that the current wholesale ingestion of aspartame products constitute a perceived "imminent public health hazard," especially for diabetics. Yet the FDA and the American Diabetes Association (ADA) continue to express the unequivocal opinion that aspartame is "completely safe" for diabetics.
As a case in point, it has been virtually impossible to present these observations at national meetings of diabetologists and other physician groups. For example, the ADA (of which I had been a member for over three decades) refused to print an abstract of adverse reactions encountered in 58 diabetics patients that was submitted for its 1987 annual meeting. Clinical Research subsequently published (1988; Vol. 3:489A).
The following letter indicates the resistance this subject provokes. The correspondent, a 60-year-old diabetic woman with many ailments, had a sister and multiple relatives who suffered severe reactions (including convulsions) to aspartame products, but defended their use.
"How in the world can someone take a product that is relied upon by diabetics to live, and make it bad? This was a big hoax. I just wonder how many people are depriving themselves of a pleasure just because someone scared them into not using it (an aspartame tabletop sweetener). The American Diabetes Association approves its use."
Diabetic aspartame reactors have expressed severe disapproval over the continued recommendation of aspartame products by the American Diabetes Association. Some averred that this is tantamount to helping diabetics die.
Patients have expressed this attitude in dramatic confrontations with doctors, even resorting to ridicule (see Case XIII-9). For example, a diabetic patient with aspartame reactions was dismissed by her physician, "a diabetes specialist," when she became irate over his lack of knowledge or interest on the subject - especially after providing him considerable information on aspartame disease obtained from the Internet.
The virtual unconditional approval of aspartame products by endocrinologists astonished parents of diabetic children when they learned the adverse effects of this chemical. For example, the outraged mother of a 9-year-old diabetic boy stated, "His endocrinologist backs aspartame 1001 percent, and highly recommends diet sodas. When I questioned any side effects from drinking so much, he assured me that the boy would have to drink over 100 cans/bottles of diet soda for the rest of his life to have any damaging side effects." end of chapter
Dr. Betty Martini, D.Hum, Founder
Mission Possible World Health Intl
9270 Riverclub Parkway
Duluth, Georgia 30097