Response to Comment on Pepino et al. Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load. Diabetes Care 2013;36:2530–2535

We appreciate the insightful comments by Grotz and Jokinen (1) regarding our study (2) that found that ingesting sucralose affects the metabolic response to subsequent glucose ingestion.Grotz and Jokinen imply that the greater increase in peak plasma glucose concentration during the oral glucose tolerance test (OGTT) after sucralose than water ingestion was not clinically important because the concentrations were still within the normal range for an OGTT. However, sucralose ingestion also caused a 20% increase in total plasma insulin concentrations, which demonstrates insulin resistance, which is a known risk factor for diabetes, metabolic syndrome, and cardiovascular disease (3). The clinical relevance of this observation is not …