Sugary Drinks Under the Microscope: They Increase Diabetes Risk

A new meta-analysis brings nuance to a long-standing debate in nutrition science: Is sugar really the villain when it comes to type 2 diabetes? According to researchers from Brigham Young University in Utah, alongside colleagues from Paderborn University and the University of Freiburg in Germany, how sugar is consumed matters more than how much.

Their findings, published in the journal Advances in Nutrition, show that sugar-sweetened beverages—like sodas, energy drinks, and even fruit juices—are closely linked to an increased risk of developing type 2 diabetes. However, sugar consumed within food may not carry the same risk—and could even offer mild protective benefits.

The Study in Numbers

The researchers reviewed data from 29 prospective cohort studies carried out in Europe, the U.S., Asia, Australia, and Latin America. Their results are clear:

• Each 12-ounce serving of sugar-sweetened beverages per day increases the risk of type 2 diabetes by 25%.

• Even fruit juice consumption increases risk by 5% per serving, despite its “healthier” image.

• Conversely, eating 20 grams of sugar per day was associated with a lower risk of developing diabetes.

This suggests that sugar is not inherently harmful, but its metabolic impact changes depending on the delivery method—drink vs. food.

Why Liquid Sugar Is Worse

The difference lies in how our bodies process sugars when they’re dissolved in liquids.

“When sugar is dissolved in liquid, it floods the system fast — and this rapid delivery overwhelms the body’s ability to process it in a healthy way,”
explains Dr. Karen Della Corte, lead researcher on the study.

Unlike whole foods, sugary drinks lack fiber, protein, or fat—components that help slow digestion and reduce blood sugar spikes.

“Liquid sugars are absorbed quickly, leading to sharp blood sugar spikes and insulin responses,”
adds dietitian Michelle Routhenstein, MS RD CDCES CDN, a Preventive Cardiology Dietitian not involved in the study.

Over time, these metabolic spikes put pressure on the pancreas and liver. In particular, fructose—abundant in sugary beverages—can overwhelm the liver, triggering a process called de novo lipogenesis, where excess sugar is converted to fat. This build-up of liver fat contributes to insulin resistance, one of the main drivers of type 2 diabetes.

The Case for Balanced Carbs

So, is all sugar bad? Not necessarily.

“This study challenges the idea that all sugar is bad,”
says Dr. Della Corte.
“Our results show that the health effects of sugar depend heavily on how it’s consumed.”

Nutrition experts like Routhenstein agree that carbohydrates, including sugars, are an important part of a balanced diet—if paired wisely.

“Very low-carb diets are linked to high LDL and apoB levels, which can accelerate plaque build-up in arteries,”
she notes.

Instead of eliminating sugar, Routhenstein advises patients to pair carbohydrates with fiber, protein, and healthy fats to improve metabolic response and support heart health.

Read the full study here: Dietary Sugar Intake and Incident Type 2 Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies