One of the most dramatic changes in diabetes in my lifetime has been the development of multiple artificial sweeteners: there are now seven approved in the US. You can find lots of discussion about them at Wikipedia.
One cute tale about opinions about the safety of artificial sweeteners is worth retelling. According to the story (which is on the FDA website), Dr. Harvey Wiley, who was at the time the Chief Chemist in the Department of Agriculture, told President Teddy Roosevelt in 1906:
Of course, people have bad-mouthed (pun intended!) these products regularly: cyclamates might cause cancer (according to the FDA); saccharin might also; and aspartame has been accused of everything except perhaps causing diabetes. And now -- there's a claim that artificial sweeteners might contribute to diabetes!
To quote the authors of a scientific paper, Artificial sweeteners induce glucose intolerance by altering the gut microbiota , "consumption of commonly used NAS [non-caloric artificial sweeteners] formulations drives the development of glucose intolerance through induction of compositional and functional alterations to the intestinal microbiota." Or, in other words, they found that using artificial sweeteners provoke something that could be glucose intolerance by changing the gut's bacteria. There's nothing about antibodies in the entire article, so presumably the gut effects, if any, are on folks predisposed to type 2 diabetes rather than type 1.
Seems that most NAS pass through the gastrointestinal tract without being digested, and therefore get to the region of the gut where bacteria thrive. And the bacteria are somehow affected by NAS -- so that 381 non-diabetic individuals who participated in an ongoing clinical nutritional study, were found to have a positive correlation between NAS consumption and clinical parameters such as increased weight, higher fasting blood glucose, A1C, and GTT results.
The authors also did a mini-study, and commented that "We followed seven healthy volunteers... who do not normally consume NAS or NAS-containing foods for 1 week. During this week, participants consumed on days 2-7 the FDA’s maximal acceptable daily intake (ADI) of commercial saccharin (5mg per kg (body weight)) as three divided daily doses equivalent to 120 mg, and were monitored by continuous glucose measurements and daily GTT... Notably, even in this short-term 7-day exposure period, most individuals (4 out of 7) developed significantly poorer glycaemic responses 5-7 days after NAS consumption..., compared to their individual glycaemic response on days 1-4."
They conclude "Our findings suggest that NAS may have directly contributed to enhancing the exact epidemic that they themselves were intended to fight."
If this study is replicated, it will be another blow to non-diabetic folks using artificial sweeteners: NAS might contribute to the development of type 2 diabetes -- and it certainly the situation would be worse if the person using large amounts of NAS happens to be genetically predisposed, and overeats, and under-exercises.
But nothing in this scientific article discusses any adverse effects of artificial sweeteners for those of us who already have diabetes. For PWD, I think using artificial sweeteners as sugar substitutes is still worthwhile -- less calories to be sure, and I really don't care if my gut bacteria are happy or not.