But water, coffee and low-fat milk appear to be associated with lower risks.

In prospective cohort studies in the general population, intake of sugar-sweetened beverages is associated with excess risk for type 2 diabetes and cardiovascular disease (CVD); higher intake of plain water, low-fat milk and coffee is associated with lower risk for these conditions (as well as obesity and early mortality). Among people with diabetes, however, we know little about how beverage choice affects CVD and mortality.

Researchers analysed data from two large, long-running prospective cohort studies with 170,000 total participants; the researchers identified 15,000 individuals who had type 2 diabetes at enrolment or developed it during follow up and who had no CVD or cancer at baseline or before developing diabetes. Beverage consumption was assessed every two to four years; for each beverage, the cohort was divided into five strata based on average intake.

During an average 18 years of follow up, participants with the highest intake of sugar-sweetened beverages were significantly more likely to die of any cause (hazard ratio [HR], 1.20) and to have incident CVD (HR, 1.25) than those with the lowest intake. High intakes of coffee, plain water and low-fat milk were associated with significantly lower mortality and CVD risks than were low intakes. These analyses were adjusted for numerous potential confounding factors.

Comment: The associations between various beverages and mortality and CVD in people with diabetes appear to be similar to those in the general population. These data might be helpful in counselling patients with diabetes about the importance of beverage choice.

Bruce Soloway, MD, Associate Professor Emeritus of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.

Ma L, et al. Beverage consumption and mortality among adults with type 2 diabetes: prospective cohort study. BMJ 2023 Apr 19; 381: e073406.

This summary is taken from the following Journal Watch titles: General Medicine, Ambulatory Medicine.