CClinicalTrials.gg
CompletedNCT03944616SODASUpdated Sep 11, 2025Results posted

Study Of Drinks With Artificial Sweeteners in People With Type 2 Diabetes

An interventional study of Diet Beverage and Water in Type 2 Diabetes, sponsored by University of California, Irvine. Completed at 2 sites in United States. Open to participants aged 35 Years and older. Per ClinicalTrials.gov, last updated 2025-09-11.

Sponsored by University of California, Irvine · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
181
Allocation
Randomized
Ages
35 Years and older
Sex
All
01

Study summary

Diet beverages sweetened with artificial sweeteners occupy a unique category in the food environment as they are a source of intensely sweet taste with no calories. Diet beverages are the single largest contributor to artificial sweetener intake in the U.S. diet, and people with diabetes are the highest consumers of diet beverages, tending to consume them as a replacement for dietary sources of sugar, especially in place of sugar-sweetened beverages. This behavior has been endorsed by dietetic and scientific organizations, and diet beverages are marketed as being synonymous with better health, suitable for weight loss, and thus advantageous for diabetes control. The underlying public health concern is that there are few data to support or refute the benefit or harm of habitual diet beverage consumption by people with diabetes; therefore randomized trials with relevant outcomes must be conducted because they would address many limitations of previous research and have major implications for dietary recommendations on diet beverage intake and primary and secondary prevention of chronic disease. To begin addressing this important scientific gap the investigators are testing the effect of diet beverage intake on diabetes control parameters in free-living adults with type 2 diabetes in a randomized, two arm parallel trial with a run-in period of 2-weeks and an active intervention period of 24-weeks. This study will recruit 200 patients with type 2 diabetes who are usual consumers of commercial diet beverages and randomize them to receive and consume either: 1) A commercial diet beverage of choice (3 servings or 24 oz. daily); or 2) Unflavored bottled water of choice (sparkling or plain) (3 servings or 24 oz. daily). The primary outcome will be a central measure of clinical diabetes control in glycated hemoglobin (HbA1c). The study will also measure the nature and magnitude of glycemic excursions via continuous glucose monitors, as well as clinical markers of cardiometabolic risk and kidney function. Lastly, investigators will measure plausible mechanisms whereby diet beverage intake may alter risk by assessing the effect of diet beverage intake on the functional composition of the gut microbiome via stool samples and comprehensive metabolomics, satiety hormones, as well as usual dietary intake, and upstream behavioral pathways which may inform dietary intake patterns.

02

Conditions studied

  • Type 2 Diabetes

Keywords

  • Diet beverages
  • diet
  • diabetes control
  • artificial sweeteners
  • continuous glucose monitor
  • gut microbiome
  • metabolomics
03

In context

Diabetes Mellitus, Type 2

9,359 studies on the registry are indexed under Diabetes Mellitus, Type 2; 1,318 are open to participants now.

This study's enrollment of 181 is above the median of 80 across 7,525 interventional studies indexed under Diabetes Mellitus, Type 2.

Browse Diabetes Mellitus, Type 2 studies →

Lead sponsor

University of California, Irvine is the lead sponsor of 466 studies on the registry; 96 are open to participants now.

Of its 41 completed or terminated interventional studies of FDA-regulated products, 30 (73%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
35 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion criteria: We will include men, women and non-binary participants with T2D, age 35 years and older, able to provide informed consent, otherwise healthy, who meet the following criteria:

  • Physician diagnosed type 2 diabetes ≥ 6 months prior to screening
  • HbA1c 6.5-8.5% at participant screening
  • Current treatment with lifestyle changes or stable diabetes-related medication levels for the past 3 months
  • Willingness to provide consent to contact treating physician and physician agreement to refrain from changing diabetes-related medications during the trial (change defined as > 2 fold change in dose of any 1 hyperglycemic agent or addition or subtraction of an agent)
  • No physician-directed medication change for 3 months if prescribed medication for lipids or blood pressure
  • Usual consumers of diet beverages (≥ 3 servings/ week (24 oz.) and the willingness to maintain fidelity of the intervention, and participate in all aspects of the intervention
  • Not actively looking to make major lifestyle alterations during the study period with stable weight for 2 months (within 3%).

Exclusion Criteria:

  • Type 1 diabetes or suspected type 1 diabetes (lean with polyuria, polydipsia, and weight loss with little response to metformin)
  • "Secondary" diabetes due to specific causes (e.g. monogenic syndromes, pancreatic surgery, and pancreatitis)
  • Diabetic Ketoacidosis hospitalization within last 6 months
  • Severe/major hypoglycemia in the last 3 months-severe/major hypoglycemia is defined as a hypoglycemic event in which patient requires assistance of another person to manage the episode
  • Glucocorticoid use (prednisone 2.5 mg/d or more or its equivalent)
  • History of intolerance or allergy to diet beverages or AS or phenylketonuria
  • Any condition that is known to affect the validity of the glycemic measures (Hba1c)
  • Major cardiovascular disease event or surgery within past 6 months
  • Gastrointestinal disease
  • Renal or liver disease
  • Current treatment for cancer
  • Those with major surgery planned or history of bariatric surgery
  • Antibiotic treatment (> 6 days) within past 6 months
  • Currently pregnant (via self-report) or planning to become pregnant during study period; \<1 year postpartum and breast feeding
  • Current participation in another interventional clinical trial
  • Previous randomization in this study,
  • Heavy alcohol consumption (on average >2 drinks/day for women and >3 drinks/day for men)
  • Habitual consumer of SSB ≥ 1 serving / day (8 oz.)
  • Does not drink diet beverages
  • BMI \< 20.0 kg/m2
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
181 participants (actual)

Study arms

  • Active comparator
    Diet Beverage

    Participants will receive and consume three daily servings (24 ounces) of a non-caloric commercial diet beverage of their choice sweetened with FDA approved artificial sweeteners.

    Behavioral: Diet Beverage

  • Experimental
    Water

    Participants will receive and consume three daily servings (24 ounces) of plain bottled/canned water in place of their usual commercial diet beverage. The water will be unflavored, unsweetened, non-caloric, and may be plain or sparkling. Participants randomized to consume water will be instructed to avoid intake of diet beverages.

    Behavioral: Water

Interventions

  • BehavioralDiet Beverage

    Participants will receive and consume three daily servings (24 ounces) of a non-caloric commercial diet beverage of their choice sweetened with FDA approved artificial sweeteners.

  • BehavioralWater

    Participants will receive and consume three daily servings (24 ounces) of plain bottled/canned water in place of their usual commercial diet beverage. The water will be unflavored, unsweetened, non-caloric, and may be plain or sparkling. Participants randomized to consume water will be instructed to avoid intake of diet beverages.

06

What researchers measure

Primary outcomes

  1. HbA1c

    Glycated hemoglobin

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

Secondary outcomes

  1. Time In Range

    Time in range is collected by a masked Continuous Glucose Monitor (CGM), which measures individual glucose levels every 15 minutes for two weeks via a sensor placed on the participants upper arm (underside). Time in Range is defined as the % of time each day with a glucose measure between 70-180 mg/dl. The range of CGM data for inclusion in this study will be 5 to 14 days, consistent with manufacturer's recommendations.

    Time frame: All 14 day periods: Run-in (2-weeks, usual-baseline), weeks 11 and 12 (14 days), weeks 23 and 24 (14 days)

  2. Glycemic Variability

    Glycemic variability is collected by a masked Continuous Glucose Monitor (CGM), which measures individual glucose levels every 15 minutes for two weeks via a sensor placed on the participants upper arm (underside). Glycemic variability is defined as the Standard Deviation (SD) of the mean glucose during the wear period. The range of CGM data for inclusion in this study will be 5 to 14 days, consistent with manufacturer's recommendations.

    Time frame: All 14 day periods: Run-in (2-weeks, usual-baseline), weeks 11 and 12 (14 days), weeks 23 and 24 (14 days)

  3. Mean Glucose (mg/dl)

    A measure of the mean, 24 hour glucose concentration calculated across all recorded glucose readings during the wear period

    Time frame: All 14 day periods: Run-in (2-weeks, usual-baseline), weeks 11 and 12 (14 days), weeks 23 and 24 (14 days)

  4. Fasting Glucose

    Standard (mg/dl) measure taken fasting (morning) during baseline, 12 weeks, 24 weeks

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  5. Fasting Insulin (Pmol/L)

    Standard lab measurement for fasting insulin assessment

    Time frame: Time 0 (directly after 2-week run-in), week 12, week 24

  6. Fructosamine

    Fructosamine (umol/L) represents usual glycemia over the past 2-3 weeks, and is considered a valid marker of short term clinical glycemic patterns by the American Diabetes Association

    Time frame: Time 0 (directly after 2-week run-in),12, 24 weeks

  7. Weight (kg)

    Weight measured on standardized scale in gown

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  8. Total Cholesterol (mg/dL)

    Total cholesterol was measured as part of a lipid panel, a standard measurement for assessing clinical CVD risk

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  9. Kidney Function

    eGFR-Cystatin-C (estimated glomerular filtration rate) = mL/min/1.73 m\^2

    Time frame: Time 0 (directly after 2-week run-in),12, 24 weeks

  10. Systolic Blood Pressure

    Systolic blood pressure (mmHg)

    Time frame: Time 0 (directly after 2-week run-in),12, 24 weeks

  11. Diastolic Blood Pressure

    Standard part of blood pressure measurement (mmHG)

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  12. Apolipoprotein-AI

    Apo-AI the major protein component of high density lipoprotein (HDL)

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  13. Apolipoprotein B

    ApoB levels indicate the atherogenic particle concentration independent of the particle cholesterol content

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  14. Fibrinogen (mg/dL)

    A protein involved in forming blood clots in the body

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  15. C-reactive Protein

    biomarker of inflammation

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  16. Aspartate Aminotransferase (AST) (U/L)

    AST (aspartate aminotransferase) is an enzyme that reflects liver function

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  17. Aminotransferase (ALT) (U/L)

    ALT (alanine transaminase) is an enzyme, a protein that reflects liver function

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  18. Alkaline Phosphatase (ALKPhos ) (U/L)

    ALP is an enzyme, a protein, that reflects liver function

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  19. Thyroid Stimulating Hormone (TSH)

    Hormone measured in the blood with energy balance related role

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  20. Dietary Quality (Healthy Eating Index -HEI)

    The Healthy Eating Index (HEI) is a measure of diet quality used to assess how well a set of foods aligns with key recommendations and dietary patterns published in the Dietary Guidelines for Americans (Dietary Guidelines). The overall HEI scores are made up of 13 components that reflect the different food groups and key recommendations in the Dietary Guidelines for Americans. The HEI is scored 0-100 (low to high), with higher scores representing greater reported intake of an overall dietary pattern aligning with USDA Dietary Guidelines. In the SODAS study, dietary intake was assessed by multiple unannounced 24-hour dietary recalls that occurred during the 2-week run-in period to assess usual habits (2 recalls over 2 weeks) and the active intervention (5 recalls over 24 weeks: 2 to 3 recalls during weeks 1-12 (period 1), and 2 to 3 recalls during weeks 13-24 (period 2). to measure any changes in diet quality. Scores during each period represent the average score of recalls.

    Time frame: Run-in period (2 weeks) - baseline, Week 1-12 (period 1), Week 13-24 (period 2).

  21. The Diabetes Health Profile (DHP-18)

    The Diabetes Health Profile (DHP-18) is used to assess health related quality of life in diabetes across three domains (psychological distress, barriers to activity and disinhibited eating). Each item is scored on a 4-point scale, and the subscale scores are then rescaled to a 0-100 range, with higher scores indicating poorer well-being.

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  22. Food Craving Inventory (FCI)

    The FCI is a valid and reliable self-report measure of specific food cravings. The inventory consists of 4 factors or subscales measuring cravings for high fats (8 items), carbohydrates/starches (8 items), sweets (8 items), and fast food fats (4 items), and a total score is calculated by summing the subscales. Participants rate each food on a 5-point Likert scale ranging from 0 (never) to 4 (always/almost every day). We calculated the total score by summing the individual item responses in each subscale. Higher scores indicate more frequent cravings of the 28 items.

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  23. The Pittsburgh Sleep Quality Index (PSQI)

    The Pittsburgh Sleep Quality Index (PSQI) is a self-report questionnaire that assesses sleep quality over a one-month time interval. Each component score of the PSQI ranges from 0 to 3, with 3 indicating the greatest dysfunction or disturbance. The seven component scores are then summed to obtain a global PSQI score, which ranges from 0 to 21. Higher scores indicate poorer sleep quality, with a score greater than 5 suggesting significant sleep difficulties

    Time frame: Time 0 (directly after 2-week run-in), 12, 24 weeks

  24. Medication Effect Score (MES)

    The medication effect score (MES) is a measure of overall diabetes regimen intensity, and is based on the dosages of medications used and their potencies. The MES is calculated for each diabetes medication in a regimen using the following equation: (actual drug dose/maximum drug dose) × drug-specific adjustment factor. The adjustment factor equates to the expected decrease in HbA1c achieved by the drug as monotherapy. The MES presumes a linear relationship between medication dosage and HbA1c, and the sum of MES values attributed to individual medications represents the maximum A1c reduction that may be expected by the regimen. It is a continuous variable with range 0 (no medications), and the maximum achievable MES is patient specific and dependent on the total number of and dose of medications reported.

    Time frame: Time 0 (directly after 2-week run-in), 6, 12, 18, 24 weeks

  25. Therapeutic Intensity Score (TIS)

    The therapeutic intensity score (TIS) is a summary measure that accounts for the number of medications and the relative doses a patient received to lower blood pressure. It is a continuous variable with range 0 (no medications), and the maximum achievable TIS is patient specific and dependent on the total number of antihypertensive medications reported.

    Time frame: Time 0 (directly after 2-week run-in), 6, 12, 18, 24 weeks

07

Results

Posted Sep 11, 2025

Participant flow

Participant flow — Overall Study
MilestoneDiet BeverageWater
Started9190
Completed9188
Not completed02
Withdrew: Lost to follow-up02

Outcome measures

PrimaryHbA1c

Glycated hemoglobin

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · Hba1c(%)
HbA1c
Hba1c(%)Diet BeverageWater
Time 07.19 ± 1.107.20 ± 0.69
12 weeks7.13 ± 1.027.43 ± 1.02
24 weeks7.14 ± 1.197.44 ± 1.04
SecondaryTime In Range

Time in range is collected by a masked Continuous Glucose Monitor (CGM), which measures individual glucose levels every 15 minutes for two weeks via a sensor placed on the participants upper arm (underside). Time in Range is defined as the % of time each day with a glucose measure between 70-180 mg/dl. The range of CGM data for inclusion in this study will be 5 to 14 days, consistent with manufacturer's recommendations.

Time frame:
All 14 day periods: Run-in (2-weeks, usual-baseline), weeks 11 and 12 (14 days), weeks 23 and 24 (14 days)
Reported as:
Mean · % Time in Range
Time In Range
% Time in RangeDiet BeverageWater
Baseline76.0 ± 19.272.3 ± 20.9
Week 11-1275.2 ± 22.666.9 ± 26.2
Week 23-2472.8 ± 23.264.7 ± 26.5
SecondaryGlycemic Variability

Glycemic variability is collected by a masked Continuous Glucose Monitor (CGM), which measures individual glucose levels every 15 minutes for two weeks via a sensor placed on the participants upper arm (underside). Glycemic variability is defined as the Standard Deviation (SD) of the mean glucose during the wear period. The range of CGM data for inclusion in this study will be 5 to 14 days, consistent with manufacturer's recommendations.

Time frame:
All 14 day periods: Run-in (2-weeks, usual-baseline), weeks 11 and 12 (14 days), weeks 23 and 24 (14 days)
Reported as:
Mean · SD of mean glucose (mg/dl)
Glycemic Variability
SD of mean glucose (mg/dl)Diet BeverageWater
Baseline39.6 ± 14.742.0 ± 13.1
Weeks 11-1240.0 ± 12.944.9 ± 15.4
Weeks 23-2440.8 ± 14.945.8 ± 16.3
SecondaryMean Glucose (mg/dl)

A measure of the mean, 24 hour glucose concentration calculated across all recorded glucose readings during the wear period

Time frame:
All 14 day periods: Run-in (2-weeks, usual-baseline), weeks 11 and 12 (14 days), weeks 23 and 24 (14 days)
Reported as:
Mean · mg/dl
Mean Glucose (mg/dl)
mg/dlDiet BeverageWater
Baseline147.3 ± 42.1151.4 ± 33.1
Weeks 11-12149.4 ± 46.4161.2 ± 50.5
Weeks 23-24153.1 ± 50.7162.3 ± 47.3
SecondaryFasting Glucose

Standard (mg/dl) measure taken fasting (morning) during baseline, 12 weeks, 24 weeks

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · mg/dl
Fasting Glucose
mg/dlDiet BeverageWater
Baseline147.5 ± 40.0147.6 ± 36.2
Week 12146.2 ± 41.8149.3 ± 44.2
Week 24149.2 ± 44.0153.7 ± 51.3
SecondaryFasting Insulin (Pmol/L)

Standard lab measurement for fasting insulin assessment

Time frame:
Time 0 (directly after 2-week run-in), week 12, week 24
Reported as:
Mean · pmol/L
Fasting Insulin (Pmol/L)
pmol/LDiet BeverageWater
Baseline128.0 ± 97.1138.5 ± 134.1
Week 12135.7 ± 141.0134.2 ± 145.0
Week 24143.5 ± 145.4144.2 ± 144.0
SecondaryFructosamine

Fructosamine (umol/L) represents usual glycemia over the past 2-3 weeks, and is considered a valid marker of short term clinical glycemic patterns by the American Diabetes Association

Time frame:
Time 0 (directly after 2-week run-in),12, 24 weeks
Reported as:
Mean · umol/L
Fructosamine
umol/LDiet BeverageWater
Baseline273.2 ± 44.8285.5 ± 42.4
Week 12272.1 ± 43.5286.6 ± 47.2
Week 24273.0 ± 51.3291.6 ± 45.8
SecondaryWeight (kg)

Weight measured on standardized scale in gown

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · kg
Weight (kg)
kgDiet BeverageWater
Baseline102.1 ± 21.196.1 ± 21.5
Week 12101.5 ± 20.495.8 ± 21.8
Week 24101.2 ± 20.695.9 ± 21.9
SecondaryTotal Cholesterol (mg/dL)

Total cholesterol was measured as part of a lipid panel, a standard measurement for assessing clinical CVD risk

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · mg/dl
Total Cholesterol (mg/dL)
mg/dlDiet BeverageWater
Baseline165.9 ± 41.3163.6 ± 40.9
Week 12164.8 ± 39.5163.6 ± 40.3
Week 24161.1 ± 36.4163.4 ± 40.1
SecondaryKidney Function

eGFR-Cystatin-C (estimated glomerular filtration rate) = mL/min/1.73 m\^2

Time frame:
Time 0 (directly after 2-week run-in),12, 24 weeks
Reported as:
Mean · eGFR-Cystatin-C (mL/min/1.73 m^2)
Kidney Function
eGFR-Cystatin-C (mL/min/1.73 m^2)Diet BeverageWater
Baseline83.2 ± 21.181.5 ± 20.0
Week 1282.8 ± 20.580.8 ± 19.5
Week 2482.0 ± 20.780.9 ± 20.7
SecondarySystolic Blood Pressure

Systolic blood pressure (mmHg)

Time frame:
Time 0 (directly after 2-week run-in),12, 24 weeks
Reported as:
Mean · mmHG
Systolic Blood Pressure
mmHGDiet BeverageWater
Baseline136.3 ± 15.0131.9 ± 15.0
Week 12135.5 ± 14.8129.5 ± 13.1
Week 24135.6 ± 15.6129.6 ± 14.8
SecondaryDiastolic Blood Pressure

Standard part of blood pressure measurement (mmHG)

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · mmHG
Diastolic Blood Pressure
mmHGDiet BeverageWater
Baseline78.5 ± 7.776.6 ± 7.4
Week 1278.3 ± 8.475.4 ± 7.6
Week 2477.7 ± 8.675.6 ± 7.2
SecondaryApolipoprotein-AI

Apo-AI the major protein component of high density lipoprotein (HDL)

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · mg/dL
Apolipoprotein-AI
mg/dLDiet BeverageWater
Baseline146.6 ± 24.3150.3 ± 23.3
Week 12148.0 ± 25.5151.0 ± 23.7
Week 24147.2 ± 22.5152.7 ± 24.2
SecondaryApolipoprotein B

ApoB levels indicate the atherogenic particle concentration independent of the particle cholesterol content

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · mg/dL
Apolipoprotein B
mg/dLDiet BeverageWater
Baseline88.0 ± 21.185.0 ± 24.0
Week 1288.0 ± 23.186.6 ± 25.1
Week 2485.4 ± 21.386.8 ± 25.8
SecondaryFibrinogen (mg/dL)

A protein involved in forming blood clots in the body

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · mg/dL
Fibrinogen (mg/dL)
mg/dLDiet BeverageWater
Baseline265.0 ± 51.9269.3 ± 55.1
Week 12268.7 ± 55.7263.1 ± 50.9
Week 24270.4 ± 53.3265.4 ± 43.2
SecondaryC-reactive Protein

biomarker of inflammation

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · mg/L
C-reactive Protein
mg/LDiet BeverageWater
Baseline3.93 ± 3.733.54 ± 3.27
Week 123.60 ± 3.813.56 ± 3.12
Week 243.85 ± 4.423.53 ± 3.35
SecondaryAspartate Aminotransferase (AST) (U/L)

AST (aspartate aminotransferase) is an enzyme that reflects liver function

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · U/L
Aspartate Aminotransferase (AST) (U/L)
U/LDiet BeverageWater
Baseline21.9 ± 9.524.9 ± 15.2
Week 1222.5 ± 11.323.9 ± 15.4
Week 2421.9 ± 8.723.9 ± 13.0
SecondaryAminotransferase (ALT) (U/L)

ALT (alanine transaminase) is an enzyme, a protein that reflects liver function

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · U/L
Aminotransferase (ALT) (U/L)
U/LDiet BeverageWater
Baseline26.6 ± 14.528.2 ± 21.6
Week 1226.8 ± 15.827.1 ± 23.2
Week 2426.6 ± 15.026.3 ± 19.0
SecondaryAlkaline Phosphatase (ALKPhos ) (U/L)

ALP is an enzyme, a protein, that reflects liver function

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · U/L
Alkaline Phosphatase (ALKPhos ) (U/L)
U/LDiet BeverageWater
Baseline88.0 ± 41.883.3 ± 24.7
Week 1290.1 ± 42.982.6 ± 24.5
Week 2488.7 ± 41.983.4 ± 24.6
SecondaryThyroid Stimulating Hormone (TSH)

Hormone measured in the blood with energy balance related role

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · µU/mL
Thyroid Stimulating Hormone (TSH)
µU/mLDiet BeverageWater
Baseline2.45 ± 1.582.17 ± 1.34
Week 122.65 ± 3.322.32 ± 1.91
Week 242.36 ± 1.662.27 ± 1.47
SecondaryDietary Quality (Healthy Eating Index -HEI)

The Healthy Eating Index (HEI) is a measure of diet quality used to assess how well a set of foods aligns with key recommendations and dietary patterns published in the Dietary Guidelines for Americans (Dietary Guidelines). The overall HEI scores are made up of 13 components that reflect the different food groups and key recommendations in the Dietary Guidelines for Americans. The HEI is scored 0-100 (low to high), with higher scores representing greater reported intake of an overall dietary pattern aligning with USDA Dietary Guidelines. In the SODAS study, dietary intake was assessed by multiple unannounced 24-hour dietary recalls that occurred during the 2-week run-in period to assess usual habits (2 recalls over 2 weeks) and the active intervention (5 recalls over 24 weeks: 2 to 3 recalls during weeks 1-12 (period 1), and 2 to 3 recalls during weeks 13-24 (period 2). to measure any changes in diet quality. Scores during each period represent the average score of recalls.

Time frame:
Run-in period (2 weeks) - baseline, Week 1-12 (period 1), Week 13-24 (period 2).
Reported as:
Mean · units on a scale
Dietary Quality (Healthy Eating Index -HEI)
units on a scaleDiet BeverageWater
Baseline54.7 ± 12.053.7 ± 13.6
Period 154.8 ± 13.253.1 ± 12.7
Period 253.3 ± 12.351.7 ± 13.4
SecondaryThe Diabetes Health Profile (DHP-18)

The Diabetes Health Profile (DHP-18) is used to assess health related quality of life in diabetes across three domains (psychological distress, barriers to activity and disinhibited eating). Each item is scored on a 4-point scale, and the subscale scores are then rescaled to a 0-100 range, with higher scores indicating poorer well-being.

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · units on a scale
The Diabetes Health Profile (DHP-18)
units on a scaleDiet BeverageWater
Baseline79.6 ± 11.177.9 ± 11.1
Week 1279.8 ± 9.9878.1 ± 10.9
Week 2480.6 ± 11.178.6 ± 11.7
SecondaryFood Craving Inventory (FCI)

The FCI is a valid and reliable self-report measure of specific food cravings. The inventory consists of 4 factors or subscales measuring cravings for high fats (8 items), carbohydrates/starches (8 items), sweets (8 items), and fast food fats (4 items), and a total score is calculated by summing the subscales. Participants rate each food on a 5-point Likert scale ranging from 0 (never) to 4 (always/almost every day). We calculated the total score by summing the individual item responses in each subscale. Higher scores indicate more frequent cravings of the 28 items.

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · units on a scale
Food Craving Inventory (FCI)
units on a scaleDiet BeverageWater
Baseline33.9 ± 15.135.4 ± 14.8
Week 1229.8 ± 15.830.9 ± 15.4
Week 2427.1 ± 15.931.2 ± 14.3
SecondaryThe Pittsburgh Sleep Quality Index (PSQI)

The Pittsburgh Sleep Quality Index (PSQI) is a self-report questionnaire that assesses sleep quality over a one-month time interval. Each component score of the PSQI ranges from 0 to 3, with 3 indicating the greatest dysfunction or disturbance. The seven component scores are then summed to obtain a global PSQI score, which ranges from 0 to 21. Higher scores indicate poorer sleep quality, with a score greater than 5 suggesting significant sleep difficulties

Time frame:
Time 0 (directly after 2-week run-in), 12, 24 weeks
Reported as:
Mean · units on a scale
The Pittsburgh Sleep Quality Index (PSQI)
units on a scaleDiet BeverageWater
Baseline6.0 ± 2.76.8 ± 3.0
Week 126.0 ± 3.16.5 ± 3.1
Week 245.9 ± 2.97.1 ± 3.2
SecondaryMedication Effect Score (MES)

The medication effect score (MES) is a measure of overall diabetes regimen intensity, and is based on the dosages of medications used and their potencies. The MES is calculated for each diabetes medication in a regimen using the following equation: (actual drug dose/maximum drug dose) × drug-specific adjustment factor. The adjustment factor equates to the expected decrease in HbA1c achieved by the drug as monotherapy. The MES presumes a linear relationship between medication dosage and HbA1c, and the sum of MES values attributed to individual medications represents the maximum A1c reduction that may be expected by the regimen. It is a continuous variable with range 0 (no medications), and the maximum achievable MES is patient specific and dependent on the total number of and dose of medications reported.

Time frame:
Time 0 (directly after 2-week run-in), 6, 12, 18, 24 weeks
Reported as:
Mean · units on a scale
Medication Effect Score (MES)
units on a scaleDiet BeverageWater
Week 01.64 ± 1.052.09 ± 1.40
Week 61.64 ± 1.062.05 ± 1.36
Week 121.63 ± 1.052.03 ± 1.33
Week 181.64 ± 1.062.02 ± 1.35
Week 241.64 ± 1.062.01 ± 1.36
SecondaryTherapeutic Intensity Score (TIS)

The therapeutic intensity score (TIS) is a summary measure that accounts for the number of medications and the relative doses a patient received to lower blood pressure. It is a continuous variable with range 0 (no medications), and the maximum achievable TIS is patient specific and dependent on the total number of antihypertensive medications reported.

Time frame:
Time 0 (directly after 2-week run-in), 6, 12, 18, 24 weeks
Reported as:
Mean · score on a scale
Therapeutic Intensity Score (TIS)
score on a scaleDiet BeverageWater
Week 00.41 ± 0.510.42 ± 0.43
Week 60.40 ± 0.460.41 ± 0.43
Week 120.42 ± 0.490.42 ± 0.44
Week 180.41 ± 0.490.43 ± 0.45
Week 240.41 ± 0.490.42 ± 0.45

Adverse events

Collected over 26 weeks (2 week run-in period and 24-week randomized intervention period). Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Diet Beverage0/91 (0%)0/91 (0%)0/91 (0%)
Water0/90 (0%)0/90 (0%)0/90 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)Diet BeverageWaterTotal
Mean59.6 ± 10.460.7 ± 10.160.1 ± 10.2
Sex: Female, Male
Sex: Female, Male(Participants)Diet BeverageWaterTotal
Female474794
Male444387
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Diet BeverageWaterTotal
African American or Black426
Hispanic/Latino(a)91120
White (non-Hispanic)6867135
Other101020
Region of Enrollment
Region of Enrollment(participants)Diet BeverageWaterTotal
United States9190181
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Study locations

2 sites
  • University of California, Irvine
    Irvine, California 92697, United States
  • University of Minnesota
    Minneapolis, Minnesota 55454, United States
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References and documents

Study documents

  • Study protocol · May 30, 2019
  • Statistical analysis plan · Apr 30, 2024

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — It is not yet known if there will be a plan to make IPD available.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 11, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03944616
Lead sponsor
University of California, Irvine
Collaborators
University of Minnesota, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Responsible party
Andrew Odegaard (Associate Professor, University of California, Irvine) — Principal investigator
First posted
May 9, 2019
Start date
Jun 6, 2019
Primary completion
Mar 21, 2024
Completion
Mar 21, 2024
Results posted
Sep 11, 2025
Last update
Sep 11, 2025

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.

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