Systematic review and meta-analysis · Nutrients · 2019Conflicts declared

Steviol glycosides and type 2 diabetes markers in people

What it found

In people, steviol glycosides lowered systolic blood pressure but made no clear difference to blood sugar, HbA1c, cholesterol, triglycerides or BMI.

The authors say the evidence is limited and more trials are needed.

What they found

Studies in people

Blood pressure

Systolic blood pressure fell by about 6.32 mm Hg more with steviol glycosides than with placebo. In non-diabetic people with high blood pressure, the fall was about 10.78 mm Hg. Diastolic blood pressure showed no clear difference overall.

Blood sugar and HbA1c

Fasting blood glucose showed no clear difference between steviol glycosides and placebo. HbA1c also showed no clear difference. This was true in both diabetic and non-diabetic groups.

Cholesterol and triglycerides

Total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides showed no clear differences between steviol glycosides and placebo overall. One analysis found HDL cholesterol fell when one study was removed, but the authors say this should be treated with caution.

BMI and weight

BMI showed no clear difference between steviol glycosides and placebo. There was a trend towards lower BMI in the diabetic group, but it did not reach statistical significance.

Animal and lab studies

Animal and lab studies

In diabetic rats and mice, stevioside lowered blood glucose, raised insulin and reduced glucagon. In lab tests on cells and isolated islets, stevioside and steviol increased glucose-stimulated insulin release. These effects were seen mainly at high glucose levels.

What the authors conclude

“From this systematic review and meta-analysis including data from published RCTs, Stevioside is suggested to generate reductions in blood pressure, in particular in SBP.”
Bundgaard Anker CC, Rafiq S, Jeppesen PB, 2019

Also in their conclusions

  • They say stevioside is suggested to reduce blood pressure, especially systolic blood pressure.
  • They note that most included studies looked at steviol glycosides as a sweetener rather than a medicine, so the doses used were probably not high enough to cause physiological changes.
  • They call for further clinical trials in diabetic subjects, lasting more than 6 months, that prohibit antidiabetic medications if possible.

How it was done

Type 2 diabetes is a growing problem worldwide, and existing drugs are costly and cause side effects. The authors wanted to see whether steviol glycosides from the stevia plant could help with diabetes-related markers.

They pooled data from 7 studies covering 9 randomised controlled trials with a total of 462 participants. Participants took stevioside at 200 to 1500 mg a day, or a placebo, for 4 hours up to 2 years.

What it can’t tell you

  • The included trials varied widely in design, dose, duration and whether participants continued their medications, so the results should be interpreted with caution.
  • The review cannot show whether steviol glycosides would have different effects at higher doses or in newly diagnosed diabetics.
  • Most trials did not aim to study these health markers, so the evidence for many outcomes is limited.

The paper

Title
Effect of Steviol Glycosides on Human Health with Emphasis on Type 2 Diabetic Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Type
Systematic review and meta-analysisThe authors follow a set, published method to find every relevant study, then combine the numbers from them into one result.
Evidence
Studies in people · animals · lab
Summarised from
Full text
Cite
Bundgaard Anker CC, Rafiq S, Jeppesen PB (2019). Effect of Steviol Glycosides on Human Health with Emphasis on Type 2 Diabetic Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. doi:10.3390/nu11091965Free full textPubMed 31438580DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error