BackgroundTo evaluate use of low-calorie sweeteners (LCS) among adults with type 1 diabetes (T1D) and its impact on quality of life (QOL).MethodsIn this single center, cross-sectional survey study with 532 adults with T1D, Food related QOL (FRQOL), LCS specific questionnaire (LCSSQ), Diabetes Self-Management Questionnaire (DSMQ), Food Frequency Questionnaire (FFQ), Audit of Diabetes-Dependent QOL (AddQOL), Type 1 Diabetes and Life (T1DAL) questionnaires were administered through RedCAP, a secure, HIPAA-compliant web-based application. Demographics and scores of adults who used LCS in last month (recent users) and others (non-users) were compared. Results were adjusted for age, sex, diabetes duration and other parameters.ResultsOf 532 participants (mean age 36 ± 13, 69% female), 99% heard LCS before, 68% used them in the last month, 73% reported better glucose control with LCS use and 63% reported no health concerns about LCS use. Recent LCS users were older and had a longer diabetes duration and more complications (hypertension, or any complication) than non-users. However, A1c, AddQOL, T1DAL, FRQOL scores did not differ significantly between recent LCS users and non-users. DSMQ scores, DSMQ management, diet, health care scores did not differ between two groups; however, recent LCS users had lower physical activity score than non-users (p = 0.001).ConclusionsMost of the adults with T1D have used LCS and perceived that LCS use improved their QOL and glycemic control; however, these were not verified with questionnaires. There was no difference in QOL questionnaires except DSMQ physical activity between recent LCS users and not users with T1D. However, more patients in need to increase their QOL may be using LCS; therefore, associations between the exposure and outcome can be bi-directional.