Replacing diet drinks with water more than doubles type 2 diabetes remission in women, ADA 2025 study shows

In a new clinical study presented at the 85th Scientific Sessions of the American Diabetes Association (ADA) in Chicago, researchers demonstrated that replacing diet beverages with plain water led to a two-fold increase in remission rates among adult women with type 2 diabetes. The data, released by D2Type founder and endocrinologist Dr. Hamid R. Farshchi and his team, also showed significantly greater weight loss and improved insulin-related markers in the water group versus those who continued consuming artificially sweetened drinks.

The findings were presented on June 22, 2025, during the ADA’s general poster session, highlighting a simple yet transformative dietary intervention that may impact treatment guidelines for women managing type 2 diabetes. Institutional sentiment around the study indicates rising confidence in lifestyle-focused adjunct therapies, with experts suggesting this could redefine non-pharmacologic diabetes management strategies.

What did the ADA 2025 study reveal about switching from diet sodas to water for diabetes remission?

The 18-month randomized trial enrolled 81 adult women diagnosed with type 2 diabetes who were overweight or obese and had a habitual intake of diet sodas five times per week, typically after lunch. Participants were randomly assigned to one of two groups: the intervention group substituted their post-lunch diet drinks with water, while the control group maintained their regular diet beverage consumption pattern.

All participants underwent a structured 6-month weight loss program followed by a 12-month weight maintenance phase. At the conclusion of the trial, those in the water group showed significantly better clinical outcomes. The average weight loss was -6.82 ± 2.73 kilograms, compared to -4.85 ± 2.07 kilograms in the diet beverage group (P<0.001). More strikingly, 90% of women in the water cohort achieved remission of type 2 diabetes, compared to only 45% in the diet drink group (P<0.0001).

The study measured several metabolic and biochemical markers, with improvements in fasting blood glucose, postprandial glucose, insulin levels, insulin resistance (HOMA-IR), triglycerides, and BMI—all favoring the water group.

How do researchers explain the biological mechanisms linking water intake to improved diabetes outcomes?

Although diet beverages are calorie-free, prior studies have suggested they may still elicit physiological responses that hinder metabolic control. Artificial sweeteners, for instance, have been implicated in disrupting gut microbiota, altering insulin sensitivity, and creating hedonic feedback loops that influence appetite and satiety differently than water.

In this trial, replacing sweetened drinks with water removed this potential disruption, supporting healthier postprandial insulin responses and likely promoting better hormonal regulation tied to energy balance. The research team emphasized that even without caloric load, diet drinks are not metabolically neutral, and that water’s neutrality may offer protective metabolic effects not previously emphasized in dietary guidelines.

Lead investigator Dr. Hamid R. Farshchi, a former associate professor at the University of Nottingham’s School of Life Sciences, stated that the study confronts a major misconception in public health messaging. “There’s a long-held assumption in the U.S. that diet beverages are benign alternatives to sugar-laden drinks. Our data challenge that narrative and suggest that water should be prioritized—not simply tolerated—in dietary plans for individuals with diabetes.”

Why are institutional experts taking notice of this beverage-focused lifestyle intervention?

Institutional sentiment surrounding the trial’s outcomes reflects a growing interest in low-cost, high-impact public health interventions. As global diabetes prevalence climbs and pharmaceutical costs increase, data-backed lifestyle interventions such as beverage substitution offer scalable, patient-friendly strategies. Analysts noted that the ADA’s endorsement of these findings through its Scientific Sessions platform lends the study greater clinical visibility.

Healthcare providers and insurers may also take notice, given the potential cost savings associated with diabetes remission and lower dependency on pharmacologic therapies. While remission does not imply a cure, it represents a state where glucose control is maintained without medication—an outcome that has gained prominence in modern diabetes care goals.

Medical institutions tracking diabetes-related innovations are expected to further evaluate the durability of these remission rates, as well as their reproducibility in more diverse population cohorts beyond middle-aged women.

How does this research fit into broader ADA 2025 themes of lifestyle-based disease reversal?

The 85th Scientific Sessions of the ADA, held from June 20 to 23 in Chicago, featured several studies focused on non-pharmacologic methods for managing diabetes. The water versus diet soda research aligns with this broader emphasis, which included sessions on physical activity, sleep optimization, circadian eating patterns, and stress reduction.

Farshchi and his co-authors—Mehdi Farshchi, BSc; Ameneh Madjd, PharmD, PhD; Moira Taylor, PhD; and Ian A. Macdonald, PhD—have indicated plans to expand their work to examine how sleep quality, exercise routines, and emotional health interact with dietary choices to support diabetes remission. Their integrative approach aims to move beyond single-variable interventions toward more comprehensive lifestyle protocols.

The ADA 2025 event attracted thousands of scientists, clinicians, and health policy leaders, many of whom are seeking sustainable, scalable approaches to reverse metabolic disease in real-world populations. In that context, beverage choice—a seemingly simple factor—has emerged as a surprisingly powerful modifier of health outcomes.

What are analysts and public health officials projecting as the next steps following this trial?

Analysts expect the findings from this trial to influence future dietary guidelines and potentially catalyze public awareness campaigns encouraging water as the default beverage choice. Given that roughly one-fifth of the U.S. population regularly consumes diet sodas, especially among those attempting weight loss, this study may shift consumer perceptions and reshape institutional recommendations.

Experts believe that further studies replicating these results in larger, more ethnically diverse populations will be necessary to formalize water substitution as a standard recommendation in diabetes treatment protocols. However, the magnitude of benefit—particularly the dramatic increase in remission rate—makes this study a pivotal starting point for rethinking beverage-related health guidance.

In the public health sphere, stakeholders are also eyeing the opportunity to align educational programs with low-cost interventions. Promoting water consumption is a financially viable campaign strategy for municipal health departments, insurance providers, and global diabetes foundations.

What long-term impacts could this trial have on clinical practice and diabetes reversal frameworks?

The water versus diet drink study represents a critical piece of evidence supporting the role of daily behavior in chronic disease remission. If replicated and validated through multi-site trials, this research could change how clinicians counsel patients with type 2 diabetes, particularly in the early stages of diagnosis or during structured weight loss programs.

In a healthcare environment increasingly attuned to value-based care, the emphasis on remission—not just glycemic control—has gained traction. This new data supports that orientation by offering a measurable, low-barrier action that can produce outsized results.

For women living with type 2 diabetes, especially those already engaged in structured dietary or weight management programs, substituting water for diet soda may offer one of the most effective tools for reaching remission and improving long-term cardiometabolic health.