Sugars, particularly fructose-containing sugars, have been implicated as an important driver in the rise in incidence of type 2 diabetes.1,2 Sugar-sweetened beverages, which represent the greatest source of fructose-containing sugars in the diet, 3 form most of the basis for this link. 4,5 It remains unclear whether the association between beverages sweetened with sugars and type 2 diabetes can be explained by the fructose that these beverages contain. Several high-quality systematic reviews and meta-analyses have assessed the relation of sugar-sweetened beverages with incident type 2 diabetes. Our objective was to conduct a systematic review and meta-analysis of prospective cohort studies to determine the role of fructose-containing sugars independent of food form in the development of type 2 diabetes. MethodsOur systematic review and meta-analysis followed the Cochrane Handbook for Systematic Reviews and Interventions, 6 and reported results according to Meta-analysis of Observational Studies in Epidemiology (MOOSE) guideline 7 and PRISMA guideline (www.prisma-statement.org). The study protocol is registered (ClinicalTrials.gov identifier, NCT01608620). ABSTRACT BACKGROUND: Sugar-sweetened beverages are associated with type 2 diabetes. To assess whether this association holds for the fructose-containing sugars they contain, we conducted a systematic review and meta-analysis of prospective cohort studies.