Effects of Palatinose and Sucrose Intake on Glucose Metabolism and Incretin Secretion in Subjects With Type 2 Diabetes

Keyhani-Nejad, Farnaz; Kemper, Margrit; Schueler, Rita; Pivovarova, O; Rudovich, Natalia; Pfeiffer, Andreas F. H.

doi:10.2337/dc15-1891

Cited by 24 publications

(19 citation statements)

References 6 publications

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“…Contrary to L-cell secretion, responses of GIP were consistently lower after intake of the slowly digested saccharides in both groups. This agrees with previous findings in unoperated subjects (26)(27)(28)30,33) and was expected, considering the higher density of K-cells in the ADVANCE ARTICLE: proximal intestine (14). Overall GIP secretion (i.e.…”

Section: Discussionsupporting

confidence: 92%

“…While the alpha-1,2 glycosidic bond in sucrose is rapidly hydrolyzed, the alfa-1,6 linkage in isomaltulose is more resistant towards enzymatic breakdown (25). Consequently, isomaltulose is digested at a lower rate than sucrose resulting in a prolonged and presumably more distal absorption, which may affect GLP-1 secretion (26)(27)(28). The enzymatic activity of alpha-glucosidases can be inhibited pharmacologically by administration of acarbose.…”

mentioning

confidence: 99%

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Augmented GLP-1 Secretion as Seen After Gastric Bypass May Be Obtained by Delaying Carbohydrate Digestion

Martinussen

Bojsen‐Møller

Dirksen

et al. 2019

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context: Exaggerated postprandial Glucagon-like Peptide-1 (GLP-1) secretion seems important for weight loss and diabetes remission after Roux-en-Y gastric bypass (RYGB) and may result from carbohydrate absorption in the distal small intestine. Objective: To investigate distal (GLP-1; Peptide YY, PYY) and proximal (Glucosedependent Insulinotropic Polypeptide, GIP) gut hormone secretion in response to carbohydrates hydrolyzed at different rates. We hypothesized that slow digestion restricts proximal absorption, facilitating distal delivery of carbohydrates and thereby enhanced GLP-1 secretion in unoperated individuals, while this may not apply after RYGB. Design: Single-blinded, randomized, crossover study. Setting: Hvidovre Hospital, Denmark. Participants: 10 RYGB-and 10 unoperated matched subjects. Interventions: 4 separate days with ingestion of different carbohydrate loads, either rapidly/proximally digested (glucose+fructose; sucrose) or slowly/distally digested (isomaltulose; sucrose+acarbose). Main outcome measures: GLP-1 secretion (area-under-the-curve above baseline). Secondary outcomes included PYY and GIP. Results: Isomaltulose enhanced secretion of GLP-1 nearly 3-fold (p=0.02) and PYY 9-fold (p=0.08) compared with sucrose in unoperated subjects but had modest effect after RYGB. Acarbose failed to increase sucrose induced GLP-1 secretion in unoperated subjects and diminished the responses by 50% after RYGB (p=0.03). In both groups, GIP secretion was reduced by isomaltulose and even more so by sucrose+acarbose when compared to sucrose intake. Conclusions: GLP-1 secretion depends on the rate of carbohydrate digestion, but in a different manner after RYGB. Enhanced GLP-1 secretion is central after RYGB, but it may also be obtained in unoperated individuals by delaying hydrolysis of carbohydrates, pushing their digestion and absorption distally in the small intestine.

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Augmented GLP-1 Secretion as Seen After Gastric Bypass May Be Obtained by Delaying Carbohydrate Digestion

Martinussen

Bojsen‐Møller

Dirksen

et al. 2019

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Additionally, insulin resistance is associated with increased expression of endothelin-1 [45], which worsens ED by mediating vasoconstriction. Besides lower glycemia, slowly absorbable carbohydrates prevent an excessive postprandial insulin response, particularly in the early postprandial phase, although we could not document this event due to the late timing of blood sampling [31,44,46]. Moreover, a low-GI beverage containing isomaltulose compared to a high-GI beverage led to reduced daylong insulinemia and attenuated insulin resistance after one week of inactivity [30].…”

Section: Discussionmentioning

confidence: 74%

Efficacy of Isomaltulose Compared to Sucrose in Modulating Endothelial Function in Overweight Adults

Groot

Schweitzer²,

Theis³

2020

Nutrients

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Hyperglycemia is linked to impaired arterial endothelial function (EF), an early sign of cardiovascular disease. We compared the efficacy of low-glycemic index isomaltulose (Palatinose™) with that of sucrose in modulating EF, as assessed by flow-mediated dilation (FMD). In this double-blinded cross-over study, 80 overweight mildly hypertensive subjects were randomized to receive 50 g of either isomaltulose or sucrose. On two non-consecutive days, brachial artery ultrasound FMD scans were obtained prior to and hourly (T0–T3) after carbohydrate load. Blood was drawn immediately after scanning. Glucose and insulin levels were analyzed. Overall, the FMD decrease was attenuated by isomaltulose compared to sucrose (ΔFMD = −0.003% and −0.151%; p > 0.05 for the interaction treatment x period). At T2, FMD was significantly higher after isomaltulose administration compared to that after sucrose administration (FMD = 5.9 ± 2.9% and 5.4 ± 2.6%, p = 0.047). Pearson correlations between FMD and blood glucose showed a trend for a negative association at T0 and T2 independently of the carbohydrate (r-range = −0.20 to −0.23, p < 0.1). Sub-analysis suggested a lower FMD in insulin-resistant (IR) compared to insulin-sensitive subjects. Isomaltulose attenuated the postprandial decline of FMD, particularly in IR persons. These data support the potential of isomaltulose to preserve the endothelial function postprandially and consequently play a favorable role in cardiovascular health.

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“…Die glykosidische α1,2-Verknüpfung der Zucker in Saccharose wird sehr schnell von den intestinalen Glukosidasen gespalten, während die α1,6-Verknüpfung der Isomaltulose langsam gespalten wird. Tatsächlich führt dies bei Menschen und Mäusen zu einem erheblich geringeren Insulin-, GIP-und Glukoseanstieg nach Aufnahme von 50 g Isomaltulose im Vergleich zu Saccharose, aber einem ausgeprägten GLP-1-Anstieg [19,20]…”

Section: Ddg-preisträgerunclassified

GIP ist ein Inkretinhormon, das durch westliche Ernährung verstärkt freigesetzt wird und so zu einer ungesunden metabolischen Wirkung beiträgt – Werner-Creutzfeldt-Preis 2019 – eine Kurzübersicht des Preisträgers Andreas F. H. Pfeiffer

Pfeiffer

2019

Diabetologie und Stoffwechsel

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Effects of Palatinose and Sucrose Intake on Glucose Metabolism and Incretin Secretion in Subjects With Type 2 Diabetes

Cited by 24 publications

References 6 publications

Augmented GLP-1 Secretion as Seen After Gastric Bypass May Be Obtained by Delaying Carbohydrate Digestion

Augmented GLP-1 Secretion as Seen After Gastric Bypass May Be Obtained by Delaying Carbohydrate Digestion

Efficacy of Isomaltulose Compared to Sucrose in Modulating Endothelial Function in Overweight Adults

GIP ist ein Inkretinhormon, das durch westliche Ernährung verstärkt freigesetzt wird und so zu einer ungesunden metabolischen Wirkung beiträgt – Werner-Creutzfeldt-Preis 2019 – eine Kurzübersicht des Preisträgers Andreas F. H. Pfeiffer

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