Metabolic Effects of Replacing Sucrose by Isomaltulose in Subjects With Type 2 Diabetes

Abstract

OBJECTIVETo test the hypothesis that replacement of sucrose with isomaltulose in sweet foods and beverages improves metabolic control in patients with type 2 diabetes.RESEARCH DESIGN AND METHODSOne hundred ten patients with type 2 diabetes were randomized to receive sweet foods containing either 50 g/day isomaltulose or sucrose for 12 weeks as part of their habitual diet under free-living conditions. HbA1c at 12 weeks was the primary outcome parameter.RESULTSIn the final analysis comprising 101 patients, isomaltulose did not significantly affect HbA1c at 12 weeks (sucrose: 7.39 ± 0.78%; isomaltulose: 7.24 ± 0.76%; regression coefficient [b]: 0.02 [95% CI: −0.21 to 0.25], P = 0.844). Triglycerides at 12 weeks were significantly lower in the isomaltulose versus the sucrose group (b: 34.01 [6.59–61.44], P = 0.016). Other secondary parameters did not significantly differ between groups.CONCLUSIONSIsomaltulose did not influence glycemic control assessed as HbA1c in type 2 diabetes under free-living conditions but was associated with lower triglyceride levels.

Effect of an alcohol-free beer enriched with isomaltulose and a resistant dextrin on insulin resistance in diabetic patients with overweight or obesity

“…However, the effect of this carbohydrate in subjects with T2DM has been barely explored. Brunner et al did not observe significant changes in glucose metabolism after intake of 50 g/d of isomaltulose during 12 weeks although they did denote a significant decrease in triglycerides compared with those participants consuming 50 g/d of sucrose [30]. Another research study demonstrated that the ingestion of 1 g/kg-isomaltulose attenuated postprandial hyperglycemia by reducing oral glucose appearance and inhibiting endogenous glucose production, in comparison with the intake of rapidly absorbed sucrose in patients with T2DM [31].…”

A Low Glycaemic Index Diet Incorporating Isomaltulose Is Associated with Lower Glycaemic Response and Variability, and Promotes Fat Oxidation in Asians

“…Studies also showed that isomaltulose supplementation continuously over several months can improve glycaemic responses in both diabetic and non-diabetic, Caucasians and Japanese Asians [26,28]. Furthermore, van Can et al reported, less decline in fat oxidation during isomaltulose co-ingestion in overweight, impaired glucose tolerant subjects and improved glycaemia and insulin sensitivity [27].…”

“…The rate of protein oxidation was assumed to be constant during the time in the WBC [59]. Although the study was performed in male subjects alone, previous studies have demonstrated a similar effect in mixed groups including men and women [26,28]. Serum insulin measurements could have significantly strengthened the study and further support the link between glycaemic response and fuel utilization.…”

Effectiveness of carbohydrates as a functional ingredient in glycemic control

“…Altogether, low glycemic carbohydrates will lead to a longer postprandial energy supply by carbohydrates associated with a lower peak glycemic response. Ot is important to highlight that isomaltulose provides the same energy content (8 kJ or 4 kcal/g) provided by sucrose, however, in a balanced manner due to the slow release of glucose in the intestines increased of glycemia resulting from rapidly absorbed carbohydrates is avoided (Brunner et al, 2012;Holub et al, 2010) Ot has been demonstrated by several groups that a lower GO in meals is associated with a higher postprandial fat oxidation in healthy subjects (Wee et al, 2005). Considering obese subjects, the ingestion of isomaltulose with a lipid-rich meal also improved the profile of triglycerides and free fatty acids (FFA) in addition to the effects on postprandial glycemia (Suklaew et al, 2015).…”