Metabolic Response to Oral Challenge of Hydrogenated Starch Hydrolysate Versus Glucose In Diabetes

Wheeler, Madelyn L.; Fineberg, S. Edwin; Gibson, Robert L.; Fineberg, Naomi S.

doi:10.2337/diacare.13.7.733

Cited by 23 publications

(11 citation statements)

References 21 publications

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“…Based on data in Table 4 for normal subjects. Wheeler et al (1990) more than simply due to the GI of polyols and sucrose being lower than for glucose.…”

Section: Glycaemic and Insulinaemic Indices Of Polyolsmentioning

confidence: 99%

Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties

2003

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Polyols are hydrogenated carbohydrates used as sugar replacers. Interest now arises because of their multiple potential health benefits. They are non-cariogenic (sugar-free tooth-friendly), lowglycaemic (potentially helpful in diabetes and cardiovascular disease), low-energy and lowinsulinaemic (potentially helpful in obesity), low-digestible (potentially helpful in the colon), osmotic (colon-hydrating, laxative and purifying) carbohydrates. Such potential health benefits are reviewed. A major focus here is the glycaemic index (GI) of polyols as regards the health implications of low-GI foods. The literature on glycaemia and insulinaemia after polyol ingestion was analysed and expressed in the GI and insulinaemic index (II) modes, which yielded the values: erythritol 0, 2; xylitol 13, 11; sorbitol 9, 11; mannitol 0, 0; maltitol 35, 27; isomalt 9, 6; lactitol 6, 4; polyglycitol 39, 23. These values are all much lower than sucrose 65, 43 or glucose 100, 100. GI values on replacing sucrose were independent of both intake (up to 50 g) and the state of carbohydrate metabolism (normal, type 1 with artificial pancreas and type 2 diabetes mellitus). The assignment of foods and polyols to GI bands is considered, these being: high (> 70), intermediate (> 55-70), low (> 40-55), and very low (< 40) including non-glycaemic; the last aims to target particularly low-GI-carbohydrate-based foods. Polyols ranged from low to very low GI. An examination was made of the dietary factors affecting the GI of polyols and foods. Polyol and other food GI values could be used to estimate the GI of food mixtures containing polyols without underestimation. Among foods and polyols a departure of II from GI was observed due to fat elevating II and reducing GI. Fat exerted an additional negative influence on GI, presumed due to reduced rates of gastric emptying. Among the foods examined, the interaction was prominent with snack foods; this potentially damaging insulinaemia could be reduced using polyols. Improved glycated haemoglobin as a marker of glycaemic control was found in a 12-week study of type 2 diabetes mellitus patients consuming polyol, adding to other studies showing improved glucose control on ingestion of low-GI carbohydrate. In general some improvement in long-term glycaemic control was discernible on reducing the glycaemic load via GI by as little as 15-20 g daily. Similar amounts of polyols are normally acceptable. Although polyols are not essential nutrients, they contribute to clinically recognised maintenance of a healthy colonic environment and function. A role for polyols and polyol foods to hydrate the colonic contents and aid laxation is now recognised by physicians. Polyols favour saccharolytic anaerobes and aciduric organisms in the colon, purifying the colon of endotoxic, putrefying and pathological organisms, which has clinical relevance. Polyols also contribute towards short-chain organic acid formation for a healthy colonic epithelium. Polyol toothfriendliness and reduced energy values are affirmed and add to the ...

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“…Based on data in Table 4 for normal subjects. Wheeler et al (1990) more than simply due to the GI of polyols and sucrose being lower than for glucose.…”

Section: Glycaemic and Insulinaemic Indices Of Polyolsmentioning

confidence: 99%

Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties

2003

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“…We also used the RIA to investigate temporal change in serum concentrations in 6 nondiabetic women who received an oral glycemic challenge with sustacal ( Fig. 3) (29). We measured serum concentrations of proinsulin with two different antibodies that were specific for different regions on the proinsulin molecule.…”

Section: Resultsmentioning

confidence: 99%

A Rapid and Sensitive Radioimmunoassay for the Measurement of Proinsulin in Human Serum

1992

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RIA methodology is used widely to measure proinsulin in human serum. However, some RIAs lack the sensitivity necessary to quantify proinsulin in unextracted serum and require long incubation periods. We developed an RIA with a sensitivity of 3.5 pM that permits the routine measurement of proinsulin in less than 48 h. This was accomplished by using a nonequilibrium binding reaction at room temperature and PEG-assisted second antibody precipitation as the method for separating bound and free proinsulin. We obtained a specific antiproinsulin antibody by absorbing the initial goat antiserum with human C-peptide-agarose. Proinsulin produced 50% displacement of tracer at 25.6 pM, whereas both human insulin and C-peptide failed to displace tracer at concentrations as high as 1 microM. We evaluated several cleaved derivatives of proinsulin for cross-reactivity with the antibody. B-chain-C-peptide cleaved derivatives (less than or equal to 50% cross-reactivity) were more potent than A-chain-C-peptide cleaved derivatives (less than 5% cross-reactivity). However, all derivatives cleaved in the region from 56-60 failed to cross-react with the antiserum. These data indicate that a major antigenic determinant is present on the C-peptide region of proinsulin adjacent to the A-chain-C-peptide junction. After administration of an oral glycemic challenge, the mean fasting serum concentration of proinsulin in normal adults rose from 4.1 +/- 0.28 to 23.6 +/- 3.8 pM. We found a significant difference in the proinsulin concentrations in 6 adults before and after a glycemic challenge when two different antibodies were used in the RIA.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…When comparing the glycemic response to glucose and two varieties of HSH in both insulin-and noninsulin dependent diabetic subjects as well as healthy individuals, the glycemia was significantly reduced after the HSH-meals (Wheeler et al, 1990). Furthermore, when combining all the subjects, a difference in glycemic responses between the two HSH-varieties could be detected, pointing in favor of the HSH with shorter hydrogenated saccharide chains (HSH, 5875).…”

Section: Effect Of Carbohydrate Structure and Propertiesmentioning

confidence: 88%

Impact of Diet Composition on Blood Glucose Regulation

Russell

Baka

Björck

et al. 2013

Critical Reviews in Food Science and Nutrition

178

121

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Nutritional management of blood glucose levels is a strategic target in the prevention and management of type 2 diabetes mellitus (T2DM). To implement such an approach, it is essential to understand the effect of food on glycemic regulation and on the underlying metabolic derangements. This comprehensive review summarizes the results from human dietary interventions exploring the impact of dietary components on blood glucose levels. Included are the major macronutrients; carbohydrate, protein and fat, micronutrient vitamins and minerals, nonnutrient phytochemicals and additional foods including low-calorie sweeteners, vinegar, and alcohol. Based on the evidence presented in this review, it is clear that dietary components have significant and clinically relevant effects on blood glucose modulation. An integrated approach that includes reducing excess body weight, increased physical activity along with a dietary regime to regulate blood glucose levels will not only be advantages in T2DM management, but will benefit the health of the population and limit the increasing worldwide incidence of T2DM.

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Metabolic Response to Oral Challenge of Hydrogenated Starch Hydrolysate Versus Glucose In Diabetes

Cited by 23 publications

References 21 publications

Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties

Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties

A Rapid and Sensitive Radioimmunoassay for the Measurement of Proinsulin in Human Serum

Impact of Diet Composition on Blood Glucose Regulation

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