The effect of small doses of fructose and allulose on postprandial glucose metabolism in type 2 diabetes: A double-blind, randomized, controlled, acute feeding, equivalence trial.

Autor: Noronha JC; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada., Braunstein CR; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada., Glenn AJ; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada., Khan TA; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada., Viguiliouk E; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada., Noseworthy R; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada., Blanco Mejia S; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada., Kendall CWC; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.; College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada., Wolever TMS; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.; Division of Endocrinology, St. Michael's Hospital, Toronto, Canada., Leiter LA; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.; Division of Endocrinology, St. Michael's Hospital, Toronto, Canada., Sievenpiper JL; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.; Division of Endocrinology, St. Michael's Hospital, Toronto, Canada.
Jazyk: angličtina
Zdroj: Diabetes, obesity & metabolism [Diabetes Obes Metab] 2018 Oct; Vol. 20 (10), pp. 2361-2370. Date of Electronic Publication: 2018 Jun 25.
DOI: 10.1111/dom.13374
Abstrakt: Aim: To assess and compare the effect of small doses of fructose and allulose on postprandial blood glucose regulation in type 2 diabetes.
Methods: A double-blind, multiple-crossover, randomized, controlled, acute feeding, equivalence trial in 24 participants with type 2 diabetes was conducted. Each participant was randomly assigned six treatments separated by >1-week washouts. Treatments consisted of fructose or allulose at 0 g (control), 5 g or 10 g added to a 75-g glucose solution. A standard 75-g oral glucose tolerance test protocol was followed with blood samples at -30, 0, 30, 60, 90 and 120 minutes. The primary outcome measure was plasma glucose incremental area under the curve (iAUC).
Results: Allulose significantly reduced plasma glucose iAUC by 8% at 10 g compared with 0 g (717.4 ± 38.3 vs. 777.5 ± 39.9 mmol × min/L, P = 0.015) with a linear dose response gradient between the reduction in plasma glucose iAUC and dose (P = 0.016). Allulose also significantly reduced several related secondary and exploratory outcome measures at 5 g (plasma glucose absolute mean and total AUC) and 10 g (plasma glucose absolute mean, absolute and incremental maximum concentration [C max ], and total AUC) (P < .0125). There was no effect of fructose at any dose. Although allulose showed statistically significant reductions in plasma glucose iAUC compared with fructose at 5 g, 10 g and pooled doses, these reductions were within the pre-specified equivalence margins of ±20%.
Conclusion: Allulose, but not fructose, led to modest reductions in the postprandial blood glucose response to oral glucose in individuals with type 2 diabetes. There is a need for long-term randomized trials to confirm the sustainability of these improvements.
(© 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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