TY - JOUR
T1 - Glycemic, hormone, and appetite responses to monosaccharide ingestion in patients with type 2 diabetes
AU - Vozzo, Rosalie
AU - Baker, Ben
AU - Wittert, Gary A.
AU - Wishart, Judith M.
AU - Morris, Howard
AU - Horowitz, Michael
AU - Chapman, Ian
N1 - Funding Information:
From the Department of Medicine, Royal Adelaide Hospital, Adelaide; and the Division of Clinical Biochemistry, Institute of Medical and Veterinary Science, Adelaide, South Australia, Australia. Submitted March 21, 2001, accepted February 14, 2002. Supported by a grant from Novo Nordisk Diabetes Regional Support Scheme. Address correspondence to Ian Chapman, MBBS, PhD, Department of Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia 5000. Copyright 2002, Elsevier Science (USA). All rights reserved. 0026-0495/02/5108-0001$35.00/0 doi:10.1053/meta.2002.34012
PY - 2002/8
Y1 - 2002/8
N2 - To investigate the relative effects of fructose and glucose on blood glucose, plasma insulin and incretin (glucagon-like peptide-1 [GLP-1] and gastric inhibitory peptide [GIP]) concentrations, and acute food intake, 10 (6 men, 4 women) patients with diet-controlled type 2 diabetes (diabetic) (44 to 71 years) and 10 age and body mass index (BMI)-matched (6 men, 4 women) nondiabetic, control subjects with varying degrees of glucose tolerance (nondiabetic), were studied on 3 days. In random order, they drank equienergetic preloads of glucose (75 g) (GLUC), fructose (75 g) (FRUCT) or vehicle (300 mL water with noncaloric flavoring [VEH]) 3 hours before an ad libitum buffet lunch. Mean glucose concentrations were lower after FRUCT than GLUC in both type 2 diabetics (FRUCT v GLUC: 7.5 ± 0.3 v 10.8 ± 0.4 mmol/L, P <.001) and nondiabetics (FRUCT v GLUC: 5.9 ± 0.2 v 7.2 ± 0.3 mmol/L, P <.05). Mean insulin concentrations were approximately 50% higher after FRUCT in type 2 diabetics than in nondiabetics (diabetics v nondiabetics: 23.1 ± 0.7 v 15.1 ± 1.3 μU/mL; P <.0001). Plasma GLP-1 concentrations after fructose were not different between type 2 diabetics and nondiabetics (P >.05). Glucose, but not FRUC, increased GIP concentrations, which were not different between type 2 diabetics and nondiabetics (P >.05). Food intake was suppressed 14% by GLUC (P <.05 v CONT) and 14% by FRUC (P <.05 v CONT), with no difference between the amount of food consumed after GLUC and FRUC treatment in either type 2 diabetics or nondiabetics (P >.05). We have confirmed that oral fructose ingestion produces a lower postprandial blood glucose response than equienergetic glucose and demonstrated that (1) fructose produces greater increases in plasma insulin concentration in type 2 diabetics than nondiabetics, not apparently due to greater plasma incretin concentrations and (2) fructose and glucose have equivalent short-term satiating efficiency in both type 2 diabetics and nondiabetics. We conclude that on the basis of improved glycemic control, but not satiating efficiency, fructose may be useful as a replacement for glucose in the diet of obese patients with type 2 diabetes.
AB - To investigate the relative effects of fructose and glucose on blood glucose, plasma insulin and incretin (glucagon-like peptide-1 [GLP-1] and gastric inhibitory peptide [GIP]) concentrations, and acute food intake, 10 (6 men, 4 women) patients with diet-controlled type 2 diabetes (diabetic) (44 to 71 years) and 10 age and body mass index (BMI)-matched (6 men, 4 women) nondiabetic, control subjects with varying degrees of glucose tolerance (nondiabetic), were studied on 3 days. In random order, they drank equienergetic preloads of glucose (75 g) (GLUC), fructose (75 g) (FRUCT) or vehicle (300 mL water with noncaloric flavoring [VEH]) 3 hours before an ad libitum buffet lunch. Mean glucose concentrations were lower after FRUCT than GLUC in both type 2 diabetics (FRUCT v GLUC: 7.5 ± 0.3 v 10.8 ± 0.4 mmol/L, P <.001) and nondiabetics (FRUCT v GLUC: 5.9 ± 0.2 v 7.2 ± 0.3 mmol/L, P <.05). Mean insulin concentrations were approximately 50% higher after FRUCT in type 2 diabetics than in nondiabetics (diabetics v nondiabetics: 23.1 ± 0.7 v 15.1 ± 1.3 μU/mL; P <.0001). Plasma GLP-1 concentrations after fructose were not different between type 2 diabetics and nondiabetics (P >.05). Glucose, but not FRUC, increased GIP concentrations, which were not different between type 2 diabetics and nondiabetics (P >.05). Food intake was suppressed 14% by GLUC (P <.05 v CONT) and 14% by FRUC (P <.05 v CONT), with no difference between the amount of food consumed after GLUC and FRUC treatment in either type 2 diabetics or nondiabetics (P >.05). We have confirmed that oral fructose ingestion produces a lower postprandial blood glucose response than equienergetic glucose and demonstrated that (1) fructose produces greater increases in plasma insulin concentration in type 2 diabetics than nondiabetics, not apparently due to greater plasma incretin concentrations and (2) fructose and glucose have equivalent short-term satiating efficiency in both type 2 diabetics and nondiabetics. We conclude that on the basis of improved glycemic control, but not satiating efficiency, fructose may be useful as a replacement for glucose in the diet of obese patients with type 2 diabetes.
UR - https://www.scopus.com/pages/publications/0036347912
U2 - 10.1053/meta.2002.34012
DO - 10.1053/meta.2002.34012
M3 - Article
C2 - 12145765
AN - SCOPUS:0036347912
SN - 0026-0495
VL - 51
SP - 949
EP - 957
JO - Metabolism: Clinical and Experimental
JF - Metabolism: Clinical and Experimental
IS - 8
ER -