PMID- 25030779
OWN - NLM
STAT- MEDLINE
DCOM- 20141110
LR  - 20230318
IS  - 1938-3207 (Electronic)
IS  - 0002-9165 (Linking)
VI  - 100
IP  - 4
DP  - 2014 Oct
TI  - Comparison of the effects of slowly and rapidly absorbed carbohydrates on 
      postprandial glucose metabolism in type 2 diabetes mellitus patients: a 
      randomized trial.
PG  - 1059-68
LID - 10.3945/ajcn.113.076638 [doi]
AB  - BACKGROUND: Isomaltulose attenuates postprandial glucose and insulin 
      concentrations compared with sucrose in patients with type 2 diabetes mellitus 
      (T2DM). However, the mechanism by which isomaltulose limits postprandial 
      hyperglycemia has not been clarified. OBJECTIVE: The objective was therefore to 
      assess the effects of bolus administration of isomaltulose on glucose metabolism 
      compared with sucrose in T2DM. DESIGN: In a randomized, double-blind, crossover 
      design, 11 participants with T2DM initially underwent a 3-h 
      euglycemic-hyperinsulinemic (0.8 mU . kg(-1) . min(-1)) clamp that was 
      subsequently combined with 1 g/kg body wt of an oral (13)C-enriched isomaltulose 
      or sucrose load. Hormonal responses and glucose kinetics were analyzed during a 
      4-h postprandial period. RESULTS: Compared with sucrose, absorption of 
      isomaltulose was prolonged by  approximately 50 min (P = 0.004). Mean plasma concentrations of 
      insulin, C-peptide, glucagon, and glucose-dependent insulinotropic peptide were 
       approximately 10-23% lower (P < 0.05). In contrast, glucagon-like peptide 1 (GLP-1) was  approximately 64% 
      higher (P < 0.001) after isomaltulose ingestion, which results in an increased 
      insulin-to-glucagon ratio (P < 0.001) compared with sucrose. The cumulative 
      amount of systemic glucose appearance was  approximately 35% lower after isomaltulose than 
      after sucrose (P = 0.003) because of the reduction in orally derived and 
      endogenously produced glucose and a higher first-pass splanchnic glucose uptake 
      (SGU). Insulin action was enhanced after isomaltulose compared with sucrose (P = 
      0.013). CONCLUSIONS: Ingestion of slowly absorbed isomaltulose attenuates 
      postprandial hyperglycemia by reducing oral glucose appearance, inhibiting 
      endogenous glucose production (EGP), and increasing SGU compared with ingestion 
      of rapidly absorbed sucrose in patients with T2DM. In addition, GLP-1 secretion 
      contributes to a beneficial shift in the insulin-to-glucagon ratio, suppression 
      of EGP, and enhancement of SGU after isomaltulose consumption. This trial was 
      registered at clinicaltrials.gov as NCT01070238.
CI  - (c) 2014 American Society for Nutrition.
FAU - Ang, Meidjie
AU  - Ang M
AD  - From Medical Clinic and Policlinic 3, Justus Liebig University, Giessen, Germany.
FAU - Linn, Thomas
AU  - Linn T
AD  - From Medical Clinic and Policlinic 3, Justus Liebig University, Giessen, Germany.
LA  - eng
SI  - ClinicalTrials.gov/NCT01070238
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20140716
PL  - United States
TA  - Am J Clin Nutr
JT  - The American journal of clinical nutrition
JID - 0376027
RN  - 0 (Blood Glucose)
RN  - 0 (C-Peptide)
RN  - 0 (Dietary Carbohydrates)
RN  - 0 (Insulin)
RN  - 57-50-1 (Sucrose)
RN  - 59392-49-3 (Gastric Inhibitory Polypeptide)
RN  - 67I334IX2M (Isomaltose)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
RN  - 9007-92-5 (Glucagon)
RN  - V59P50X4UY (isomaltulose)
SB  - IM
MH  - Blood Glucose/metabolism
MH  - C-Peptide/blood
MH  - *Carbohydrate Metabolism
MH  - Cross-Over Studies
MH  - Diabetes Mellitus, Type 2/*blood
MH  - Dietary Carbohydrates/*pharmacokinetics
MH  - Double-Blind Method
MH  - Female
MH  - Gastric Inhibitory Polypeptide/blood
MH  - Glucagon/blood
MH  - Glucagon-Like Peptide 1/blood
MH  - Humans
MH  - Hyperglycemia/blood
MH  - Insulin/blood
MH  - Isomaltose/*analogs & derivatives/pharmacokinetics
MH  - Male
MH  - Middle Aged
MH  - *Postprandial Period
MH  - Sucrose/pharmacokinetics
EDAT- 2014/07/18 06:00
MHDA- 2014/11/11 06:00
CRDT- 2014/07/18 06:00
PHST- 2014/07/18 06:00 [entrez]
PHST- 2014/07/18 06:00 [pubmed]
PHST- 2014/11/11 06:00 [medline]
AID - S0002-9165(23)04787-1 [pii]
AID - 10.3945/ajcn.113.076638 [doi]
PST - ppublish
SO  - Am J Clin Nutr. 2014 Oct;100(4):1059-68. doi: 10.3945/ajcn.113.076638. Epub 2014 
      Jul 16.