Acute responses of stevia and d-tagatose intake on metabolic parameters and appetite/satiety in insulin resistance.

OBJECTIVE: To examine the effects of d-tagatose or stevia preloads on carbohydrate metabolism markers after an oral glucose load, as well as subjective and objective appetite in women with insulin resistance (IR). RESEARCH DESIGN AND METHODS: Randomized controlled crossover study. Women with IR without T2DM (n = 33; aged 23.4 ± 3.8; BMI 28.1 ± 3.4 kg × m-2) underwent three oral glucose loads (3 h each) on three different days. Ten min before oral glucose load, volunteers consumed a preload of 60 mL water (control), 60 mL water with stevia (15.3 mg), or d-tagatose (5000 mg). Serum glucose and C-peptide were evaluated at -10, 30-, 60-, 90-, 120-, and 180-min. Subjective appetite was determined with a visual analog scale. Food intake was measured at ad libitum buffet after 180 min. RESULTS: C-peptide iAUC was significantly higher for stevia (median (IQR): 1033 (711-1293) ng × min × L-1) vs. d-tagatose (794 (366-1134) ng × min × L-1; P = 0.001) or control (730 (516-1078) ng × min × L-1; P = 0.012). At 30- and 60-min serum glucose was higher for stevia vs other conditions (P < 0.01). Volunteers reported greater satiety for stevia and d-tagatose vs. control at 60 min and greater desire to eat for stevia vs. control at 120- min (all P < 0.05). Objective appetite did not vary by condition (P = 0.06). CONCLUSIONS: Our findings suggest that these NNS are not inert. Stevia intake produced an acute response on C-peptide release while increased serum glucose at earlier times. It is possible that NNS affects subjective but not objective appetite. This trial is registered at clinicaltrials.gov as NCT04327245. CLINICAL TRIAL REGISTRY: NCT04327245.

Effect of high and low glycemic index breakfast on postprandial metabolic parameters and satiety in subjects with type 2 diabetes mellitus under intensive insulin therapy: Controlled clinical trial.

BACKGROUND AND AIM: The results of studies evaluating the metabolic effects of glycemic index (GI) in subjects with type 2 diabetes mellitus (DM2) have been contradictory. Consequently, the benefits of its application are controversial and polarized opinions of international organizations have been disclosed. The above situation leads this study to evaluate the acute effect of low and high GI breakfast on the glycemic response and satiety in subjects with DM2 under intensive insulin therapy (IIT). METHODS: A controlled, crossover and single-blind clinical trial was developed involving 10 obese subjects with DM2 under IIT, with a period of at least six months under IIT and with fast insulin prescription before breakfast. Subjects ingested on two different occasions a high or low GI breakfast. In both stages, glycemia was evaluated at 0 (basal), 30, 60 and 120 min, and satiety and satiation were evaluated through a visual analogue scale. RESULTS: In contrast to high GI breakfast, the low GI meal generated a significant decrease of 46% for the area under the curve of glucose (Δ 1940 mg/dL × 120 min, p = 0.022) and in mean glycemia evaluated at 30, 60 and 120 min. Moreover, in the low GI stage 8 of 10 patients achieved a 2 h postprandial glycemia lower than 180 mg/dL, without statistical significance. A nonsignificant increase of 12.7% (Δ 1.06 cm, p = 0.271) in satiety at 120 min in the low GI stage was observed. CONCLUSION: In contrast to high GI breakfast, the low GI breakfast generated a significantly lower glycemic response. This assay allowed for the contribution of more in depth nutritional recommendations for this group of patients. Registered under ClinicalTrials.gov Identifier no. NCT02881164.