Sucralose for people with diabetes
It has been proposed that sucralose has no effect on blood glucose (BG) or insulin levels and thus can be suitable for people with diabetes as an alternative to sugar in their diets. This abstract of a study looks at the proposal in actual type 2 diabetic patients.
Glucose Homeostasis Study – Lack of effect of sucralose on glucose homeostasis in subjects with type 2 diabetes.
Grotz VL, Henry RR, McGill JB et al. J Am Diet Assoc. 2003; 103(12): 1607-1612.
Background
People with diabetes often use low calorie sweeteners to decrease their sugar consumption and there is potential for sucralose as a sugar substitute for such people. Studies on the effect of sucralose on BG and insulin levels are limited in diabetic patients; however, clinical studies in normal non-diabetic humans have shown that sucralose has no effect on either of these parameters.
Objective
This study investigated the effect of the intake of high daily doses of sucralose in type 2 diabetics over a 3 month period.
Design/Methods
128 type 2 diabetics who had been diagnosed over a year ago were randomly selected to participate in this study. The participants were between the ages of 31 to 70 years of age, in good health and managed their diabetes with either insulin or an oral hypoglycaemic agent, but not both. This study consisted of 3 phases – a 6 week screening phase, 13 week test phase and 4 week follow up phase. Initially all patients were asked to follow a standard diet and to monitor their blood glucose (BG) levels 3 times per day minimum, 2 days per week for the duration of the study. For the last 4 weeks of the screening phase and for the whole follow up phase all patients were blindly given placebo capsules to take twice a day, at breakfast and dinnertime. However during the test phase the patients were randomly split into 2 treatment groups to receive 2 capsules each day of either sucralose (667mg/day) or placebo, for the 13 weeks.
At the end of the screening phase baseline measurements were taken for glycated haemoglobin (HbA1c); fasting plasma glucose (FPG); fasting serum C-peptide and insulin/oral hypoglycaemic agent dosage level. The former 3 were then assessed every 2 weeks during the test phase. Any changes in medications and any adverse events were also recorded for the remainder of the study period and BG control was evaluated as at the 6 week point and in addition physical examinations and haematology, blood chemistry and urinalysis assessments were conducted at the end of the follow up phase.
Results
67 patients received sucralose and 69 received placebo during the test phase. Baseline patient characteristics were similar among these 2 groups, on the whole patients were obese and in both treatment groups about 50% consumed oral hypoglycaemia agents and the rest took insulin. Changes in Hb1Ac, FPG or fasting serum C-peptide levels were not statistically significant between the two treatment groups and no significant differences were found between the placebo (n=65) and sucralose (n=63) groups in any of the safety measures. There were no significant differences between groups in the type, number, or severity of adverse events documented. No patients withdrew from this study due to an adverse event and no adverse events were reported as a potential or specific result of sucralose ingestion.
Conclusions
Although study participants consumed doses of approximately 3 times greater than the maximum estimated daily intake for sucralose of 2.4mg/kg/day, this study found that sucralose had no effect on any measure of glucose control assessed and no tendency towards a loss of BG management was displayed either, in people with type 2 diabetes. Results from this study demonstrated that sucralose was as well tolerated by diabetic patients as the placebo and thus the authors summarise that foods and beverages sweetened with sucralose may be advantageous for the dietary management of individuals who have, or are at risk of, diabetes. These results are consistent with the findings of studies previously carried out but mainly conducted on nondiabetic human subjects, proposing that individuals who are not obese, or whose diabetes is controlled through diet alone, would react similarly to sucralose ingestion.
Further information on sucralose may be obtained from www.splenda.co.uk or by calling the SPLENDA® Information Service on 0800 028 1222 (UK) or 1 800 924 657 (IRL), Mon - Fri: 9am-5pm. Alternatively you may like to call the SPLENDA® HCP Nutrition Specialist Direct on 0800 028 2224, Mon – Fri: 9am-5pm. A copy of the full article can be found at www.sciencedirect.com
References
Grotz VL, Henry RR, McGill JB et al. Glucose Homeostasis Study – Lack of effect of sucralose on glucose homeostasis in subjects with type 2 diabetes. J Am Diet Assoc. 2003; 103(12): 1607-1612.
Published in partnership with the Royal College of Nursing's Practice Nurse Association
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