Postprandial glucose, insulin and gastrointestinal hormones in healthy and diabetic subjects fed a fructose-free and res

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ORIGINAL CONTRIBUTION

Postprandial glucose, insulin and gastrointestinal hormones in healthy and diabetic subjects fed a fructose-free and resistant starch type IV-enriched enteral formula Cruz Erika Garcı´a-Rodrı´guez • Marı´a Dolores Mesa • Josune Olza Gilda Buccianti • Milagros Pe´rez • Rosario Moreno-Torres • ´ ngel Gil Antonio Pe´rez de la Cruz • A



Received: 25 July 2012 / Accepted: 5 November 2012 Ó Springer-Verlag Berlin Heidelberg 2012

Abstract Background Reducing the dietary glycaemic response has been proposed as a means of reducing the risk of diabetes. Aim To evaluate the effects of a new diabetes-specific formula (DSF) enriched with resistant starch type IV and fructose-free on postprandial glycaemia, insulinaemia and gastrointestinal hormones in healthy volunteers and in outpatient type 2 diabetics. Methods (1) Twenty-four healthy volunteers were divided into two groups: Group 1 (n = 10) was provided 50 g of the carbohydrate (CHO) constituent of the new product and 50 g of glucose separated by 1 week; Group 2 (n = 14) was provided 400 ml of the new DSF (T-Diet PlusÒ Diabet NP) and 400 ml of a control product separated by 1 week. (2) Ten type 2 diabetic patients received 400 ml of the new DSF and two other commercially available DSF (GlucernaÒ SR and NovasourceÒ Diabet) on three occasions separated by 1 week. Venous blood samples were drawn at time 0 and at different times until 120 min. Glucose, insulin and gastrointestinal hormones

´ . Gil C. E. Garcı´a-Rodrı´guez (&)  M. D. Mesa  J. Olza  A Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology ‘‘Jose´ Mataix’’, Biomedical Research Centre, University of Granada, Avenida del Conocimiento s/n, 18100 Armilla, Granada, Spain e-mail: [email protected] G. Buccianti  R. Moreno-Torres  A. Pe´rez de la Cruz Clinical Nutrition and Dietetic Unit, University Hospital Virgen de las Nieves, Granada, Spain M. Pe´rez Research and Development Department, VEGENAT, S.A., Pueblonuevo del Guadiana, Badajoz, Spain

were determined. Glycaemic and insulinaemic indices and glycaemic load were calculated. Results The CHO constituent and the new DSF showed low glycaemic index and glycaemic load. In healthy subjects, insulin and C-peptide release were lower after administration of the CHO constituent as well as after the new DSF (P \ 0.001). Ghrelin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) production were lower after intake of the CHO constituent (P ranging from \0.001 to 0.019) compared with glucose, and GIP was lower after ingestion of the new DSF (P = 0.002) than after the control product. In type 2 diabetic patients, glucose AUC was lower after the administration of the new DSF (P = 0.037) compared with the others. Conclusions Our results indicate that this new product could be beneficial for diabetic patients. Keywords Enteral nutrition  Diabetes mellitus type 2  Carbohydrates  Insulin  Blood glucose  Gastrointestinal hormones

Introduction Diabetes mellitus is a chronic dise