Metabolic Response to Oral Challenge of Hydrogenated Starch Hydrolysate Versus Glucose In Diabetes

Abstract

Our objective was to determine whether 1) hydrogenated starch hydrolysates (HSHs), bulking/sweetening agents used in hard candies, produce a diminished postmeal glycemic response relative to glucose in individuals with and without diabetes and 2) any diminished glycemia is secondary to altered carbohydrate absorption. This study followed a randomized double-blind crossover design and was performed in 12 individuals with diabetes (6 non-insulin dependent, 6 insulin dependent) and 6 nondiabetic individuals. Each group consisted of 3 men and 3 women, none with known neuropathy. After an overnight fast, each subject was challenged with 50 g of glucose, HSH 5875 (7% sorbitol/60% maltitol), and HSH 6075 (14% sorbitol/78% hydrogenated maltooligosaccharides)/1.73 m2 of body surface area in random order on 3 successive days. Individuals with diabetes were maintained on continuous subcutaneous insulin infusion throughout the study to achieve prechallenge glucose levels between 4.5 and 6.7 mM. For all groups, the order of plasma glucose responses over 5 h postchallenge was glucose>HSH 6075>HSH 5875, P < 0.001 (glucose vs. HSH). Pooled data for all groups for areas under the curve confirmed that HSH 6075 resulted in greater glycemia than HSH 5875 (P < 0.05). This was reflected in the order of C-peptide responses seen in the nondiabetic and non-insulindependent groups (glucose>HSH 6075>HSH 5875, P < 0.001). Breath H2 after glucose was low, whereas HSH 5875 > HSH 6075 (P = 0.003). Gastric distress was noticed with all products. HSH ingestion as a single carbohydrate ingredient results in decreased glycemia relative to glucose in individuals with and without diabetes. Decreased glycemia results from altered small intestinal carbohydrate absorption. HSH as a single ingredient appears to be a suitable product for consumption by individuals with diabetes mellitus.