Postprandial metabolic effects of fructose and glucose in type 1 diabetes patients: a pilot randomized crossover clinical trial

Arch Endocrinol Metab. 2019 Jul 29;63(4):376-384. doi: 10.20945/2359-3997000000148.

Abstract

Objective: To test the influence of oral fructose and glucose dose-response solutions in blood glucose (BG), glucagon, triglycerides, uricaemia, and malondialdehyde in postprandial states in type 1 diabetes mellitus (T1DM) patients.

Subjects and methods: The study had a simple-blind, randomized, two-way crossover design in which T1DM patients were selected to receive fructose and glucose solutions (75g of sugars dissolved in 200 mL of mineral-water) in two separate study days, with 2-7 weeks washout period. In each day, blood samples were drawn after 8h fasting and at 180 min postprandial to obtain glucose, glucagon, triglycerides, uric acid, lactate, and malondialdehyde levels.

Results: Sixteen T1DM patients (seven men) were evaluated, with a mean age of 25.19 ± 8.8 years, a mean duration of disease of 14.88 ± 4.73 years, and glycated hemoglobin of 8.13 ± 1.84%. Fructose resulted in lower postprandial BG levels than glucose (4.4 ± 5.5 mmol/L; and 12.9 ± 4.1 mmol/L, respectively; p < 0.01). Uric acid levels increased after fructose (26.1 ± 49.9 µmol/L; p < 0.01) and reduced after glucose (-13.6 ± 9.5 µmol/L; p < 0.01). The malondialdehyde increased after fructose (1.4 ± 1.6 µmol/L; p < 0.01) and did not change after glucose solution (-0.2 ± 1.6 µmol/L; p = 0.40). Other variables did not change.

Conclusions: Fructose and glucose had similar sweetness, flavor and aftertaste characteristics and did not change triglycerides, lactate or glucagon levels. Although fructose resulted in lower postprandial BG than glucose, it increased uric acid and malondialdehyde levels in T1DM patients. Therefore it should be used with caution. ClinicalTrials.gov registration: NCT01713023.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / analysis
  • Blood Glucose / drug effects
  • Cross-Over Studies
  • Diabetes Mellitus, Type 1 / metabolism*
  • Dose-Response Relationship, Drug
  • Drug Tolerance
  • Female
  • Fructose / metabolism*
  • Fructose / pharmacology
  • Glucose / metabolism*
  • Glucose / pharmacology
  • Humans
  • Male
  • Malondialdehyde / blood
  • Middle Aged
  • Pilot Projects
  • Postprandial Period / drug effects*
  • Single-Blind Method
  • Solutions / pharmacology
  • Sweetening Agents / metabolism*
  • Sweetening Agents / pharmacology
  • Taste / drug effects
  • Triglycerides / blood
  • Uric Acid / blood
  • Young Adult

Substances

  • Blood Glucose
  • Solutions
  • Sweetening Agents
  • Triglycerides
  • Uric Acid
  • Fructose
  • Malondialdehyde
  • Glucose

Associated data

  • ClinicalTrials.gov/NCT01713023