Postprandial glucose, insulin and gastrointestinal hormones in healthy and diabetic subjects fed a fructose-free and resistant starch type IV-enriched enteral formula

Eur J Nutr. 2013 Sep;52(6):1569-78. doi: 10.1007/s00394-012-0462-x. Epub 2012 Nov 23.


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 Plus(®) 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 (Glucerna(®) SR and Novasource(®) 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 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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Area Under Curve
  • Blood Glucose / metabolism
  • C-Peptide / metabolism
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Dietary Carbohydrates / administration & dosage
  • Dietary Fats, Unsaturated / administration & dosage
  • Dietary Supplements*
  • Enteral Nutrition*
  • Fatty Acids, Omega-3 / administration & dosage
  • Female
  • Fructose / administration & dosage*
  • Gastric Inhibitory Polypeptide / blood
  • Ghrelin / blood
  • Glucagon-Like Peptide 1 / blood
  • Glycemic Index
  • Healthy Volunteers
  • Humans
  • Insulin / blood
  • Lipids / blood
  • Male
  • Middle Aged
  • Postprandial Period*
  • Starch / administration & dosage*
  • Young Adult


  • Blood Glucose
  • C-Peptide
  • Dietary Carbohydrates
  • Dietary Fats, Unsaturated
  • Fatty Acids, Omega-3
  • Ghrelin
  • Glucerna
  • Insulin
  • Lipids
  • Fructose
  • Gastric Inhibitory Polypeptide
  • Glucagon-Like Peptide 1
  • Starch