Topic Effects of low doses of casein hydrolysate on postchallenge glucose and insulin levels

Authur J.T. Jonker et al.

Year 2011

N 13-T2DM

Study design blockedrandomized, placebocontrolled, double-blind,

The effect of different protein hydrolysate/carbohy drate mixtures on postprandial glucagon and insulin responses in healthy subjects

M. Claessens et al.

2009

18 healthy normalweight male subjects

Randomized, single-blind trials (repeated measures design with Latin square randomizatio n)

Viscosity of gums in vitro and their

S.L. Brenelli et

1997

16 healthy volunteers

Intervention/Protocol - Glucose, insulin and C-peptide responses were determined after the oral administration of 0 (control), 6 or 12 g protein hydrolysate in combination with 50 g carbohydrate. - Patients received three different treatments consisting of a single oral bolus (300 ml) containing 50 g of carbohydrates (50% glucose and 50% maltodextrin; Syral, Marckolsheim, France) with 0 (control), 6, or 12 g of protein hydrolysate. Patients received each treatment on a distinct study day and the three study days were separated by an interval of at least 7 days. Patients were instructed to continue their routine medication (including the biguanides) during the study. The evening before study days, subjects consumed a standardized meal (16 En(energy)% protein, 49 En% carbohydrate, 35 En% fat, 900 kcal). At the study days patients were admitted to the hospital in the morning after an overnight fast for at least 12 h. After arrival an intravenous cannula was inserted. The first blood sample was taken approximately 5 min before ingestion of the treatment drink. After ingestion of the treatment drink, samples were taken every 15 min for 2 h, followed by sampling every 30 min for another 2 h. - Protein hydrolysates (pea, rice, soy, gluten, whey and egg protein hydrolysate) consisted of 0.2 g hydrolysate per kg body weight (bw) and 0.2 g maltodextrin per kg bw and were compared tomaltodextrin alone. Postprandial plasma glucose, glucagon, insulin and amino acids were determined over 2h. - After an overnight fast, subjects reported to the laboratory where a Teflon catheter (Baxter BV, Utrecht, The Netherlands) was inserted into an antecubital vein and a resting blood sample was drawn (t 0). Then subjects were offered the test drink, which they had to consume as fast as possible and at least within 5 min. Blood samples were drawn 15, 30, 60, 90 and 120 min after finishing the test drink for glucose, amino-acid, insulin and glucagon analyses. - Experiments were carried out in vitro with three viscous polysaccharides (guar gum, pectin, and

Result 12 g of casein hydrolysate, but not 6 g, elevated insulin levels and decreased glucose levels postchallenge. These changes over time were not large enough to also affect the total area under the curve of glucose and insulin. C-peptide levels did not change after both treatments

Conclusion Ingestion of six grams of casein hydrolysate did not affect glucose or insulin responses. Intake of 12 g of casein hydrolysate has a small positive effect on postchallenge insulin and glucose levels in patients with type 2 diabetes.

All protein hydrolysates induced an enhanced insulin secretion compared to maltodextrin alone and a correspondingly low plasma glucose response. A significant difference was observed in area under the curve (AUC) for plasma glucagon between protein hydrolysates and the maltodextrin control drink (Po0.05). Gluten protein hydrolysate induced the lowest glucagon response.

High amino-acid-induced glucagon response does not necessarily go together with low insulin response. Protein hydrolysate source affects AUC for glucagon more profoundly than for insulin, although the protein load used in this study seemed to be at lower level for significant physiological effects.

Guar gum showed greater viscosity than the other gums during

temperature, the process of acidification,

Topic ability to reduce postprandial hyperglycemia in normal subjects

Authur al.

Year

Study design

Intervention/Protocol carboxymethylcellulose (CMC)) of similar initial viscosity submitted to conditions that mimic events occurring in the stomach and duodenum, and their viscosity in these situations was compared to their actions on postprandial hyperglycemia in normal human subjects. - All subjects took part in two or more experiments, one of which was a control, performed in a randomized order at least two days apart. The meals were taken over an 8-min period in the morning after an overnight fast, with the basic meal consisting of 75 g glucose in 400 ml water. In the test experiments, 10 g guar gum (10 subjects), 40 g pectin (10 subjects) or 11.65 g methylcellulose (11 subjects) was added to the basic meal. Venous blood samples were taken under fasting conditions and 15, 30, 45, 60, 90, 120 and 180 min after the beginning of the meal for analysis of plasma glucose and serum insulin as previously described (Brenelli SL,1995). The area under the curve for the insulin and glucose profiles was calculated by planimetry.

Result acidification and/or alkalinization and also showed larger effects on plasma glucose levels (35% reduction in maximum rise in plasma glucose) and on the total area under the curve of plasma glucose (control: 20,314 1007 mg dl-1 180 min-1 vs guar gum: 18,277 699 mg dl-1 180 min-1, P<0.01). Pectin, which showed a marked reduction in viscosity at 37oC and after events mimicking those that occur in the stomach and duodenum, did not have a significant effect on postprandial hyperglycemia. The performance of viscosity and the glycemia response to CMC were at an intermediate level between guar gum and pectin

Conclusion alkalinizationand exposure to intestinal ions induce different viscosity changes in gums having similar initial viscosity, establishing a direct relationship between a minor decrease of gum viscosity in vitro and a reduction of postprandial hyperglycemia. starting from similar initial viscosity of three gums before ingestion, the temperature, the process of acidification, alkalinization and exposure to ionic intestinal constituents induce changes in gum viscosity in vitro and fibers that maintain higher viscosity during these steps have more important effects on the reduction of postprandial plasma glucose and serum insulin levels in human subjects.

Unabsorbable carbohydrates and diabetes: decreased post-prandial hyperglycmia (Abstract)

DavidJ. A. Jenkins et al.

1976

8 noninsulinrequiring diabetic volunteers

High viscosity hydroxypropylmeth ylcellulose reduces postprandial blood glucose concentrations in NIDDM patients

Christos Re ppas Et al.

1993

10 NIDDM

two-way crossover,

Two test meals were taken in random order on separate days by 8 non-insulin-requiring diabetic volunteers after 14-hour overnight fasts. Addition of 16 g guar and 10 g pectin to the control meal containing 106 g carbohydrate decreased markedly and significantly the rise in blood-glucose between 30 and 90 minutes and also resulted in significantly lower insulin levels between 30 and 120 minutes. When these meals were fed to 3 insulin-dependent diabetic subjects, a similar flattening of the postprandial glucose rise ensued. single-dose administration of 10 g prehydrated high viscosity HPMC, or placebo, with a standard carbohydrate-rich meal.

This addition of certain forms of dietary fibre to the diet of diabetics significantly decreases post-prandial hyperglycaemia and would be expected to improve the control of blood-glucose concentration.

NIDDM, HPMC reduced blood glucose concentrations at the 60-, 75-, 90-, 120- and 150-min sampling intervals, with an average reduction in the maximum postprandial blood glucose concentration, Cmax, of 24% (P < 0.05). The time at which the maximum concentration was reached, Tmax, remained unchanged.

alterations in the blood glucose profile are mediated by luminal events rather than by changes in hormonal response. In contrast to the NIDDM patients, neither the pharmacokinetic parameters nor the blood glucose concentrations at specific

Topic

Authur

Year

Study design

Intervention/Protocol

Result The area under the blood concentration versus time plot, AUC0 6h, was reduced by an average of 15% (P < 0.05). The blood concentration profile of insulin followed that of glucose. Concentrations were significantly lower than in the placebo phase only at the 120-min sampling time, while pharmacokinetic parameters (Cmax, Tmax and AUC06h) were unchanged. Addition of 2.5% of guar gum or locust bean gum to an oral glucose tolerance test solution significantly altered the postprandial serum glucose response. Although all three complex carbohydrates tested did not reduce the initial rise in serum glucose, locust bean gum and guar gun significantly reduced its subsequent rebound hypoglycemia. Further tests with locust bean gum showed that these effects were dependent on the concentration of the gum added to the test solution or diet. Addition of locust bean gum to test diets reduced the rate of gastric emptying and thus slowed down the passage of food from the stomach into the upper small intestine.

Conclusion sampling times were significantly affected by the coadministration of HPMC in healthy volunteers. Overall, the results of this study suggest that HPMC may be a useful adjunct in the management of NIDDM.

Effects of Locust Bean Gum on Glucose Tolerance, Sugar Digestion, and Gastric Motility in Rats

Alan c. Tsai, Becky Peng

1981

24+16+16 +16+14+ 16 rats

6Experimental design

- locust bean gum, guar gum, and pectin Exp1: 24 rats were fasted overnight and randomly assigned to 4 groups to examine the effect of the complex carbohydrates by means of a glucose tolerance test. They were lightly anesthetized with ether and treated with gastric intubation of 500 mg glucose/kg body weight (5% glucose solution, w/v) or this solution enriched with 2.5% pectin, guar gum or locust bean gum. Blood samples were taken from the tip of the tail before dosing and at 45 and 90 minutes after dosing. Exp2 : 16 rats repeatedly for glucose tolerance tests. In each test they were fasted overnight and treated with gastric intubation, a glucose solution (10% solution, w/v, l g glucose/kg body weight) or the same solution enriched with locust bean gum. Treatment groups were assigned randomly during the first test. The experiment was repeated three times with 1.0, 1.5, and 2.5% locust bean gum, respectively. Tests were performed approximately two weeks apart. In each test, blood samples were taken from the tail before dosing and at 45,90, and 135 minutes after dosing. Serum samples were analyzed for glucose concentrations. Exp3: 16 rats, glucose was administered intravenously, were fasted overnight and randomly assigned to two groups for the test. Lightly anesthetized rats were injected (i.V.,tail vein) with 250 mg glucose/kg body weight, and orally dosed with either water (l ml/100 g body weight) or the same volume of 2.5% (w/v) locust bean gum

The study suggests that addition of locust bean gum to the diet can flatten the post prandial serum glucose curve by slowing the rate of food passage from the stomach into the small intestine. It is probable that locust bean gum and other similar materials may be useful as an adjunct dietary treatment of diabetes mellitus in humans.stomach into the upper small intestine.

Topic

Authur

Year

Study design

Effect of acarbose, pectin, a combination of acarbosewith pectin,

PAJ SPETH et al.

1983

9 patients with previous gastric

double-blind study

Intervention/Protocol solution. Blood samples were taken from the tail before glucose administration and at 45, 90, and 135 minutes after administration. Serum was analyzed for glucose concentration. Exp4 : 16 rats were fasted for two days and randomly assigned to two groups. One group was treated with gastric intubation 1 g glucose/kg body weight (10% glucose solution, w/v). The other group was treated with the same solution enriched with 2.5% (w/v) locust bean gum. Rats were dosed under light ether anesthesia and decapitated 75 minutes after dosing. Blood was collected from the neck for determination of serum glucose and insulin levels. The gastrointestinal tract was removed and divided into three sections: stomach, upper small intestine (upper half), and lower small intestine (lower half). The contents of each section were washed and the washings were analyzed for glucose. Exp5 : (similar to Exp4) The test meal contained 20% casein, 65.6% glucose, 10% soybean oil, 4% mineral mix, and 0.4% vitamin mix. 14 rats were fasted for 2 days and randomly assigned to two groups. The control group was treated with a suspension of this diet (26.7%, w/v) at an equivalent of 1.75 g glucose/kg body weight. The experimental group was treated with the same suspension enriched with 1.3% (w/v) locust bean gum. Rats were killed two hours after dosing. Serum samples and washings of the gastrointestinal contents were analyzed for glucose. Exp6 : (similar to Exp5 except sucrose replaced glucose in the diet) 16 rats were fasted for two days and randomly assigned to two groups. Each rat was treated with gastric intubation 4 g diet in 10 ml suspension (containing 2.62 g sucrose per kg body weight) or this preparation enriched with 2% (w/v) locust bean gum. They were killed three hours after dosing. Serum glucose and the amount of sucrose in the gastro-intestinal washings were determined. - compared the effect of 50 mg acarbose, 100 mgacarbose, 4.2 g pectin, a combination of 50 mg acarbose with 4.2 g pectin, and placebo on plasmaglucose, plasma insulin, breath hydrogen

Result

Conclusion

Fifty milligrams acarbose,100 mg acarbose and the combination of 50 mg acarbose with 4.2 g pectin significantly inhibitedthe postprandial

Topic and placebo on postprandial reactivehypoglycae mia after gastric surgery

Authur

Year

N surgery

Study design

Variations in Postprandial Blood Glucose Responses and Satiety after Intake of Three Types of Bread

Marianne S. H. Lunde Et al.

2011

10 Pakistani immigrant women

crossover design

Intervention/Protocol and hypoglycaemic symptoms after a normalcarbohydrate rich meal. - After an overnight fast the patients ingestedwithin 15 minutes a standard breakfast containingthree slices of bread with 20 g butter, 42 gmarmalade, and 10 g sugar, 100 ml tea containing 10g sugar, and 150 ml milk. In total the breakfastcontained 88 g carbohydrate, 18.5 g fat and 11 gprotein, together 2350 Joules (560 Calories). Duringeach breakfast the patients ingested in random orderand in a double-blind fashion two tablets containingeither 50 mg acarbose each, or one placebo and one50 mg acarbose, or both placebo, and six largecapsules containing 0.7 g pectin each or placebo.Acarbose (BAY g 5421) was obtained from BayerClinical Research Benelux, Mijdrecht, The Netherlands, and pectin from Pomosin, Bunschoten, TheNetherlands. The studies were performed at leasttwo days apart. Blood samples were drawn at -15,0, 15, 30, 45, 60, 90, 120, 150, and 180 minutesthrough an AbbocathR needle perfused with 0.9%saline. Plasma glucose was measured by the methodof Hoffman7 and plasma insulin by radioimmunoassay.8 At the same time intervals end-expiratory gas samples were obtained for analysis of breat hydrogen.9 In addition, we studied whether thepatients had hypoglycaemic symptoms during the period 60 to 150 minutes after ingestion of the meal. After fasting overnight, all women participated in 3 experiments having a crossover design and involving ingestion of various types of bread: regular coarse bread or fibre enriched-bread with two levels of rapeseed oil, all providing 25 g available carbohydrates (CHO). Blood glucose and satiety were determined before the meal and every 15 min over the next 2 hours.

Result peak glucose concentration (p<0.01); The lowest plasma glucose concentration,observed 60-150 minutes after ingestion of the meal, was significantly increased by the additionof 50 mg acarbose (p<0.01) and the combination of acarbose with pectin (p<005). Thecombination of acarbose with pectin was the only treatment that significantly inhibited the plasmainsulin peak (p<005). Eight of nine patients had symptoms of hypoglycaemia on placebo, two on50 mg acarbose (p<005), two on 100 mg acarbose (p<005), five on pectin (ns), and two on thecombination of acarbose and pectin (p<005). All treatments with acarbose induced significantincreases in breath hydrogen excretion (p<005).

Conclusion

High-methoxyl pectin has greater enhancing effect on

Meehye Kim

2005

After equilibrium, jejunal and ileal segments were simultaneously perfused with anisotonic electrolyte solution (pH 7.4) containing glucose (10 mM/L)

Intake of an amount of pea fibreenriched bread containing 25 g CHO attenuated, the postprandial peak glucose value, the incremental area under the glucose versus time curve during 15 to 75 min, and the glycemic profile, and increased duration of satiety ( < . 0 5), as compared with intake of regular bread with 25 g carbohydrate. High- and low-methoxylpectins in the perfusate signicantly inhibited jejunal uptake ofglucose compared

Pea fibre-enriched breads can reduce PPG and prolong satiety.

These results suggest that the decrease in intestinal absorption of glucose

Topic glucose uptake inintestinal perfused rats

Authur

Year

Study design

Intervention/Protocol and high- or low-methoxylpectins (10 g/L). Each test or control solution was perfused in a random sequence, with perfusiontimes of 30 min. Changes in glucose concentration of perfusate solution reservoir were determinedover the experimental period.

Effects of agar and pectin on gastric emptying and postprandial glycaemic profiles in healthy human volunteers

Sanaka M Et al.

2007

10 healthy males

Three occasions with three different test meals (450 kcal/500 mL): (i) a fibre-free meal; (ii) a meal with 2.0 g agar; or (iii) a meal with 5.2 g pectin. On each occasion, participants underwent a [(13)C]-acetate breath test along with serial blood sampling. To quantify gastric emptying, the half [(13)CO(2)] excretion time (t((1/2)b)) and the time for maximal [(13)CO(2)] excretion rate (t(lag)) were determined. The post-prandial glycaemic response was expressed as an incremental change from the fasting value at each sampling time. Data were analysed using repeated-measures analysis of variance (anova), followed by a post hoc paired Student's t-test with Bonferroni adjustment.

Result with the control (P 0.05). Highmethoxylpectins had greater inhibitive effecton intestinal absorption of glucose than lowmethoxylpectins. The observed changes in glucose andwater absorptions caused by high- or lowmethoxylpectins were reversible by switching to apectin-free perfusate. In addition, net water absorption changed to secretion after addition of highor low-methoxylpectins. The time-course for respiratory [(13)CO(2)] excretion differed significantly among the three test meals (P = 0.0004, anova). Compared with the control meal, [(13)CO(2)] excretion was significantly lower following consumption of the agar meal (between 40 and 105 min postprandially; P < 0.025, Student's t-test) and the pectin meal (between 40 and 180 min post-prandially; P < 0.025, Student's t-test). Among the three meals, significant differences were found in t((1/2)b) (P = 0.002, anova) and t(lag) (P = 0.011, anova). Compared with the control meal, the agar and pectin meals exhibited a significantly prolonged t((1/2)b) (P = 0.007 and P < 0.0001, respectively, Student's t-test) and t(lag) (P = 0.006 and P = 0.002, respectively, Student's t-test). Neither the agar nor pectin meal affected the post-prandial glucose profile.

Conclusion observedafter perfusion of high- or low-methoxylpectins may be caused by viscosityrelated increases in mucosal unstirred layer thickness.

In healthy adults, agar and pectin delay gastric emptying but have no impact on the post-prandial glucose response.

Decrease in Postprandial Insulin and Glucose Concentration s by Guar and

Topic

Authur

Year

Study design

Intervention/Protocol

Result

Conclusion

Pectin Ann Intern Med January 1, 197786:20-23

(dont have paper yet)