Table 2.
Summary of human trials examining the effect of rare sugars on postprandial blood glucose elevation*
| Study and location | Study population | Trial design | RS dose | CHO load | Ratio RS:CHO | Control | Difference in AUC | P | Conclusions |
|---|---|---|---|---|---|---|---|---|---|
| Braunstein et al., 2018(56), Canada | Healthy volunteers (n 25). Age 37 (sd 16). BMI 24·7 (sd 3·4) | Randomised, controlled, double-blind, multiple-crossover | 5 g PSI in glucose solution | 75 g glucose solution | 1:15 | No addition to CHO load | –35 (sd 22) mmol/l × min (15·6 % reduction) | 0·11 | No significant effect on plasma glucose iAUC compared with 0 g PSI control |
| 10 g PSI in glucose solution | 2:15 | –23 (sd 22) mmol/l × min (10·3 % reduction) | 0·07 | ||||||
| Hayashi et al., 2010(28), Japan | Borderline diabetes (n 15) and healthy volunteers (n 11). Age 55·0 (sd 11·4). BMI 24·9 (sd 4·4) | Randomised, controlled, double-blind, crossover | 5 g PSI single dose in tea given with meal | Standard meal (425 kcal, 84·5 g CHO, 13·3 g protein, 3·7 g fat) | 1:17 | Aspartame | –743·3 mg × min/dl overall for meal (11·5 % reduction) | < 0·01 | AUC for PSI meal was significantly less than control aspartame meal overall and in subgroup of subjects with borderline diabetes but not in subgroup of healthy participants |
| Kimura et al, 2017(57), Japan | Healthy volunteers (n 13). Age 35·7 (sd 2·0). BMI 20·9 (sd 0·7) | Randomised, controlled, single-blind, crossover | 5 g PSI single dose in solution, 30 min before meal | Standard meal (571 kcal; 61 % of energy as CHO, 25 % as fat, 14 % as protein. (estimated 93 g CHO) | 1:19 | Aspartame | NA | NA | PSI supplementation gave significantly lower change in plasma glucose at 90 min only, compared with aspartame control. No significant difference in plasma insulin |
| Noronha et al., 2018(29), Canada | Subjects with T2D, controlled with diet or OHA, not insulin (n 24). Age 66 (sd 1·2). BMI 27·0 (sd 0·9) | Randomized controlled, double-blind, crossover | 5 g PSI in glucose solution | 75 g glucose solution | 1:15 | No addition to CHO load | –48·1 mol × min/l (6·2 % reduction) | 0·051 | Significant linear dose–response gradient for reduction in AUC for glucose |
| 10 g PSI in glucose solution | 2:15 | –60·1 mol × min/l (7·7 % reduction) | 0·015 | ||||||
| Matsuo & Lu, 2011(30), Japan† | Healthy volunteers (n 44) | No crossover, no info on randomisation or blinding | 6 g PSI single dose before meal | Normal lunch selected by subjects (636 kcal, 87·6 g CHO for males, 513 kcal, 18·9 g CHO for females) | 1:15 male, 1:3 female | 6 g d-fructose | NA | NA | Postprandial glycaemic response significantly lower after PSI compared with D-fructose control |
| Iida et al., 2008(32), Japan† | Healthy volunteers (n 20) | Randomised, single-blind crossover | 2·5, 5 or 7·5 g PSI | 75 g maltodextrin solution | 1:10, 1:15 or 1:30 | No addition to CHO load | NA | NA | Dose-dependent reduction in postprandial blood glucose, with significant effects at doses of 5 g or greater |
| Tanaka et al., 2020(35)
Japan† |
Healthy volunteers (n ?) | Randomised, single blind crossover | 0, 1·8, 3·6 or 12·5 g PSI in 50 g chocolate | 50 g chocolate (carbohydrate content not provided) | NA | NA | NA | NA | Reduction in postprandial blood glucose and insulin with PSI compared with control |
| Nakamura et al., 2017(34), Japan† | Healthy volunteer (n 10) | Randomised, single-blind, placebo-controlled crossover | 0, 15, 25 or 35 g RSS | Total 50 g CHO-sucrose with part replaced by RSS | 3:7, 5:5 or 7:3 | Sucrose | NA | NA | Compared with 100 % sucrose control, 5:5 and 7:3 ratios gave significant reduction in iAUC for glucose and insulin. 3:7 ratio gave significant reduction in iAUC for insulin but not glucose |
| Healthy volunteers (n 12) | 5 g RSS | Total 10 g CHO-sucrose with half replaced by RSS | 1:1 | Sucrose | Significant reduction in iAUC for glucose and insulin with 1:1 RSS:sucrose compared with sucrose alone | ||||
| Yamada et al., 2018(31), Japan† | Healthy volunteers (n 14) | Randomised, single blind, placebo-controlled crossover | Half sucrose replaced with RSS | Sucrose (no info on amount) | 1:1 | Sucrose | NA | NA | Significant reduction in iAUC for glucose compared with sucrose control |
| Healthy volunteers (n 10) | Sucrose replaced with RSS | 3:10 and 5:5 | Sucrose | Significant reduction in iAUC for glucose compared with sucrose control | |||||
| Kwak et al., 2013(33), Korea | Healthy volunteers (n 52). Age 35·8 (sd 1·45). BMI 23·7 (sd 0·54) | Randomised, double-blind, placebo-controlled crossover | 5 or 10 g TAG in drink before a meal | Standard meal, 356 kcal of which 60 % (53 g) CHO | 1:10 or 1:5 | Sucralose-erythritol drink | –3·3 mg/dl per h (1·32 % reduction) | NS | Significant reduction in iAUC only in hyperglycaemic subjects |
| Hyperglycaemic subjects (impaired fasting glucose or newly diagnosed T2D, n 33). Age 57·2 (sd 1·71). BMI 25·0 (sd 0·46) | –15·4 mg/dl per h (4·0 % reduction) | < 0·05 | |||||||
| Wu et al., 2012(52), Australia | Healthy volunteers (n 10). Age 28·2 (sd 4·0). BMI 25·5 (sd 1·5) | Randomised, single-blind, placebo-controlled crossover | 40 g TAG–isomalt mixture (16 g TAG), 20 min before meal | Standard meal containing 63 g CHO | 1:4 | Sucralose preload | +0·5 mmol/l × min (0·25 % increase) | NS | Significant increase in iAUC with glucose preload, but no significant differences between TAG and control |
RS, rare sugar; PSI, d-psicose; CHO, carbohydrate; T2D, type 2 diabetes; OHA, oral hypoglycaemic agents; NA, not available; RSS, rare sugar syrup; TAG, d-tagatose; NS, not significant.
*
Difference in iAUC (incremental area under the curve) for glucose is the difference between rare sugar treatment group v. control group in 120 min following ingestion of carbohydrate load. P-values are for significance of difference as stated in the referenced article. Ages are given in years, and BMI is given in kg/m2. †Articles not available in English