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Clinical Care/Education
Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance
Dong Hee Shin, Ji Hye Lee, Myung Shin Kang, Tae Hoon Kim, Su Jin Jeong, Chong Hwa Kim, Sang Soo Kim, In Joo Kim
Diabetes Metab J. 2016;40(4):283-289.   Published online June 15, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.283
  • 5,093 View
  • 48 Download
  • 18 Web of Science
  • 19 Crossref
AbstractAbstract PDFPubReader   
Background

Rebaudioside A and erythritol are nonnutritive sweeteners. There have been several studies of their glycemic effects, but the outcomes remain controversial. The purpose of this study was to evaluate the glycemic effects of rebaudioside A and erythritol as a sweetener in people with glucose intolerance.

Methods

This trial evaluated the glycemic effect after 2 weeks of consumption of rebaudioside A and erythritol as sweeteners in a pre-diabetic population. The patients were evaluated for fructosamine, fasting plasma glucose, C-peptide, insulin, and 2-hour plasma glucose before and after consumption of sweetener. The primary outcome was a change in fructosamine levels from the baseline to the end of treatment. Secondary outcomes were the changes in levels of fasting plasma glucose and 2-hour plasma glucose.

Results

From the baseline to the end of experiment, the changes in fructosamine levels after consumption of rebaudioside A and erythritol, did not differ significantly (244.00±19.57 vs. 241.68±23.39 µmol/L, P=0.366). The change in levels from the baseline to end of the study for rebaudioside A and erythritol were fasting plasma glucose (102.56±10.72 vs. 101.32±9.20 mg/dL), 2-hour plasma glucose (154.92±54.53 vs. 141.92±42.22 mg/dL), insulin (7.56±4.29 vs. 7.20±5.12 IU/mL), and C-peptide (2.92±1.61 vs. 2.73±1.31 ng/mL), respectively, and also did not differ significantly (P>0.05 for all).

Conclusion

Our study suggests that consumption of rebaudioside A and erythritol does not alter the glucose homeostasis in people with glucose intolerance.

Citations

Citations to this article as recorded by  
  • The Cardiometabolic Impact of Rebaudioside A Exposure during the Reproductive Stage
    Isabella Bracchi, Juliana Morais, João Almeida Coelho, Ana Filipa Ferreira, Inês Alves, Cláudia Mendes, Beatriz Correia, Alexandre Gonçalves, João Tiago Guimarães, Inês Falcão Pires, Elisa Keating, Rita Negrão
    Biology.2024; 13(3): 163.     CrossRef
  • Re‐evaluation of erythritol (E 968) as a food additive
    Maged Younes, Gabriele Aquilina, Laurence Castle, Gisela Degen, Karl‐Heinz Engel, Paul J. Fowler, Maria José Frutos Fernandez, Peter Fürst, Ursula Gundert‐Remy, Rainer Gürtler, Trine Husøy, Melania Manco, Wim Mennes, Peter Moldeus, Sabina Passamonti, Romi
    EFSA Journal.2023;[Epub]     CrossRef
  • Sugar-Free Dark Chocolate Consumption Results in Lower Blood Glucose in Adults With Diabetes
    Barbara Oliveira, Kaja Falkenhain, Jonathan P Little
    Nutrition and Metabolic Insights.2022; 15: 117863882210769.     CrossRef
  • Acute responses of stevia and d-tagatose intake on metabolic parameters and appetite/satiety in insulin resistance
    Verónica Sambra, Isabella A. Vicuña, Kathleen M. Priken, Selva L. Luna, Daniela A. Allendes, Paula M. Godoy, Victoria Novik, Claudia A. Vega
    Clinical Nutrition ESPEN.2022; 49: 217.     CrossRef
  • Modulating effects of steviol and steviol glycosides on adipogenesis, lipogenesis, glucose uptake and insulin resistance in 3T3-L1 adipocyte model
    Jakub Michał Kurek, Joanna Zielińska-Wasielica, Katarzyna Kowalska, Zbigniew Krejpcio, Anna Olejnik
    Journal of Functional Foods.2022; 94: 105141.     CrossRef
  • Stevia, sucralose and sucrose added to a maqui-Citrus beverage and their effects on glycemic response in overweight subjects: A randomized clinical trial
    Débora Villaño, Hedyeh Masoodi, Javier Marhuenda, Cristina García-Viguera, Pilar Zafrilla
    LWT.2021; 144: 111173.     CrossRef
  • Low-energy sweeteners and body weight: a citation network analysis
    Mie Normand, Christian Ritz, David Mela, Anne Raben
    BMJ Nutrition, Prevention & Health.2021; 4(1): 319.     CrossRef
  • Diabetes and COVID-19, potentialities of Morus alba L. (mulberry) and Stevia rebaudiana Bertoni (stevia). Mini-review
    Hernandez Claudia Chavez, Payrol Juan Abreu, Laime Sirley Gonzalez, Garcia Ariel Martinez, Michel Lazaro, Legarreta Morera, Perez Marisol Gonzalez
    Global Journal of Rare Diseases.2021; : 006.     CrossRef
  • Evaluation of minor steviol glycosides effect on insulin resistance, serum triglycerides, and antioxidant capacity of diabetised Wistar rats
    Carolina Díaz Canul, Fibi Yenisie Coop Gamas, María Luisa Ávila Escalante, David Betancur-Ancona, Irma Aranda-González
    International Food Research Journal.2021; 28(2): 342.     CrossRef
  • Effects of the Daily Consumption of Stevia on Glucose Homeostasis, Body Weight, and Energy Intake: A Randomised Open-Label 12-Week Trial in Healthy Adults
    Nikoleta S. Stamataki, Benjamin Crooks, Abubaker Ahmed, John T. McLaughlin
    Nutrients.2020; 12(10): 3049.     CrossRef
  • Safety of a proposed amendment of the specifications for steviol glycosides (E 960) as a food additive: to expand the list of steviol glycosides to all those identified in the leaves of Stevia Rebaudiana Bertoni
    Maged Younes, Gabriele Aquilina, Karl‐Heinz Engel, Paul Fowler, Maria Jose Frutos Fernandez, Peter Fürst, Rainer Gürtler, Ursula Gundert‐Remy, Trine Husøy, Melania Manco, Wim Mennes, Peter Moldeus, Sabina Passamonti, Romina Shah, Ine Waalkens‐Berendsen, D
    EFSA Journal.2020;[Epub]     CrossRef
  • A comparison of the effects of Stevia extract and metformin on metabolic syndrome indices in rats fed with a high‐fat, high‐sucrose diet
    Tahereh Ranjbar, Ali Akbar Nekooeian, Nader Tanideh, Omid Koohi‐Hosseinabadi, Seyed Jalil Masoumi, Sasan Amanat, Negar Azarpira, Ahmad Monabati
    Journal of Food Biochemistry.2020;[Epub]     CrossRef
  • The effect of a new mixture of sugar and sugar-alcohols compared to sucrose and glucose on blood glucose increase and the possible adverse reactions: A phase I double-blind, three-way randomized cross-over clinical trial
    Mohammad Ali Mohsenpour, Fatemeh Kaseb, Reza Nazemian, Hassan Mozaffari-Khosravi, Hossein Fallahzadeh, Amin Salehi-Abargouei
    Endocrinología, Diabetes y Nutrición.2019; 66(10): 647.     CrossRef
  • Effect of Steviol Glycosides on Human Health with Emphasis on Type 2 Diabetic Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
    Bundgaard Anker, Rafiq, Jeppesen
    Nutrients.2019; 11(9): 1965.     CrossRef
  • The effect of a new mixture of sugar and sugar-alcohols compared to sucrose and glucose on blood glucose increase and the possible adverse reactions: A phase I double-blind, three-way randomized cross-over clinical trial
    Mohammad Ali Mohsenpour, Fatemeh Kaseb, Reza Nazemian, Hassan Mozaffari-Khosravi, Hossein Fallahzadeh, Amin Salehi-Abargouei
    Endocrinología, Diabetes y Nutrición (English ed.).2019; 66(10): 647.     CrossRef
  • Non-nutritive Sweeteners and Glycaemic Control
    Yoona Kim, Jennifer B. Keogh, Peter M. Clifton
    Current Atherosclerosis Reports.2019;[Epub]     CrossRef
  • FDA regulatory approach to steviol glycosides
    Judith D. Perrier, Jeremy J. Mihalov, Susan J. Carlson
    Food and Chemical Toxicology.2018; 122: 132.     CrossRef
  • Health outcomes of non-nutritive sweeteners: analysis of the research landscape
    Szimonetta Lohner, Ingrid Toews, Joerg J. Meerpohl
    Nutrition Journal.2017;[Epub]     CrossRef
  • Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults
    Katie C. Hootman, Jean-Pierre Trezzi, Lisa Kraemer, Lindsay S. Burwell, Xiangyi Dong, Kristin A. Guertin, Christian Jaeger, Patrick J. Stover, Karsten Hiller, Patricia A. Cassano
    Proceedings of the National Academy of Sciences.2017;[Epub]     CrossRef
Case Report
Maintenance of Insulin Therapy by Desensitization in Insulin Allergy Patient.
Jun Hwa Hong, Ji Hye Lee, Jong Ho Shin, Dong Pil Kim, Bong Suk Ko, Byung Joon Kim, Hyun Jin Kim, Kang Seo Park
Korean Diabetes J. 2008;32(6):529-531.   Published online December 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.6.529
  • 2,237 View
  • 26 Download
  • 4 Crossref
AbstractAbstract PDF
Allergic reaction to human insulin is uncommon. But they can cause mild to severe symptoms such as dyspnea, hypotensive shock, etc. Here we report the case of a patient with type 2 diabetes and insulin allergy successfully managed with desensitization. A 60-year-old man with insulin allergy was transferred. He had poorly controlled type 2 diabetes (fasting blood glucose 230 mg/dL). He developed itching sense and erythema at the injection sites of human insulin in a few minutes. And serum IgE level was elevated to 1618.0 IU/mL. The insulin was changed to other preparations, including short and long-acting insulin analogues, with similar responses. He was commenced on twice a day injection protocol in addition to his oral hypoglycemic agents, and achieved fair control (fasting blood glucose 100 mg/dL) on 24 units of Novomix Flex Pen per day, with little or no skin or systemic reaction. This is the case report of insulin allergy in type 2 diabetes being successfully managed by desensitization.

Citations

Citations to this article as recorded by  
  • Allergic reaction to recombinant human insulin
    Seong Jin Choi, Min Kwan Kwon, Moon Park, Soo Ya Bae, Hyun Ho Oh, Jong Ho Lee, Ji In Moon, Chan Sun Park, Jong Chul Won, Kyung Soo Ko, Byoung Doo Rhee, Jung Min Kim
    Allergy, Asthma & Respiratory Disease.2015; 3(4): 302.     CrossRef
  • Two Cases of Allergy to Insulin in Gestational Diabetes
    Gi Jun Kim, Shin Bum Kim, Seong Il Jo, Jin Kyeong Shin, Hee Sun Kwon, Heekyung Jeong, Jang Won Son, Seong Su Lee, Sung Rae Kim, Byung Kee Kim, Soon Jib Yoo
    Endocrinology and Metabolism.2015; 30(3): 402.     CrossRef
  • Successful Management of Insulin Allergy and Autoimmune Polyendocrine Syndrome Type 4 with Desensitization Therapy and Glucocorticoid Treatment: A Case Report and Review of the Literature
    Joselyn Rojas, Marjorie Villalobos, María Sofía Martínez, Mervin Chávez-Castillo, Wheeler Torres, José Carlos Mejías, Edgar Miquilena, Valmore Bermúdez
    Case Reports in Immunology.2014; 2014: 1.     CrossRef
  • Clinical applications of drug desensitization in the Asia-Pacific region
    Bernard Yu-Hor Thong
    Asia Pacific Allergy.2011; 1(1): 2.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal