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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
  • 5,109 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 Reports
A Case of Necrobiosis Lipoidica at the Insulin Injection Site in a Patient with Type 2 Diabetes Mellitus.
Woo Tae Kim, Tae Hoon Kim, Se Min Lee, Kang Hyun Choi, Seung Hyun Ko, Yu Bai Ahn, Ki Ho Song, Ho Young Son, Kyung Moon Kim, Si Young Kim
Korean Diabetes J. 2004;28(5):452-457.   Published online October 1, 2004
  • 1,100 View
  • 18 Download
AbstractAbstract PDF
Nearly one third of patients with diabetes mellitus have some kinds of dermatologic complication. Necrobiosis lipoidica (NL) is a rare degenerative disease of the collagen in the dermis occurring in 0.3~0.7% of the diabetic population. This is a dermatologic condition presenting plaques that have an erythematous, violaceous border and yellowish atrophic center with telangiectasis on its surface. One third of these lesions may progress to ulcer if exposed to any trauma. There is some controversy regarding the degree of association between NL and diabetes mellitus. Necrobiosis lipoidica is commonly seen in patients with type 1 diabetes, but 7~30% of diabetic patients with NL have type 2 diabetes. We report a case of 54 year-old woman with 25 years of diabetic history. Her skin lesion was oval or irregular indurated plaques with central atrophy occurring both arm, lower abdomen and both anterior thigh, especially at insulin injecton site. We focused glycemic control as a treatment and used antiplatelet agents such as aspirin and cilostazol on the basis of microangiopathic athophysiology, combined with antibiotics. We need to inspect more closely any of skin lesions in diabetic patients, thus misdiagnosis and improper treatment should be reduced.
A Case of Invasive Aspergillosis of the Nasal Septum in a Patient with Diabetes Mellitus.
Tae Hoon Kim, Ji Sung Yoon, Ji O Mok, Yeo Joo Kim, Hyeong Kyu Park, Chul Hee Kim, Sang Jin Kim, Dong Won Byun, Kyo Il Suh, Myung Hi Yoo, Jang Mook Kim, Yoon Jung Kim
Korean Diabetes J. 2003;27(4):373-378.   Published online August 1, 2003
  • 1,250 View
  • 16 Download
AbstractAbstract PDF
Invasive aspergillosis of the nasal cavity and paranasal sinuses is characterized by invasion and destruction of the bony sinus walls, the orbit, and other soft tissues of the face. It occurs particularly in patients with severe immune deficits, and less frequently in patients with diabetes mellitus. The therapeutic outcome of invasive aspergillosis is unsatisfactory. Mortality rates range from 50 to 80%, depending primarily on the underlying disease. In general, the prognosis depends on making a prompt diagnosis of infection and providing early treatment. However the diagnosis of invasive aspergillosis is difficult because there is no specific symptom, nor any rapid diagnostic method for confirmation. We report a case of a 64-year old woman with diabetes mellitus and invasive aspergillosis of the nasal septum. She was diagnosed by biopsy of the nasal septum and treated with systemic antifungal agent and surgical debridement. (Ed- paragraphs combined here) In conjunction with this case we review the previous literatures and suggest that prompt antifungal therapy with glycemic control is an important element in the treatment of invasive aspergillosis in a diabetic patient.

Diabetes Metab J : Diabetes & Metabolism Journal