Isomaltulose – low blood glucose response scientifically established

Carbohydrates can largely differ in their effect on blood glucose levels. While readily digestible carbohydrates like cooked starch, maltodextrin and most sugars induce a high rise in blood sugar levels, the slow release carbohydrate isomaltulose has a low effect on blood sugar levels, yet it still provides the desired carbohydrate energy. The low glycemic properties of isomaltulose have been verified in a large body of research and confirmed for different population groups. With a GI of 32, tested at Sydney University, isomaltulose classifies as ‘low GI’ carbohydrate.

GI value tested
The Glycaemic Index (GI) is a tool to describe and compare carbohydrates regarding their effect on blood sugar levels. The Glycemic Index (GI) of isomaltulose has been determined at Sydney University, one of the leading research institutes in the field of blood glucose response testing and GI-related research. Following internationally recognized standard methodology, 10 healthy adults consumed 50 g isomaltulose dissolved in water after overnight fasting, and blood glucose and insulin concentrations were determined over a period of 120 minutes. The test was repeated with sucrose, and with glucose as reference carbohydrate on different test days.
A GI of 32 was determined for isomaltulose, in comparison with a GI of 68 for sucrose and a GI of 100 for glucose. Hence, isomaltulose is classified as a “low glycaemic” or “low GI” carbohydrate. The GI value of isomaltulose is listed in the GI database of Sydney University, one of the worldwide largest collection of GI and GL values of foods.

Low glycemic properties confirmed
The low glycemic properties of isomaltulose have been studied extensively. Data are available today from over 30 human intervention trials comparing the blood glucose response of isomaltulose with that of sucrose or other traditional readily available carbohydrates. The majority of the studies assessed the insulin response in parallel.
The blood glucose rise was consistently lower with isomaltulose in comparison with sucrose, maltodextrin or other references. Insulin concentrations were lower as well, where insulin was determined in parallel. The latter is an important aspect for the relevance of the lower blood glucose response to health, and must be demonstrated as well for a corresponding health claim in the EU. Accordingly, the low glycemic properties of isomaltulose and its potential to lower the glycaemic properties of foods when replacing other sugars has been acknowledged by regulatory bodies in the EU with a positive EFSA opinion issued in 2011, and the approval of a corresponding health claim in the Annex of Regulation (EU) 432/2012.

Blood glucose response studies have been conducted in leading test centers in different parts of the world including  Australia and North America, Europe and Asia. In addition to this evidence for the global population, the research group of Henry specifically addressed and confirmed the lower blood glucose response with isomaltulose versus sucrose for different ethnic groups (Tan et al 2017).

Verification for people with prediabetic and diabetic conditions
Lowering blood sugar levels is beneficial to overall health and hence equally important to all age groups as part of a healthy diet. Blood sugar management becomes even more important when rising blood sugar levels indicate a risk for metabolic diseases in a prediabetic state, and it becomes mandatory when people are diagnosed with diabetes mellitus. Research with isomaltulose has been conducted in all these population groups: Most studies address and confirm a lower blood glucose response of isomaltulose in the healthy population; see for instance the studies of SUGiRS 2002, Holub et al 2010, Maeda et al 2013, Henry et al 2017, Pfeiffer and Kehyni-Nejad 2018 and corresponding relevance for health conscious eaters. Evidence for people with health issues and the metabolic syndrome come for instance from studies by König et al 2012 or van Can et al 2012. Studies in people with diabetes mellitus include for instance those in Type 1 DM (West et al 2011) or Type 2 DM (Kawai et al 1989, Ang & Linn 2014, Pfeiffer Keyjani-Nejad et al 2016). The lower blood glucose response has also been linked with an improved metabolic profile and a higher fat ox with relevance for weight management, or with benefits in physical activity and sports.

References

Ang M, Linn T (2014) Comparison of the effects of slowly and rapidly absorbed carbohydrates on postprandial glucose metabolism in type 2 diabetes mellitus patients: a randomized trial. Am J Clin Nutr 100(4):1059–1068. https://doi.org/10.3945/ajcn.113.076638

Henry CJ, Kaur B, Quek RYC, Camps SG (2017) A Low Glycaemic Index Diet Incorporating Isomaltulose Is Associated with Lower Glycaemic Response and Variability, and Promotes Fat Oxidation in Asians. Nutrients 9(5). http://www.mdpi.com/2072-6643/9/5/473/htm

Holub I, Gostner A, Theis S, Nosek L, Kudlich T, Melcher R, Scheppach W (2010) Novel findings on the metabolic effects of the low glycaemic carbohydrate isomaltulose (Palatinose™). Br J Nutr 103(12):1730–1737. http://www.ncbi.nlm.nih.gov/pubmed/20211041

Kawai K, Yoshikawa H, Murayama Y, Okuda Y, Yamashita K (1989) Usefulness of palatinose as a caloric sweetener for diabetic patients. Horm Metab Res 21(6):338–340. http://www.ncbi.nlm.nih.gov/pubmed/2673967

Keyhani-Nejad F, Kemper M, Schueler R, Pivovarova O, Rudovich N, Pfeiffer AF (2016) Effects of Palatinose and Sucrose Intake on Glucose Metabolism and Incretin Secretion in Subjects With Type 2 Diabetes. Dia Care 39(3):e38-e39. http://www.ncbi.nlm.nih.gov/pubmed/26721819

Koenig D, Theis S, Kozianowski G, Berg A (2012) Postprandial substrate use in overweight subjects with the metabolic syndrome after isomaltulose (Palatinose™) ingestion. Nutrition 28(6):651–656. http://www.ncbi.nlm.nih.gov/pubmed/22264450

Maeda A, Miyagawa J, Miuchi M, Nagai E, Konishi K, Matsuo T, Tokuda M, Kusunoki Y, Ochi H, Murai K, Katsuno T, Hamaguchi T, Harano Y, Namba M (2013) Effects of the naturally-occurring disaccharides, palatinose and sucrose, on incretin secretion in healthy non-obese subjects. J Diabetes Investig. 4(3):281–286. http://www.ncbi.nlm.nih.gov/pubmed/24843667

Pfeiffer AFH, Keyhani-Nejad F (2018) High glycemic index metabolic damage – a pivotal role of GIP and GLP-1. Trends Endocrinol Metab 29(5):289-299. https://www.cell.com/trends/endocrinology-metabolism/fulltext/S1043-2760(18)30046-8

Sydney University’s Glycaemic Research Service (SUGiRS) (2002): See GI Database at www.glycemicindex.com

van Can JG, van Loon LJ, Brouns F, Blaak EE (2012) Reduced glycaemic and insulinaemic responses following trehalose and isomaltulose ingestion: implications for postprandial substrate use in impaired glucose-tolerant subjects. Br J Nutr 108(7):1210–1217. http://www.ncbi.nlm.nih.gov/pubmed/22172468

West DJ, Morton RD, Stephens JW, Bain SC, Kilduff LP, Luzio S, Still R, Bracken RM (2011) Isomaltulose improves postexercise glycemia by reducing CHO oxidation in T1DM. Med Sci Sports Exerc 43(2):204–210. http://journals.lww.com/acsm- msse/Fulltext/2011/02000/Isomaltulose_Improves_Postexercise_Glycemia_by.2.aspx