When blood sugar levels rise
It’s a slow and gradual transition from healthy blood sugar regulation with insulin to a state of reduced insulin sensitivity, i.e. where the body shows a weaker response to insulin and blood sugar levels are raised (prediabetic state). Without diet and lifestyle changes, such conditions are likely to progress further towards the manifestation of insulin resistance and diabetes mellitus. Diabetic disturbances in glucose and insulin metabolism are linked with further metabolic disorders such as overweight and abdominal fat distribution, disturbed lipid metabolism and cardiovascular diseases as well as raised blood pressure and hypertension. It is known as the ‘metabolic syndrome’ or ‘syndrome X’ (Figure 1), and affects large parts of the population today in association with modern dietary habits and a more sedentary lifestyle.
Diet and lifestyle changes are key
People are more likely to experience reduced insulin sensitivity and develop a metabolic syndrome at conditions of overweight, advanced age, poor diet and excess calories or poor nutrition, lack of physical activity, smoking and such conditions in family history (IDF 2017). While people with prediabetic conditions have a high risk of developing type 2 diabetes, not everyone does. Lifestyle interventions show effectiveness in preventing the progression of prediabetes into diabetes (IDF 2017). Weight loss, increased physical activity and dietary changes towards a healthy diet are key.
Looking at dietary changes, carbohydrate quality and blood sugar management play a key role. Carbohydrates represent the largest source of daily energy intake. Giving preference to those that help reducing blood glucose fluctuations and insulin demand in context with a carbohydrate-based diet supports metabolic regulation and helps in the prevention of diabetes mellitus, coronary heart disease, and probably also weight management on a long-term perspective (Augustin et al 2015).
Improving blood sugar levels and metabolic health with isomaltulose
The slow release carbohydrate isomaltulose can help to lower the blood glucose response to meals and promote fat burning, when being consumed in place of higher glycaemic carbohydrates. The findings of König et al (2012) illustrate this for overweight to obese adults with the metabolic syndrome and insulin resistance, i.e. those at risk of developing type 2 diabetes mellitus. When the participants of this study consumed foods and drinks sweetened with isomaltulose instead of a sucrose/glucose syrup blend as high glycaemic reference for breakfast and lunch, the isomaltulose-containing breakfast lead to a significantly lower blood glucose response and a lower insulin release in comparison with the breakfast containing high glycaemic sugars. Also significantly higher fat burning was observed with isomaltulose in association with the better metabolic profile after the meals in this population group.
Further studies in overweight and obese adults with impaired glucose tolerance (van Can et al 2012) and diabetic persons predominantly treated by diet alone (Kawai et al, 1989) confirm the lower effect of isomaltulose on blood glucose and insulin concentrations for these population groups.
In the long-term, when eating a diet including isomaltulose in place of sucrose and other carbohydrates enables the glycemic profile of foods to be reduced. Beneficial outcomes for weight management, blood glucose control and cardiovascular risk factors have been reported (Figure 2):
Body weight and insulin resistance: Benefits of isomaltulose for body composition and body weight goals, with less abdominal fat storage and insulin resistance have been demonstrated. The link of liver fat and insulin sensitivity has been addressed in research of Keyhani-Nejad et al (2015), suggesting potential of isomaltulose as a nutritional strategy in the prevention of fatty liver and insulin resistance, independent of obesity: Feeding isomaltulose instead of sucrose for 22 weeks prevented the development of a non-alcoholic fatty liver and improved glucose tolerance in rats. Comparisons in normal rats and those lacking the GIP receptor illustrated that the incretin hormone GIP plays a key role in the fatty liver development. Unlike sucrose, isomaltulose has a low effect on GIP release (Maeda et al 2013, Ang and Linn 2014, Keyhani-Nejad et al 2016).
Blood glucose control: Several studies show improvements in blood glucose control and lipid metabolism upon regular consumption of isomaltulose when compared with other carbohydrates such as sucrose, maltodextrin, or glucose. Reductions in fasting blood glucose and improvements in insulin resistance (HOMA-IR) in healthy persons or those with poor insulin sensitivity have been observed as well as reductions in fasting triglyceride levels (e.g. Oizumi et al 2007, Yamori et al 2007, Okuno et al 2010, Sakuma et al 2009, Fujiwara et al 2007, Brunner et al 2012, Keller et al 2016).
Lipid metabolism and cardiovascular risk: Research in people with impaired glucose tolerance, diabetes mellitus and/or impaired lipid metabolism demonstrates that isomaltulose does not have any adverse effects on blood lipids (including total cholesterol and LDL-cholesterol) or cardiovascular risk markers (e.g. Holub et al 2010, Brunner et al 2012, Oizumi et al 2007). Emerging science proposes that isomaltulose may even have positive effects on arterial stiffness: Keller et al (2016) observed a prolonged arterial relaxation and higher GLP-1 section after one week of low physical activity and the consumption of isomaltulose-sweetened beverages instead of high-GI beverages with maltodextrin and sucrose. And also the decline in insulin sensitivity, that was observed during this one week of physical inactivity, was significantly less with isomaltulose drinks in comparison with the high GI beverages.
The type of carbohydrate can make a difference.
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