Dietary fructose as a natural sweetener in poorly controlled type 2 diabetes: a 12-month crossover study of effects on glucose, lipoprotein and apolipoprotein metabolism.
The metabolic effects of fructose incorporated in the normal diets of 13 poorly controlled, Type 2 diabetic patients were studied in a 6-month, randomized, crossover study. Patients used 60 g day-1 of crystalline fructose in divided amounts as part of their isocaloric (1400-3900 kcal), weight-maintaining diet. During fructose supplementation, the distribution of carbohydrate-derived calories was 35% complex and 15% simple, the latter solely from fructose. This was compared with the patients' values on their usual diabetic diet (carbohydrate 50% (mostly complex), fat 38%, and protein 12%). After 6 months of taking fructose, fasting serum glucose decreased from 12.6 +/- 1.1 (+/- SE) to 9.8 +/- 1.3 mmol l-1 (p less than 0.02), while it was unchanged on normal diet (11.0 +/- 0.1 vs 11.6 +/- 0.9 mmol l-1, NS). Glycosylated haemoglobin was also reduced from 11.3 +/- 0.4 to 9.9 +/- 0.5% (p less than 0.05) on fructose, but unchanged on the control diet (10.4 +/- 0.7 vs 11.2 +/- 0.7%, NS). No significant long-term deleterious changes were observed in the fasting serum lipids, lipoproteins, and apolipoproteins A-1 and B-100. Fructose was well tolerated without significant effects on body weight, or lactic acid and uric acid levels.
Osei
K
K
Department of Internal Medicine, Ohio State University Hospitals, Columbus.
Bossetti
B
B
D016632:Apolipoprotein A-I; D001054:Apolipoproteins A / Q000097:blood*; D001055:Apolipoproteins B / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003927:Diet, Diabetic; D004040:Dietary Carbohydrates; D005260:Female; D005632:Fructose; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013549:Sweetening Agents; D014280:Triglycerides / Q000097:blood
D016632:Apolipoprotein A-I; D001054:Apolipoproteins A; D001055:Apolipoproteins B; D001786:Blood Glucose; D002784:Cholesterol; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004040:Dietary Carbohydrates; D005632:Fructose; D006442:Glycated Hemoglobin; D008075:Lipoproteins, HDL; D013549:Sweetening Agents; D014280:Triglycerides