Effect of lactulose on carbohydrate metabolism and diabetes mellitus.
Unabsorbable disaccharides, by reducing transit time and possibly glucose absorption, are expected to affect carbohydrate metabolism.



To test the effects of a preparation containing fibre and lactulose in the form of biscuits on glucose and insulin levels in obesity.



In 10 obese patients glucose and insulin were measured in the fasting state and in response to a meal during two consecutive days on a strictly controlled diet; on one day a total of 11 biscuits (10 g dietary fibre, 2 g raw fibre +8.2 g lactulose) were randomly substituted for an equicaloric part of a diet.



Glucose and insulin in response to breakfast and to lunch were blunted by dietary fibre and lactulose, without any trend towards post-meal hypoglycaemia. Average day-time glucose decreased by 0.53 +/- SD 0.28 mmol/L, and insulin by 74.6 +/- 45.2 pmol/L. Plasma amino acids were higher during supplementation, ruling out malabsorption as a cause of glucose flattening.



Because of the rationale of the preparation, good compliance of patients, and significant results in short-term experiments, the association of fibre and lactulose deserves more careful evaluation in long-term clinical studies.
Bianchi
G
G
Institute of Internal Medicine, University of Bologna, Italy.
Ronchi
M
M
Marchesini
G
G
D001786:Blood Glucose / Q000378:metabolism; D018592:Cross-Over Studies; D003920:Diabetes Mellitus / Q000178:diet therapy*; D004040:Dietary Carbohydrates / Q000378:metabolism*; D004043:Dietary Fiber / Q000494:pharmacology*; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007792:Lactulose / Q000494:pharmacology*; D009765:Obesity / Q000178:diet therapy*
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004043:Dietary Fiber; D005765:Gastrointestinal Agents; D007328:Insulin; D007792:Lactulose