Background: A new sweetener with the commercial name of Lacritose has been recently produced, which is a combination of four simple sugars (lactose, fructose, sucrose, erythritol), with specific ingredients and percentages. This study aimed to assess glycemic response and short term gastrointestinal reactions in type 2 diabetic patients. Methods: In this triple-blind randomized clinical trial, 30 diabetic patients referred to Yazd Diabetes Research Center in 2018 were included. After collecting the primary data, they were assigned into three groups, including sucrose consumers as the control group, sucrose-lactose, and lacritose as the groups of consumers group. They were followed for two weeks, and fasting blood glucose (FBG), 2-hour postprandial test (2HPP), fructose amine, SGOT, SGPT, urea, creatinine, and insulin resistance index (HOMA-IR) were assessed. Results: In lacritose consumers, significant reductions were seen in FBG and 2HPP (P < 0.001 and P = 0.05, respectively), although changes among the groups were not significant. In sucrose-lacritose consumers, FBG and cholesterol levels decreased (P = 0.04 and P = 0.03, respectively). In sucrose consumers, no reduction was seen. HOMA-IR did not significantly decrease, but intergroup changes were obvious. Conclusion: The lacritose effects on FBG and 2HPP were significantly evident, but the other metabolic indices did not show any significant change.

Background: Type 2 diabetes (T2D) is a progressive disease that should be managed with insulin in case of oral glucose lowering drugs (OGLDs) failure. If basal insulin is not sufficient, rapid acting insulin will be added before the largest meal. We assessed the impact of adding one prandial insulin to a basal based regimen and insulin glargine in patients with type 2 diabetes to measure the percentage of subjects achieving the HbA1c target by the end of 24 weeks of treatment in routine clinical practice. Methods: This study was a 24-week observational study of patients with T2D not adequately controlled with OGLDs and basal insulin, for whom the physician had decided to initiate prandial insulin. The study endpoint was assessed at visit 1 (baseline), visit 2 at week 12 (±1 week) and visit 3 at week 24 (±1 week). The percentage of patients who achieved HbA1c targets was assessed at week 24. Statistical analyses were performed using IBM SPSS for Windows v 19 (IBM, Armonk, New York, USA). Logistic regression analysis was used to detect predicting factors of achieving the HbA1c target by week 24. P<0.05 was considered as significant level. Results : Four hundred and eighteen patients with a mean±SD age of 56.24±9.85 years and a mean±SD duration of diabetes of 12.50±7.16 years were included. The median total daily dose of basal insulin was 24 units, while prandial insulin was started with 6 (4, 10) U/day, titrating up to 10 (8, 18) U/day at week 24. The daily dose of prandial insulin was the only factor that could significantly predict achieving targeted HbA1c by week 24 [OR: 1.04; 95% CI: 1.007,1.079; p-value: 0.019]. At week 24, 96 (22.9%) subjects achieved the HbA1c target with one prandial insulin. Conclusion : The results of our study suggest that “basal plus therapy” can lead to good glycemic control with a low risk of hypoglycemia and weight gain in patients with type 2 diabetes.