A crossover trial of high and low sucrose-carbohydrate diets in type II diabetics with hypertriglyceridemia.

Abstract

Earlier work shows that hyperlipemic type II diabetics tolerate wide ranges of sucrose and carbohydrate intake without effects on glycemic control, but a rise of fasting serum triglycerides sometimes occurs. To address further the issue of individual susceptibility to carbohydrate, the current study was designed to use each patient as his own control when given diets widely varying in sucrose content. After a stabilization period in the hospital on a normal sucrose content diet, each subject was given either a very low sucrose (less than 3 gm/day)-low carbohydrate (38 +/- 2%) diet or a high sucrose (220 gm)-high carbohydrate (63 +/- 3%) diet for 4 weeks. On a separate admission the opposite diet was assessed, again after an initial normal sucrose content diet. No consistent differences occurred in serum glucose levels or in 24-hr urinary glycosuria. High sucrose-carbohydrate intake raised fasting hypertriglyceridemia after 2 weeks but less thereafter. Severe sucrose-carbohydrate restriction did not significantly decrease fasting serum triglycerides; postprandial triglycerides changed in a trend opposite to fasting levels. No differences occurred in fasting serum insulin or serum cholesterol levels, but postprandial insulin levels were higher in high sucrose-carbohydrate diets. A diet with low sucrose and low total carbohydrate appears to offer no improvement in glycemic control over at least 70-fold higher dietary sucrose levels. However, high sucrose and carbohydrate diets increase fasting triglyceride levels in hypertriglyceridemic type II diabetics.

Teaching Subjects With Type 2 Diabetes How to Incorporate Sugar Choices Into Their Daily Meal Plan Promotes Dietary Compliance and Does Not Deteriorate Metabolic Profile

“…However, current scientific literature suggests that consuming a moderate amount of dietary sucrosewithin a balanced meal-has an effect similar to starch on the glycemic level of patients with type 1 or type 2 diabetes (1). These studies were conducted in controlled environments where as much as 38% of calories were given as sucrose either alone or in mixed meals (2)(3)(4)(5)(6)(7)(8). In contrast, Coulston et al (5,6) found that diets containing 10 and 16% of total energy as sucrose resulted in a rise in fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TGs), and a reduction in HDL cholesterol.…”

Effects of Sucrose on Carbohydrate and Lipid Metabolism in NIDDM Patients

“…In contrast with these studies, there are five reports that suggest that increased dietary sucrose consumption over a period of 8 days to 6 wk did not result in adverse metabolic effects (21)(22)(23)(24)(25). In one of these studies the authors reported no significant metabolic effects of replacing 45 g of complex carbohydrate with an equal amount of sucrose (21).…”

“…Unfortunately, the effects of this difference in baseline values on the glycemic response is difficult to evaluate. More important, fasting hypertriglyceridemia was noted in both of these studies after the high-sucrose diet (23,24). Thus, there appears to be only a single well-controlled metabolic study on patients with diabetes conducted over an 8-day period in which the authors reported no significant differences in metabolic control as a result of increased dietary sucrose (25).…”

“…In two other studies, the nature of the experimental design made actual comparisons between the sucroseadded and sucrose-restricted diets difficult (23,24). Specifically, in one of these studies the two dietary periods used were ~11 mo apart, and the degree of metabolic control in these individuals before the experimental diets differed between the two periods (24).…”

“…Specifically, in one of these studies the two dietary periods used were ~11 mo apart, and the degree of metabolic control in these individuals before the experimental diets differed between the two periods (24). For example, mean ± SE fasting plasma glucose concentration was 187 ± 25 mg/dl before the low-sucrose diet and 237 ± 26 mg/dl before the high-sucrose diet.…”