Effects of Sucrose on Carbohydrate and Lipid Metabolism in NIDDM Patients

Abstract

Recently, there has been increasing interest toward the liberalization of sucrose in the diets of individuals with non-insulin-dependent diabetes mellitus (NIDDM).However, there is evidence from several well-controlled prospective studies demonstrating that the consumption of moderate amounts of sucrose may result in hyperglycemia, hyperinsulinemia, hypertriglyceridemia, hypercholesterolemia, and reduced high-density lipoprotein cholesterol concentrations. The fact that not all studies demonstrate these deleterious effects does not negate the positive data. The magnitude of the deleterious effects will probably vary with individual patients, baseline status, and amount of sucrose. Because these metabolic abnormalities are most disturbed in diabetes and are associated with increased risk of coronary artery disease, it would seem reasonable to continue to advise patients with NIDDM to limit sucrose consumption, at least until available data would allow us to predict in which individuals and at what level of sucrose consumption these adverse metabolic effects would not be present. Diabetes Care 12:62-66, 1989 T here is general agreement that diet should serve as the cornerstone of any therapeutic program for the treatment of diabetes. Understanding the impact of variations in diet composition on the metabolic defects present in diabetes, however, is far from clear. This is particularly true in regard to what impact sucrose may have in controlling the abnormalities in carbohydrate and lipid metabolism present in diabetes. As interest in the dietary management of diabetes has intensified, attention has been directed toward the potential role that specific dietary manipulations might have in reducing the increased risk of coronary artery disease (CAD) associated with diabetes. In this regard, the issue of dietary sucrose must assume a prominent role in the discussion of the dietary treatment of diabetes. Recent statements from both the American Diabetes Association (1) and Food and Drug Administration (2) suggest there may be no adverse health effects associated with increased sucrose consumption in patients with diabetes. On the other hand, there is evidence from several wellcontrolled prospective studies suggesting that the consumption of moderate amounts of sucrose may result in a series of deleterious metabolic effects that are associated with an increased risk for the development of CAD (3-10). Specifically, studies have shown that the addition of moderate amounts of sucrose are associated with hyperglycemia, hyperinsulinemia, hypertriglyceridemia, hypercholesterolemia, and reduced high-density lipoprotein cholesterol (HDL-chol) concentrations. These metabolic abnormalities are most disturbed in diabetes (17,18 ,31,32) and are associated with the increased risk of CAD (30-34); therefore, it would seem reasonable to question the general recommendation liberalizing sucrose consumption in these individuals. In this article, we discuss the evidence from our group and others designed to assess the metabolic impact of...

Difference in dietary intake between women with polycystic ovary syndrome and healthy controls

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Telematic expert system Diabeto: New Tool for Diet Self-Monitoring for Diabetic Patients

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Prevalence of daily hyperglycemia in obese type 2 diabetic men compared with that in lean and obese normoglycemic men: effect of consumption of a sucrose-containing beverage

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