Isomaltulose Enhances GLP-1 and PYY Secretion to a Mixed Meal in People With or Without Type 2 Diabetes as Compared to Saccharose

ScopeSecretion of the gut hormones glucagon-like peptide (GLP-1) and peptide YY (PYY) are induced by nutrients reaching the lower small intestine which regulate insulin and glucagon release, inhibit appetite, and may improve beta-cell regeneration. The aim is to test the effect of a slowly digested isomaltulose (ISO) compared to the rapidly digested saccharose (SAC) as a snack given 1 h before a standardized mixed meal test (MMT) on GLP-1, PYY, glucose-dependent insulinotropic peptide (GIP), and metabolic responses in participants with or without type 2 diabetes (T2DM).Methods and resultsFifteen healthy volunteers and 15 patients with T2DM consumed either 50 g ISO or SAC 1 h preload of MMT on nonconsecutive days. Clinical parameters and incretin hormones are measured throughout the whole course of MMT. Administration of 50 g ISO as compared to SAC induced a significant increase in GLP-1, GIP, and PYY responses over 2 h after intake of a typical lunch in healthy controls. Patients with T2DM showed reduced overall responses of GLP-1 and delayed insulin release compared to controls while ISO significantly enhanced the GIP and almost tripled the PYY response compared to SAC.ConclusionA snack containing ISO markedly enhances the release of the metabolically advantageous gut hormones PYY and GLP-1 and enhances GIP release in response to a subsequent complex meal. Incretin hormones (GLP-1,GIP and PYY) regulate insulin and glucagon secretion in response to nutrient intake. ISO enhanced GLP-1 and PYY release while SAC induced GIP secretion due to different absorption speed. ISO preload 1 h before a standardized meal enhanced PYY and GLP-1 release in patients with T2DM compared to healthy controls. GLP-1: glucagon-like peptide; GIP: glucose-dependent insulinotropic peptide; PYY: peptide YY; SAC:saccharose; ISO:isomaltulose; T2DM:type 2 diabetes. image