Effect of Isomaltulose on Glycemic and Insulinemic Responses: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: United States NLM ID: 101540874 Publication Model: Print Cited Medium: Internet ISSN: 2156-5376 (Electronic) Linking ISSN: 21618313 NLM ISO Abbreviation: Adv Nutr Subsets: MEDLINE
    • Publication Information:
      Publication: 2023- : [New York, NY] : Elsevier
      Original Publication: Bethesda, MD : American Society for Nutrition
    • Subject Terms:
      Diabetes Mellitus, Type 2* ; Glucose Intolerance* ; Hypertension*; Adult ; Aged ; Blood Glucose/analysis ; Glucose ; Humans ; Insulin ; Isomaltose/analogs & derivatives ; Randomized Controlled Trials as Topic ; Sucrose ; Water
    • Abstract:
      Evidence regarding the effect of isomaltulose on glycemic and insulinemic responses is still conflicting, which limits isomaltulose's application in glycemic management. The purpose of this study was to comprehensively evaluate its effectiveness and evidence quality. We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) prior to October 2021. RCTs were eligible for inclusion if they enrolled adults to oral intake of isomaltulose or other carbohydrates dissolved in water after an overnight fast and compared their 2-h postprandial glucose and insulin concentrations. The DerSimonian-Laird method was used to pool the means of the circulating glucose and insulin concentrations. Both random-effects and fixed-effects models were used to calculate the weighted mean difference in postprandial glucose and insulin concentrations in different groups. Subgroup, sensitivity, and meta-regression analyses were also conducted. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the certainty of evidence. Finally, 11 RCTs (n = 175 participants) were included. The trials were conducted in 4 countries (Japan, Brazil, Germany, and the Netherlands), and all of the enrolled participants were >18 y of age with various health statuses (healthy, type 2 diabetes, impaired glucose tolerance, and hypertension). Moderate evidence suggested that oral isomaltulose caused an attenuated glycemic response compared with sucrose at 30 min. Low evidence suggested that oral isomaltulose caused an attenuated but more prolonged glycemic response than sucrose and an attenuated insulinemic response. Low-to-moderate levels of evidence suggest there may be more benefit of isomaltulose for people with type 2 diabetes, impaired glucose tolerance, or hypertension; older people; overweight or obese people; and Asian people. The study was registered on PROSPERO (International Prospective Register of Systematic Reviews) as CRD42021290396 (available at https://www.crd.york.ac.uk/prospero/).
      (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.)
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    • Contributed Indexing:
      Keywords: diabetes; glycemic and insulinemic response; isomaltulose; palatinose; systematic review and meta-analysis
    • Accession Number:
      0 (Blood Glucose)
      0 (Insulin)
      059QF0KO0R (Water)
      57-50-1 (Sucrose)
      67I334IX2M (Isomaltose)
      IY9XDZ35W2 (Glucose)
      V59P50X4UY (isomaltulose)
    • Publication Date:
      Date Created: 20220520 Date Completed: 20221004 Latest Revision: 20230629
    • Publication Date:
      20231215
    • Accession Number:
      PMC9526864
    • Accession Number:
      10.1093/advances/nmac057
    • Accession Number:
      35595510