Effects of Sucralose on Insulin Secretion, GLP-1 Release and Gut Microbiota in Healthy Subjects: A Randomized Double-Blind, Placebo Controlled Trial

Presentation Number: SUN 580
Date of Presentation: April 2nd, 2017

Amornpan Lertrit*1, Sasinee Srimachai1, Sunee Saetung2, Suwannee Chanprasertyothin1, La-or Chailurkit1, Chatvara Areevut1, Pornalat Katekao1, Boonsong Ongphiphadhanakul1 and Chutintorn Sriphrapradang1
1Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 2Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Abstract

Background: Artificial sweeteners are among the most extensively used food additives worldwide. Artificial sweetener consumption is considered safe and beneficial due to their low calories. Sucralose is one of the popular artificial sweeteners due to the taste and stability. However, many emerging evidences showed that artificial sweeteners might induce glucose intolerance.

Objective: The objective of this study was to determine the effects of sucralose on glycemic response, insulin secretion, insulin sensitivity, GLP-1 release and gut microbiota in healthy subjects using randomized, double-blind crossover study.

Methods: Healthy volunteers who did not use artificial sweeteners and had normal oral glucose tolerance test (OGTT) were recruited in this study. Subjects underwent a 75-g OGTT on two separated occasions, preceded by consuming pills containing either 200 mg sucralose (equivalent to diet soda 3 cans) or placebo for 4 weeks in a randomized crossover design. Blood samples were obtained for glucose, insulin and active GLP-1 levels at 0, 30, 60, 90 and 120 minutes after ingesting 75 g glucose. On the following day, intravenous glucose tolerance test (IVGTT) with insulin levels measured at 0, 2, 3, 4, 5, 6, 8 and 10 minutes was performed to evaluate the acute insulin response.

Results: Fifteen participants (11 females and 4 males, mean age 31.9 ± 10 years and body mass index 23.1 ± 3 kg/m2) participated in the study. The acute insulin response derived from IVGTT was lower in sucralose than placebo (58.9 ± 48.61 vs 69.94 ± 28.05 μU/ml, < 0.001). The whole-body insulin sensitivity derived from the OGTT, estimated using Matsuda index, was lower in sucralose than placebo (4.69 ± 1.67 vs 5.31 ± 2.56, p < 0.001). The area under the curve (AUC) of insulin and active GLP-1 were significantly higher in the sucralose than placebo (insulin, 151.88 ± 136.94 vs 131.66 ± 43.74 μU/ml·120 min, p < 0.001 and GLP-1, 22.95 ± 18.98 vs 18.5 ± 22.22 pmol/L·120min, p < 0.001). In addition, there were alterations in gut microbiota composition after consumed sucralose for 4 weeks.

Conclusions: This study demonstrated that consumption of sucralose 200 mg daily for 4 weeks reduced acute insulin response, decreased insulin sensitivity and enhanced GLP-1 release in normal glucose tolerant subjects, along with alterations in the composition of gut microbiota. However, clinical significance of these results needed to be determined in the longer follow-up study.

 

Nothing to Disclose: AL, SS, SS, SC, LOC, CA, PK, BO, CS