EFFECT OF LACTULOSE ON CARBOHYDRATE-METABOLISM AND DIABETES-MELLITUS

Background: Unabsorbable disaccharides, by reducing transit time and p ossibly glucose absorption, are expected to affect carbohydrate metabo lism. Aim: To test the effects of a preparation containing fibre and l actulose in the form of biscuits on glucose and insulin levels in obes ity. Methods: In 10 obese patients glucose and insulin were measured i n the fasting state and in response to a meal during two consecutive d ays on a strictly controlled diet; on one day a total of 11 biscuits ( 10 g dietary fibre, 2 g raw fibre + 8.2 g lactulose) were randomly sub stituted for an equicaloric part of a diet. Results: Glucose and insul in in response to breakfast and to lunch were blunted by dietary fibre and lactulose, without any trend towards post-meal hypoglycaemia. Ave rage day-time glucose decreased by 0.53 +/- SD 0.28 mmol/L, and insuli n by 74.6 +/- 45.2 pmol/L. Plasma amino acids were higher during suppl ementation, ruling out malabsorption as a cause of glucose flattening. Conclusion: Because of the rationale of the preparation, good complia nce of patients: and significant results in short-term experiments, th e association of fibre and lactulose deserves more careful evaluation in long-term clinical studies.