SORBITOL MALABSORPTION AND NONSPECIFIC ABDOMINAL SYMPTOMS IN TYPE-II DIABETES

Some data suggest that sorbitol intake may be responsible for diarrhea in diabetic patients. One hundred thirteen hydrogen breath tests were performed in type II diabetics (72) and normal controls (41) after or al loads of sorbitol ranging from 2.5 to 20 g in iso-osmolar solutions to assess the role of malabsorption of this compound in the genesis o f abdominal symptoms. The prevalence of sorbitol malabsorption and abd ominal symptoms, peak (Cmax H-2) and total (Ctot H-2) hydrogen product ion, and mouth to cecum transit time (MCTT) did not differ in type II diabetics and controls. Malabsorption was observed more frequently wit h the highest doses of sorbitol (10% of patients at a dose of 2.5 g an d similar to 75% at 20 g). Symptoms, usually consisting of mild discom fort and abdominal distension. were observed only after sorbitol loads of 10 and 20 g in 27.2% of the diabetics and in 36.3% of the controls . Diarrhea was present in three subjects (two diabetics and one contro l) only at a dose of 20 g. These data indicate that it is highly unlik ely for sorbitol to play a role in inducing diabetes diarrhea. A moder ate (up to 10 g) sorbitol intake is not contraindicated in type II dia betics. Copyright (C) 1995 by W.B. Saunders Company