The effect of acute hyperglycaemia on appetite and food intake in Type 1 diabetes mellitus

Aims To determine the effects of acute hyperglycaemia on appetite and food intake in Type 1 diabetes mellitus. Methods Two separate studies, each involving eight adults with uncomplicate d Type 1 diabetes, were performed: one in the fasted state (A) and the othe r after a nutrient preload (B). In both studies, perceptions of appetite (h unger and fullness) and food intake at a buffet meal were evaluated during euglycaemia (blood glucose, similar to 6 mmol/l) and hyperglycaemia (blood glucose, similar to 14 mmol/l). Both experiments were randomized and single -blind. In study A, appetite was assessed in the fasted state for 90 min be fore the buffet meal. In study B, a nutrient 'preload' of Ensure (R) and mi lk containing C-13-octanoic acid was consumed 90 min before the meal. Gastr ic emptying of the preload was quantified with a radioisotopic breath test technique. Results There was no significant difference in plasma insulin concentration s between euglycaemia and hyperglycaemia in either study. In study A, there were no differences in hunger, fullness or energy intake between the two t reatment days. In study B, subjects were slightly less hungry between the p reload and buffet meal during hyperglycaemia than euglycaemia (P = 0.04), a nd tended to have slower gastric emptying during hyperglycaemia (emptying c oefficient, 3.89 +/- 0.16 vs. 3.57 +/- 0.21; P = 0.052), but there was no d ifference in food intake between hyperglycaemia and euglycaemia. Conclusions Acute hyperglycaemia suppresses hunger after a nutrient preload , but not in the fasted state, in patients with uncomplicated Type 1 diabet es. This effect is small and not associated with changes in food intake.