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.