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Diabetes Care 24:1882-1887, 2001
© 2001 by the American Diabetes Association, Inc.

Clinical Care/Education/Nutrition
Original Article

Acute Fructose Administration Improves Oral Glucose Tolerance in Adults With Type 2 Diabetes

Mary Courtney Moore, PHD1, Stephen N. Davis, MD1,2,3, Stephnie L. Mann, BSN2 and Alan D. Cherrington, PHD1,2,3

1 Molecular Physiology and Biophysics and
2 Medicine and the
3 Diabetes Research and Training Center, Vanderbilt University, Nashville, Tennessee

OBJECTIVE—In normal adults, a small (catalytic) dose of fructose administered with glucose decreases the glycemic response to a glucose load, especially in those with the poorest glucose tolerance. We hypothesized that an acute catalytic dose of fructose would also improve glucose tolerance in individuals with type 2 diabetes.

RESEARCH DESIGN AND METHODS—Five adults with type 2 diabetes underwent an oral glucose tolerance test (OGTT) on two separate occasions, at least 1 week apart. Each OGTT consisted of 75 g glucose with or without the addition of 7.5 g fructose (OGTT + F or OGTT – F), in random order. Arterialized blood samples were collected from a heated dorsal hand vein twice before ingestion of the carbohydrate and every 15 min for 3 h afterward.

RESULTS—The area under the curve (AUC) of the plasma glucose response was reduced by fructose administration in all subjects; the mean AUC during the OGTT + F was 14% less than that during the OGTT – F (P < 0.05). The insulin AUC was decreased 21% with fructose administration (P = 0.2). Plasma glucagon concentrations declined similarly during OGTT – F and OGTT + F. The incremental AUC of the blood lactate response during the OGTT – F was ~50% of that observed during the OGTT + F (P < 0.05). Neither nonesterified fatty acid nor triglyceride concentrations differed between the two OGTTs.

CONCLUSIONS—Low-dose fructose improves the glycemic response to an oral glucose load in adults with type 2 diabetes, and this effect is not a result of stimulation of insulin secretion.

Abbreviations: AUC, area under the curve • GKRP, glucokinase regulatory protein • IGT, impaired glucose tolerance • NEFA, nonesterified fatty acid • OGTT, oral glucose tolerance test • OGTT + F, oral glucose tolerance test with addition of fructose • OGTT – F, oral glucose tolerance test without addition of fructose


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