Effects of diet soda on gut hormones in youths with diabetes

Rebecca J Brown, Mary Walter, Kristina I Rother, Rebecca J Brown, Mary Walter, Kristina I Rother

Abstract

Objective: In patients with type 2 diabetes, but not type 1 diabetes, abnormal secretion of incretins in response to oral nutrients has been described. In healthy youths, we recently reported accentuated glucagon-like peptide 1 (GLP-1) secretion in response to a diet soda sweetened with sucralose and acesulfame-K. In this study, we examined the effect of diet soda on gut hormones in youths with diabetes.

Research design and methods: Subjects aged 12-25 years with type 1 diabetes (n = 9) or type 2 diabetes (n = 10), or healthy control participants (n = 25) drank 240 mL cola-flavored caffeine-free diet soda or carbonated water, followed by a 75-g glucose load, in a randomized, cross-over design. Glucose, C-peptide, GLP-1, glucose-dependent insulinotropic peptide (GIP), and peptide Tyr-Tyr (PYY) were measured for 180 min. Glucose and GLP-1 have previously been reported for the healthy control subjects.

Results: GLP-1 area under the curve (AUC) was 43% higher after ingestion of diet soda versus carbonated water in individuals with type 1 diabetes (P = 0.020), similar to control subjects (34% higher, P = 0.029), but was unaffected by diet soda in patients with type 2 diabetes (P = 0.92). Glucose, C-peptide, GIP, and PYY AUC were not statistically different between the two conditions in any group.

Conclusions: Ingestion of diet soda before a glucose load augmented GLP-1 secretion in type 1 diabetic and control subjects but not type 2 diabetic subjects. GIP and PYY secretion were not affected by diet soda. The clinical significance of this increased GLP-1 secretion, and its absence in youths with type 2 diabetes, needs to be determined.

Figures

Figure 1
Figure 1
Serial data from OGTTs. Serial glucose and hormone levels after ingestion of either 8 oz diet soda (■ with solid line) or carbonated water (○ with dotted line) at time −10 min, followed by 75-g glucose at time −0 min. Glucose AUC was not statistically different in the diet soda vs. carbonated water condition in healthy control (A), type 1 diabetic (B), or type 2 diabetic (C) subjects. There was no difference in C-peptide AUC for diet soda vs. carbonated water in any group (D–F). GLP-1 AUC was higher after diet soda in healthy control (G) and type 1 diabetic (H) subjects but not in type 2 diabetic subjects (I). Neither GIP (J–L) nor PYY (M–O) AUC were statistically different between the diet soda and carbonated water condition in any group.

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Source: PubMed

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