The effect of arabinose on sucrose-induced glycemic response and glycemic kinetics as measured by a dual stable isotope methodology

A good glycemic control is essential for cardiometabolic health. Hyperglycemia
and glycemic variability have been indirectly or causally related to obesity,
T2DM and cardiovascular disease. A delay in and/or inhibition of carbohydrate
digestion may assist in avoiding hyperglycemia and may therefore be useful in
the prevention of chronic metabolic diseases. L-arabinose may act as a sucrose
substitute in many foods and may have beneficial effects due to its
uncompetitive inhibition of sucrase activity, which then inhibits sucrose
digestion. This project will compare the glycemic and insulinemic responses as
well as the glycemic kinetics of a sucrose plus arabinose load vs. a sucrose
only load.

The purpose of the present experiment is to compare the glycemic and
insulinemic responses as well as the glycemic kinetics of a sucrose load with
and without the addition of arabinose. Several studies have shown that
differences in the glycemic index may not only reflect the differences in the
exogenous rate of appearance (RaE), but also differences in endogenous rate of
appearance (hepatic glucose production, EGP), and in peripheral glucose
disposal (Rd). To compare plasma glucose kinetics after sucrose or
sucrose/arabinose, we will use a dual stable isotope methodology with
sucrose-(glucose-13C6), added to a sucrose(/arabinose) drink, and intravenous
infusion of [6,6-2H2]-glucose.

To compare the digestion and absorption kinetics following the ingestion of
sucrose plus arabinose versus sucrose only in healthy, young subjects.

Double-blinded, randomized crossover study.

We will assess the glycemic and insulinemic responses and glycemic kinetics
after the ingestion of a beverage containing sucrose plus arabinose and compare
those to the ingestion of a beverage containing sucrose only. This is done in a
randomized, crossover manner. There will be a two-week washout period between
the two beverages.

The burden and risks involved in participating in this experiment are small.
Insertion of the catheters in a vein is comparable to a normal blood draw and
the only risk is a small local hematoma. During one visit for the experimental
trial, 12 blood samples (± 120 ml total) will be obtained. The total amount of
blood collected is much less than the amount of a normal blood donation (500
ml) and will be completely restored in several weeks. The [6,6-2H2]-glucose
tracer that will be infused intravenously during the experimental trial is
produced according to GMP standards and is safe for human use. Arabinose is
currently used as a supplement or flavor ingredient in Europe. The arabinose
and sucrose-(glucose-13C6) are also produced according to safety standards.
Participants will visit the university three times after an overnight fast,
either by public transport or by having someone drive them. The first visit
will involve a screening and will last the whole morning, during which the
eligibility of the participant will be assessed. We will ask the participants
to fill out a medical questionnaire and we will perform a DEXA scan and a 2 h
OGTT. For the second and third visit, during which the experimental trial will
take place, participants are required to come to the university in a fasted
state, not having consumed any food or beverages except for water as from 22:00
the evening before. Also, 3 days prior to the experimental trial participants
need to record their food intake and activities performed. During these 3 days
participants are not allowed to perform heavy physical exercise or drink
alcohol.
There is no direct benefit for the participants, except from their contribution
to scientific knowledge and the development of novel concepts to prevent
hyperglycemia.