Exploring the Diversity of Sugar Compounds in Healthy, Prediabetic, and Diabetic Volunteers.

SCOPE: Diabetes is thought to primarily represent a disturbance of carbohydrate metabolism; however, population studies employing metabolomics have mainly identified plasma amino acids and lipids, or their products, as biomarkers. In this pilot study, the aim is to analyze a wide spectrum of sugar compounds in the fasting state and during an oral glucose tolerance test (OGTT) in healthy, prediabetic, and type 2 diabetic volunteers. METHODS AND RESULTS: The three volunteer groups underwent a standard OGTT. Plasma samples obtained in the fasting state, 30 and 90 min after the OGTT, are subjected to a semitargeted GC-MS (gas chromatography-mass spectrometry) sugar profiling. Overall, 40 sugars are detected in plasma, of which some are yet unknown to change during an OGTT. Several sugars (e.g., trehalose) reveal significant differences between the volunteer groups both in fasting plasma and in distinct time courses after the OGTT. This suggests an endogenous production from orally absorbed glucose and/or an insulin-dependent production/removal from plasma. CONCLUSION: It is demonstrated that more sugars than expected can be found in human plasma. Since some of these show characteristic differences depending on health status, it may be worthwhile to assess their usability as biomarkers for diagnosing early-stage insulin resistance and type 2 diabetes.

Postprandial metabolic responses to ingestion of bovine glycomacropeptide compared to a whey protein isolate in prediabetic volunteers.

PURPOSE: Whey protein was shown to reduce blood glucose responses in humans and various other positive effects have been attributed to this protein. In contrast, studies using glycomacropeptide (GMP) as part of the whey fraction of bovine milk are rare. We, therefore, studied the postprandial responses to GMP administration in humans with impaired glucose tolerance compared to the effects of pure whey protein in a random design. METHODS: Fifteen prediabetic volunteers received on different occasions one of three test drinks containing 50 g of maltodextrin19 (MD19) alone or in combination with either 50 g GMP or 50 g whey protein isolate (WPI). Blood was collected over 4 h with analysis of blood glucose and hormones, gastric emptying rate as well as plasma amino- and fatty acids, ß-hydroxybutyrate and acylcarnitines. RESULTS: The WPI drink reduced the AUC of venous blood glucose compared to the MD19 drink in the prediabetic group by 11% (p = 0.0018) whereas GMP reduced the AUC by 18% (p < 0.0001), significantly different to the WPI drink (p = 0.0384). The reduction in blood glucose after the GMP drink was accompanied by a significantly lower AUC of insulin (- 34%) than for the WPI drink. Levels of C-peptide and of glucose insulinotropic polypeptide (GIP) were highly increased after the WPI drink over the MD19 control drink but remained in essence unaffected by the GMP. CONCLUSION: GMP reduced the glycemic response more potently than whey protein, whereas insulin output was less affected making GMP an interesting protein to control postprandial glucose responses.

Metabolic responses of healthy or prediabetic adults to bovine whey protein and sodium caseinate do not differ.

BACKGROUND: Casein is considered a slowly digestible protein compared with whey protein, and this may cause differences in hormone responses and the kinetics of delivering amino acids into the circulation. OBJECTIVE: We investigated whether postprandial plasma hormone and metabolite responses were different when bovine casein or whey protein was co-administered with carbohydrates in healthy and prediabetic adults. METHODS: White healthy male adults (n = 15) and white, well-defined male and female prediabetic adults (n = 15) received test drinks randomly on 3 different occasions at least 2 d apart which contained 50 g of maltodextrin19 (MD19) alone or in combination with 50 g of whey protein isolate (WPI) or 50 g of sodium caseinate (SC). Blood samples were collected over a 240-min time period and were analyzed for hormone profiles and defined metabolites. RESULTS: No evidence was found that gastric emptying was different between the 2 protein drinks. Both proteins increased peak plasma insulin concentrations in prediabetic persons by 96% compared with MD19 (each, P < 0.05), which was accompanied by a reduction of peak venous blood glucose by 21% (each, P < 0.0001) without a difference between the 2 proteins. Peak plasma glucagon concentrations increased by 101% in both groups after the protein drinks (P < 0.05). The WPI drink also increased peak plasma glucose-dependent insulinotropic polypeptide concentrations in healthy volunteers by 56% (P < 0.01). Differences in plasma metabolite concentrations in volunteers could be attributed exclusively to the differences in the amino acid composition of the 2 proteins ingested. CONCLUSION: The WPI and the SC drinks similarly reduced postprandial glucose excursions when ingested with carbohydrates in healthy and prediabetic volunteers. Under our experimental conditions, however, no evidence was found that gastrointestinal processing of the 2 protein varieties differed substantially. This trial was registered at clinicaltrials.gov as DRKS00005682.