Low Glycemic Sucrose-Isomer Isomaltulose (Palatinose) May Delay Gastric Emptying

Abstract

Purpose: It has been reported that gastric emptying is regulated by the energy contents of meals and that fructose empty from the stomach differently from glucose. Therefore, when meals are not rapidly digested and absorbed, gastric emptying may be delayed. The aim of this study is to evaluate the influence of isomaltulose, which is a disaccharide, alpha-1,6-linked glucose and fructose, digested more slowly than sucrose and has lower glycemic index, on gastric emptying after ingestion of liquid test meals. Methods: 13C-acetate breath test is performed twice in nine healthy volunteers, seven women and four men, aged 20–23 years. The patients received two kinds of liquid test meal, an isomaltulose-based formula (INSLOW; MEIJUI MILK PRODUCT) and a dextrin-based standard formula (MEIBALANCE 200; MEIJUI MILK PRODUCT), containing 100 mg of 13C-acetate in the sitting position after an overnight fast. Breath samples were collected at 10 min-intervals for 150 min and 13CO2 levels were measured. 13C was measured as the 13CO2/12CO2 isotope ratio and was expressed as delta over baseline per mil. The results of 13C-acetate breath test, gastric emptying, were expressed as the time of peak excretion, correlated closely with the scintigraphic half-emptying times both with semisolid and liquid test meals. Results: Figure illustrated 13CO2 breath excretion pattern in the two test situations. The isomaltulose-based formula seems to produce a more shallow slope of the gastric emptying profile, and the mean values of breath 13CO2 peaked at 60 min. The peak time after administration of a dextrin-based standard formula was 50 min and Cmax was higher than after administration of an isomaltulose-based formula, although the difference was not statistically significant. Conclusion: Isomaltulose may delay gastric emptying despite of the equal energy content. This effect is an important advantage for avoiding rapid transit of liquid meals, especially for patients who had past history of gastric surgery.