(P20-052-25) Influence of Breakfast With/Without Non-nutritive Sweeteners on Glycemic Response and Appetite-Satiety in Adults With Type 1 Diabetes

Objectives: To compare the effect of consuming breakfast with and without non-nutritive sweeteners (NNS) on postprandial glycemic response, glycemic index (GI), and appetite-satiety sensation in adults with type 1 diabetes (T1D).

Methods: A randomized, controlled, crossover study comparing acute responses to three iso-carbohydrate breakfasts containing 50 grams of available carbohydrates: one without NNS (B1), another with 30 drops of a mixed NNS (70.8 mg) containing 36 mg stevia and 34.8 mg sucralose (B2), and a control breakfast which included white bread (B3). Responses to the breakfasts were capillary blood glucose levels during fasting and at 15, 30, 45, 60, 90, and 120 minutes (min) and appetite/satiety scores based on hunger, satiety, fullness, and desire to eat using visual analog scales applied before and 60 and 120 min after eating. Statistical analyses were conducted using SPSS v.22; we used repeated measures ANOVA, or Friedman or Wilcoxon depending on the normality of the variables. A level of p< 0.05 was considered significant.

Results: Thirty-three adults with T1D were recruited and 24 completed the study (age=33.4 ± 7.4 years; BMI=26.0 ± 5.1 kg/m²). Regarding glycemic responses, compared to B3, B2 with NNS had higher glucose concentrations at time 15 min (median (IQR) 7.2 (5.9-8.4) vs 8.9 (7.5-11.1) mmol/L; p=0.001), 30 min (7.3 (5.5-9.2) vs 10.2 (7.4-12.4) mmol/L; p=0.005) and 45 min (7.7 (5.9-10.2) vs 10.1 (6.9-12) mmol/L; p=0.019); however, B1 was elevated only at 15 minutes (8.0 (7.6-10.2) mmol/L; p=0.006). Notably, at 30, 45, and 60 min following B2, glycemia exceeded the target range of 10 mmol/L. Compared to B3 at 60 min post-ingestion, the appetite/satiety scores indicated that participants experienced similar fullness after B1 (5.8 ± 0.9; p=0.487) but less fullness after B2 (6.0 ± 0.9 vs 5.4 ± 1.1;p=0.010).

Conclusions: Our study demonstrated that elevations in blood glucose resulting from iso-carbohydrate breakfasts containing NNS are higher versus breakfasts without NNS, while participants reported feeling less full after consuming breakfasts with versus without NNS.  Future research should explore changes in hormones in the appetite-satiety axis as a mechanistic explanation for our findings.

Funding Sources: Chilean Society of Endocrinology and Diabetes