L-arabinose co-ingestion delays glucose absorption derived from sucrose in healthy men and women: a double-blind, randomized crossover trial

Dietary interventions to delay carbohydrate digestion or absorption can effectively prevent hyperglycemia in the early postprandial phase. L-arabinose can specifically inhibit sucrase. It remains to be assessed whether co-ingestion of L-arabinose with sucrose delays sucrose digestion, attenuates subsequent glucose absorption, and impacts hepatic glucose output. In this double-blind, randomized crossover study, we assessed blood glucose kinetics following ingestion of a 200-mL drink containing 50 g sucrose with 7.5 g L-arabinose (L-ARA) or without L-arabinose (CONT) in twelve young, healthy participants (24±1 y; BMI: 22.2±0.5 kg/m2). Plasma glucose kinetics were determined by a dual stable isotope methodology involving ingestion of [U-13C6]-glucose-enriched sucrose, and continuous intravenous infusion of [6,6-2H2]-glucose. Peak glucose concentrations reached 8.18±0.29 mmol/L for CONT 30 min after ingestion. In contrast, the postprandial rise in plasma glucose was attenuated for L-ARA, because peak glucose concentrations reached 6.62±0.18 mmol/L only 60 min after ingestion. The rate of exogenous glucose appearance for L-ARA was 67 and 57% lower compared with CONT at t = 15 min and 30 min, respectively, whereas it was 214% higher at t = 150 min, indicating a more stable absorption of exogenous glucose for L-ARA compared with CONT. Total glucose disappearance during the first hour was lower for L-ARA compared with CONT (11±1 versus 17±1 g, p<0.0001). Endogenous glucose production was not differentially affected at any time point (p=0.27). Co-ingestion of L-arabinose with sucrose delays sucrose digestion, resulting in a slower absorption of sucrose-derived glucose without causing adverse effects in young, healthy adults.

Early lactate and glucose kinetics following return to spontaneous circulation after out-of-hospital cardiac arrest

Objective Lactate has been shown to be preferentially metabolized in comparison to glucose after physiological stress, such as strenuous exercise. Derangements of lactate and glucose are common after out-of-hospital cardiac arrest (OHCA). Therefore, we hypothesized that lactate decreases faster than glucose after return-to-spontaneous-circulation (ROSC) after OHCA. Results We included 155 OHCA patients in our analysis. Within the first 8 h of presentation to the emergency department, 843 lactates and 1019 glucoses were available, respectively. Lactate decreased to 50% of its initial value within 1.5 h (95% CI [0.2–3.6 h]), while glucose halved within 5.6 h (95% CI [5.4–5.7 h]). Also, in the first 8 h after presentation lactate decreases more than glucose in relation to their initial values (lactate 72.6% vs glucose 52.1%). In patients with marked hyperlactatemia after OHCA, lactate decreased expediently while glucose recovered more slowly, whereas arterial pH recovered at a similar rapid rate as lactate. Hospital non-survivors (N = 82) had a slower recovery of lactate (P = 0.002) than survivors (N = 82). The preferential clearance of lactate underscores its role as a prime energy substrate, when available, during recovery from extreme stress.