Does sucrose intake affect antropometric variables, glycemia, lipemia and C-reactive protein in subjects with type 1 diabetes?: a controlled-trial
Diabetology & Metabolic Syndrome
Does sucrose intake affect antropometric variables, glycemia, lipemia and C-reactive protein in subjects with type 1 diabetes?: a controlled-trial
Dbora Lopes Souto 0 3 5
Lenita Zajdenverg 2 4
Melanie Rodacki 2 4
Eliane Lopes Rosado 1 5
0 Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro , Brigadeiro Trompowski avenue, CCS building, - J block J - second floor - District: Ilha do Fundao, 360 Felisbelo Freire Street, Apartament 202 District: Ramos, Zipe Code: 21941-590, Rio de Janeiro , Brazil
1 Food Science and Technology, Federal University of Vicosa , Vicosa , Brazil
2 Medicine, Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
3 Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro , Brigadeiro Trompowski avenue, CCS building, - J block J - second floor - District: Ilha do Fundao, 360 Felisbelo Freire Street, Apartament 202 District: Ramos, Zipe Code: 21941-590, Rio de Janeiro , Brazil
4 Department of Internal Medicine, Section of Diabetes and Nutrology, Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
5 Institute of Nutrition Josue de Castro, Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
Background: It is unclear if the sugar intake may affect metabolic parameters in individuals with type 1 diabetes. Therefore, the purpose of this study was to evaluate the effects of sucrose intake in glycemic, lipemic, anthropometric variables, as well as in C-reactive protein (CRP) levels in these individuals. Methods: Thirty-three subjects with type 1 diabetes were evaluated at baseline and 3-months after intervention. Volunteers were randomized into groups: sucrose-free (diet without sucrose) or sucrose-added (foods containing sucrose in composition). Both groups received the same macronutrient composition and used the carbohydrate counting methods. All underwent an interview and anthropometric evaluation. Blood was drawn for glycated haemoglobin, glucose, total cholesterol, HDL, and CRP measurement, and the medical charts were reviewed in all cases. Results: At baseline, anthropometric, clinical and laboratory variables did not differ between groups, except for the triglycerides. Although at baseline triglycerides levels were higher in the sucrose-added group (p = 0.01), they did not differ between groups after the intervention (p = 0.92). After 3-months, CRP was higher in the sucrose-added than in the sucrose-free group (p = 0.04), but no further differences were found between the groups, including the insulin requirements, anthropometric variables, body composition, and glycemic control. Both groups showed sugars intake above the recommendations at baseline and after intervention. Conclusions: Sucrose intake, along with a disciplined diet, did not affect insulin requirements, anthropometric variables, body composition, lipemic and glycemic control. However, although the sucrose intakes increase CRP levels, the amount of sugar in the diet was not associated with this inflammatory marker.
Diabetes; Sucrose; Body composition; C-reactive protein; Carbohydrate
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Background
Sucrose is a very attractive source of carbohydrate [1]. The
preference for sucrose may be influenced by genetic factors
[2-5], and others complex behaviors (such as craving,
infant exposure, social habits, and personal dietary choices)
[6-10]. The effect of sugars on lipid metabolism remains an
extremely active area of inquiry because has been shown
that high-sugar diets may increase triglycerides levels in
subjects with type 2 diabetes [11-13], but they do not seem
to affect the lipid profile in subjects with type 1 diabetes, if
optimal glycemic control is preserved [14-18].
Carbohydrate is the major determinant of postprandial
glucose levels. The carbohydrate counting is the best
method for estimating the grams of carbohydrates in a
meal and then calculating the pre-meal insulin dose
based on the self-monitored blood glucose (SMBG) and
insulin-to-carbohydrate ratio [1,19].
The American Diabetes Association nutrition
recommendations state that the meal plans based on
carbohydrate counting remains a key strategy to achieve the
glycemic control [1] because the adjustment of pre-prandial
insulin doses to the amounts of dietary carbohydrates
ingested during the subsequent meal resulted in improved
in glycemic control [20-24], self-management skills, quality
of life, and dietary freedom [25-29].
However, the basic and advanced carbohydrate
counting are the common methods used currently in clinical
practice [19,22,30]. In the basic method, the subjects are
encouraged to eat constant amounts of carbohydrate at
meals. This is useful to understand the effect of food,
insulin and to identify the portion sizes, considering that
one carbohydrate serving have an approximately 15 g of
carbohydrates (these information are obtained from
exchange lists, internet and from the nutrition facts). In
the advanced method, the patients sho (...truncated)