Glucose Modulates Food Intake in Patients With Diabetes

Results of a published study suggest that glucose has an inhibitory influence on food intake in type 2 diabetic patients.

"A gain in body weight is a common adverse effect of glucose-lowering therapies in patients with type 2 diabetes, the mechanisms of which are not completely understood," Dr. Bernd Schultes and colleagues from the University of Luebeck, Germany, write.

"Blood glucose is considered to play a crucial role in the regulation of food intake."

The researchers examined the hypothesis that a short-term reduction of blood glucose concentration to normal values would acutely increase food intake in patients with type 2 diabetes. In a single-blind study, 12 diabetic patients were examined twice, once during a euglycemic (5.0 mmol/L) clamp experiment and once during a hyperglycemic (10.5 mmol/L) clamp.

Insulin was infused in both clamp conditions at a constant rate of 2.5 mU/kg per min for 125 minutes. A glucose solution was infused simultaneously at a variable rate to achieve target glucose levels. The patients were allowed to eat as much as they wanted from a standard breakfast buffet, during the last 30 minutes of the clamps.

Patients ingested an average of 25% more energy during the euglycemic clamp than during the hyperglycemic clamp (645 versus 483 kcal) and ate significantly more carbohydrates, proteins and fat.

However, when the total influx of energy was calculated, by adding the energy ingested by food and infused by glucose, this was almost identical for the euglycemic and hyperglycemic conditions (794 versus 790 kcal).

Thus, the researchers conclude, "total energy supply to the organism is tightly regulated on a short-term basis independent of the route of influx."

Diabetes Care 2005;28:2884-2889.