The effect of a new mixture of sugar and sugar-alcohols compared to sucrose and glucose on blood glucose increase and the possible adverse reactions: A phase I double-blind, three-way randomized cross-over clinical trial

Endocrinol Diabetes Nutr. 2019. // —

Mohsenpour MA, Kaseb F, Nazemian R, et al. —

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  • To
    examine the effect of a new mixture of sugars and sugar alcohol on the
    postprandial blood glucose levels and its possible gastrointestinal (GI)
    adverse reactions in human adults.


  • Various compounds such as sugars, sugar
    alcohols and non-sugar compounds (stevia, xylitol, and aspartame) have
    been introduced to induce the sweet taste in food industry.
  • Lacritose, a new sweetener, was recently introduced
    by mixing the following four sugars: lactose, fructose, sucrose, and
  • Although previous studies have shown sugars can
    interact each other during absorption in the intestine and slowdown or
    increase each other’s absorption, further research is needed regarding the
    glycemic response and possible gastrointestinal adverse reactions associated
    with Lacritose.


  • Forty participants, including 20 diabetic
    patients and 20 healthy individuals, ages 20-60 (mean age = 40) were
    enrolled between February and October of2016.
  • A double-blind, three way randomized cross-over
    clinical trial was conducted in which each participant served as his/her
    own control. After fasting overnight for at least 10 hours, participants
    were randomly given 300ml servings of three beverages containing 50g
    glucose, sucrose and lacritose. Blood samples were collected before and
    afterwards every 30 minutes for up to 2 hours. 
  • Demographic data was collected and
    anthropometric assessments were conducted on each intervention day.  A gastrointestinal reaction questionnaire,
    which assessed pain in the stomach and abdomen, heartburn, reflux,
    appetite, etc., was completed for each participant one day after the
    intervention day by a trained nutritionist on the phone.


  • Mean blood glucose was significantly lower
    during consumptions of lacritose compared to sucrose and glucose (mean±
    standard error (SE) for lacritose: 114.9 ± 2.5, glucose:154.8 ± 5.0,
    sucrose: 134.3 ± 4.0, P-value <0.001). 
    Also the increasing of blood glucose at different times was
    significantly different between the three drinks.
  • In both participants with diabetes mellitus and
    healthy subjects, blood glucose was significantly lower after ingesting
    lacritose when compared to other beverages, after adjustment for BMI,
    gender, age and rolling method (P-value <0.05).
  • The number of participants reporting abdominal
    pain, epigastric pain and also nausea after ingestion of the test
    beverages were higher when they ingested lacritose.  However the difference between beverages
    were not statistically significant for abdominal pain (P-value = 0.165),
    epigastric pain (P-value = 0.097) and nausea (P-value = 0.717).


  • Blood glucose levels were significantly lower
    after ingestion of one 50 g dose of lacritose, as compared to identical servings
    of glucose and sucrose.
  • Although lacritose contains lactose, the
    gastrointestinal adverse reactions after its ingestion was not
    significantly different compared to glucose and sucrose.
  • Further studies with more study participants
    examining the long-term effects of lacritose on appetite, body weight and
    other metabolic markers of long-term glucose control are recommended.

Points to Consider:

  • The present study included a sample of only 40
    participants and did not assess the effect of lacritose on appetite, insulin
    response and long-term outcomes.
  • The long-term effect of lacritose on overall
    health are unknown and given its relatively high amount of lactose and
    erythritol, they may be adverse reactions associated with long-term use.