Prevention of Hyperglycaemia Clinical Trial
Official title:
Dose-response Effect of an Apple Extract on Postprandial Glycaemia: a Randomised Controlled Trial. The GLU-POMME Study.
Postprandial hyperglycaemia can lead to adverse modifications to functional proteins within the body and eventually lead to the development of type 2 diabetes. Previous research by this group has shown that an apple polyphenol extract reduced hyperglycaemia following a high-carbohydrate meal. The aim of this study is to investigate the effects of lower doses of the apple extract on postprandial glycaemia, insulinaemia and plasma gastric inhibitory polypeptide concentrations following a mixed carbohydrate test meal.
Introduction:
Sharp peaks in blood glucose levels can lead to adverse modifications to functional proteins,
oxidative stress and pancreatic beta cell dysfunction. It is therefore desirable to consume a
diet that will allow more gradual rises in blood glucose levels after meals. Fruit
polyphenols may help to limit the glucose excursion following a high carbohydrate meal.
Previous research by this research group has demonstrated that 1200 mg of apple polyphenols
(Appl'In™) inhibited the average incremental area under the curve (T+0 to T+30 min) of plasma
glucose by 54% relative to placebo. Possible mechanisms include inhibition of intestinal
enzymes and inhibition of intestinal glucose absorption by decreasing SGLT1/GLUT2 transport
activity. The literature also suggests that foods rich in polyphenols exert beneficial
effects on risk factors of cardiovascular disease such as hypertension, lipid metabolism and
vascular function.
Study design:
A randomised, controlled, double-blind, cross-over study will be conducted. Four matched test
drinks will be consumed in random order on separate study visits immediately before a
mixed-carbohydrate test meal, containing either: 1) 1.2 g, 2) 0.9 g 3). 0.6 g of apple
polyphenols, or 4). placebo. Postprandial changes in plasma glucose, insulin, NEFA, GIP,
GLP-1 concentrations as well as changes in vascular function will be measured. Twenty-four
hour urine samples will be collected for analysis of urinary polyphenol metabolites and
glucose. In a sub sample of participants, a paracetamol absorption test will be incorporated
via addition of 1.5 g paracetamol into the test drink.
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