Metabolic Effects of Dissolved Aspartame in the Mouth before Meals in Prediabetic Patients; a Randomized Controlled Cross-Over Study - Abstract
In Type 2 Diabetes Mellitus, incretin axes play an important role in terms of progressive beta abnormalities. It was found that enteroendocrin cells in the small bowel have T1R2 and T1R3 taste receptors. Artificial sweeteners and glucose have significant effects on secretion of GLP-1 and GIP hormones from intestine. Recent research studies worked on healthy people showed that glucose triggers release of these hormones by the taste receptors in the L cells. The aim of this study was evaluation of the metabolic effects of dissolved aspartame in the mouth taken before meals in prediabetic patients.
This cross-over study was done in Akdeniz University, Endocrinology and Metabolism Unit. 54 prediabetic patients were included to this study. Patients were randomly separated to two groups. At the beginning of the study, patients interviewed with specialized diabetes dietitians. The first group was initiated with diet for three months and continued with diet and aspartame during second three months. Diet and aspartame were started in the second group for the first three months. Aspartame was discontinued after three months and patients continued with only diet during the second three months. Two tablets of aspartame (1 tablet equal to 18 mg) before meals were taken by dissolving on the tongue.In the two groups weight, height, BMI, waist circumference, fasting and postprandial blood glucose, hemoglobin A1c (HbA1c), fructosamine, alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), blood urea nitrogen (BUN), creatinine, LDL cholesterol, HDL cholesterol, triglycerides and insulin were evaluated at 0, 3 and 6 months.
In the first group, diet was found effective on losing weight at the end of the third
month. After aspartame was added, weight loss continued till the end of the 6 month.
In the second group, weight loss was detected with aspartame and diet during the first three months. However; in the second three months, weight gain occurred after aspartame was discontinued. Both groups were compared regarding weight loss in the first and second period. Weight loss in the first group was greater than in the second group during second period (p=0.027). The changes in the other parameters were not found significantly different.
In conclusion, aspartame has additional effect on weight loss in prediabetic patients. We need long term studies to investigate the relation between weight change and incretins.