Eat without guilt
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Clinical studies have shown that consuming 15 gms a day of levulose, a natural sweetener, did not raise blood sugar level. On the other hand, it helped improve the fasting blood glucose level.
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TIPTOEING ACROSS the room to steal a bite of the sweet kept in the kitchen is one way a diabetic deals with his craving for sweets. More the blood sugar, stiffer is the restriction to avoid eating sweets. But the craving for sweets seems to be inversely proportional to the restriction. Diabetics despair no more; help is at hand.
Diabetics Dezire produced by Chennai based Sundar Chemicals Private Limited has Levulose, which is a kind of fructose. Levulose is a natural product and is found in fruits, particularly apples and oranges. It has been found to be safe and suitable for making sweets and as a sweetener for coffee or tea.
According to Mr. K. Ramu, Chairman and Managing Director of Sundar Chemicals, levulose can be used for making any Indian sweet without the sweet losing its colour, feel or sweetness. "And unlike other products available in the market, levulose does not leave an unpleasant aftertaste," he stressed. "It gives the sweets the consistency that cannot be achieved using products other than sugar."
Low glycemic index
Levulose has a low glycemic index — the immediate effect of a food item to affect blood sugar levels — around 20. Higher the glycemic index of a food, greater will be blood sugar elevation and vice versa. Hence glucose with a glycemic index of nearly 100 tops the chart while sugar's GI is 65. Levulose is 1-1.8 times sweeter than sugar and provides four calories per gram. "So diabetics can now enjoy sweets without feeling guilty," Mr. Ramu pointed out.
The safety and the ability of Diabetics Dezire to help meet the craving for sweets without altering the blood sugar levels was recently proved by a clinical study undertaken on 30 patients with type 2 diabetes for a period of one month by the Chennai based Dr. V. Seshiah Diabetes Care and Research Institute.
The 30 patients divided into two groups of 15 each based on blood sugar control were studied for several parameters. At the end of the study it was found that consuming 15 gms of levulose a day did not raise the blood sugar level and did not alter the other parameters that were studied.
Robust study
But does a study involving just 30 patients for a period of one month be sufficient to arrive at any conclusion either on the safety or otherwise? "First of all this is a pilot study. But more than that, the study did not show any conflicting results. So studying just 30 patients was fine," explained Dr. V. Balaji, Consultant Diabetologist at the Chennai based Apollo Hospitals. "If we had got any negative results (in any of the 14 parameters studied) to be statistically significant then we would have been compelled to study more patients."
"All biological parameters vary within a short range. Any clinical trial studying a biological parameter can give fairly predictable values from 30 samples," said Dr. S. Rajagopalan, a renowned statistician and a Distinguished Fellow at the Chennai based M.S. Swaminathan Research Foundation. "I have seen the analysis and checked them too. Even if the clinical trial were to be repeated you would get the same result. It has a confidence limit of 98-99 per cent."
Having said that, the long-term effect of consuming levulose will be known only from studies that are of longer duration. The issue of weight gain on consuming 15 gms of levulose a day is another issue to be addressed as 15 gms translates to 60 calories a day.
Plans are already underway to undertake such studies that would be done not only for a longer duration of time but will also involve more number of patients.
"We are actually planning to undertake a multicentric study," said Dr. V. Seshiah Chairman of Dr. V. Seshiah Diabetes Care and Research Institute.
Insulin independent
Even though the glycemic index is only around 20, how does the consumption of 15 gms per day still not affect blood sugar levels? "It has to do with the way levulose is metabolised by the body," explained Dr. Seshiah. "Glucose, for instance, requires the assistance of insulin to enter the cells. Levulose, on the other hand, goes straight into the liver where it is metabolised."
Dr. Balaji added, "Levulose is insulin independent as it does not require insulin's assistance to enter a cell. So it has a negligible effect on insulin secretion and hence has very little effect on blood glucose too."
The insulin independence was best illustrated when the study clearly demonstrated that levulose did not increase blood sugar levels. "On the other hand, we saw an improvement in the fasting blood glucose level," Dr. Balaji pointed out.
According to Dr. Balaji, the fasting blood sugar level is based on the basal level of insulin, while post-prandial sugar level has more to do with the insulin secreted in response to the food consumed.
Objective of the study
"Probably the amount of levulose given to the patients was not sufficient enough to bring about any change to the post-prandial sugar level," Dr. Balaji explained. "But the objective of the study was not to see how levulose can be used to control blood sugar level but to see how it affects the blood sugar level."
But can the consumption of more levulose help bring down the sugar level? According to them, consuming more than 20 gms a day will increase the triglyceride levels which in turn will nullify any advantage.
"The neutral effect of levulose on triglycerides in our study could be due to the recommended quantity (15 gms a day) taken by our patients," Dr. Balaji highlighted.
R. Prasad
in Chennai
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