Vaaler S, Bjørneklett A, Jelling I, Skrede G, Hanssen K F, Fausa O, Aagenaes O
Acta Med Scand. 1987;221(2):165-70. doi: 10.1111/j.0954-6820.1987.tb01262.x.
We compared sorbitol given alone and as part of a mixed meal to nine insulin-dependent diabetics (IDD's) during continuous subcutaneous insulin infusion (CSII). Blood glucose, sorbitol and breath hydrogen + methane were measured following six test meals: Pure glucose, sorbitol and lactulose, a mixed meal alone, and sweetened with sorbitol and sucrose. Blood glucose increase was very small after lactulose and sorbitol, significantly larger after glucose. A considerable increase in breath hydrogen + methane appeared after sorbitol and lactulose, but not after glucose. No differences in blood glucose responses were found after the mixed meal alone or sweetened with sorbitol and sucrose. A sustained low level increase in breath hydrogen + methane occurred after all solid meals. Sorbitol was not detected in serum after any meal.
Sorbitol ingested by IDD's during CSII in watery solution is not absorbed in the small intestine and causes osmotic diarrhoea. Ingested in a composite meal it does not affect blood glucose and does not cause osmotic diarrhoea.
我们在持续皮下胰岛素输注(CSII)期间,将单独给予山梨醇以及作为混合餐一部分的山梨醇给予9名胰岛素依赖型糖尿病患者(IDD)。在六种测试餐后测量血糖、山梨醇以及呼出气中的氢气+甲烷:纯葡萄糖、山梨醇和乳果糖、单独的混合餐,以及用山梨醇和蔗糖调味的混合餐。乳果糖和山梨醇后血糖升高非常小,葡萄糖后显著更大。山梨醇和乳果糖后呼出气中的氢气+甲烷出现相当大的增加,但葡萄糖后没有。单独的混合餐或用山梨醇和蔗糖调味的混合餐之间血糖反应没有差异。所有固体餐后呼出气中的氢气+甲烷都出现持续的低水平增加。任何餐后血清中均未检测到山梨醇。
IDD患者在CSII期间以水溶液形式摄入的山梨醇在小肠中不被吸收,并导致渗透性腹泻。在复合餐中摄入时,它不影响血糖,也不引起渗透性腹泻。