Diabetes and fructose metabolism.

The clinical aspects of fructose supplementation in the diets of individuals with diabetes should focus on the balance between beneficial effects and possible side effects. Fructose supplementation in diabetes mellitus was advocated before insulin was discovered. Fructose elicits a lower glucose and insulin response in healthy individuals and in individuals with diabetes. The use of fructose as a sweetener in the diets of diabetics has been debated repeatedly. Short-term studies have now shown that substitution of fructose for sucrose in the diets of individuals with diabetes improves glycemic control and does not appear to have substantial side effects. In balanced diets, reasonable amounts of fructose supplementation do not affect lipoprotein metabolism or result in gastrointestinal symptoms. Long-term studies are still needed to ascertain that long-term fructose supplementation has a sustained beneficial effect in diabetes and is devoid of deleterious side effects.