Metabolic Effects of Sugar Alcohols in Diabetes Management

Sugar alcohols, or polyols, such as xylitol, erythritol and sorbitol, have gained prominence as non-caloric or low-caloric sweeteners with potential benefits in the management of diabetes. Unlike sucrose or glucose, these compounds are absorbed more slowly or remain largely unabsorbed in the gut, leading to attenuated post-prandial glycaemic and insulinaemic excursions. Some sugar alcohols are fermented by colonic bacteria, producing short-chain fatty acids that may improve insulin sensitivity. Endogenously, erythritol is synthesised via the pentose phosphate pathway (PPP) and its circulating concentration reflects flux through this route, which can be altered under conditions of hyperglycaemia and oxidative stress. Clinical studies indicate that dietary erythritol and xylitol exert minimal effects on blood glucose and insulin while promoting the release of satiation hormones such as GLP-1 and PYY. Moreover, animal studies suggest that chronic intake of certain polyols may reduce adiposity and preserve endothelial function under hyperglycaemic stress. Taken together, these findings support the incorporation of sugar alcohols into dietary regimens for people with diabetes, with potential to lower glycaemic load, enhance satiety and mitigate vascular complications. However, long-term human trials remain limited, and the interplay between endogenous synthesis and exogenous intake requires further elucidation.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Metabolic Effects of Sugar Alcohols in Diabetes Management publication trend

The graph below shows the total number of articles in metabolic effects of sugar alcohols in diabetes management across all publications each year (not limited to Nature Index journals).

Technical terms

Polyol: A sugar alcohol derived from the reduction of monosaccharides, used as a low-calorie sweetener with distinct absorption and fermentation properties.

Pentose phosphate pathway (PPP): A metabolic pathway parallel to glycolysis that generates NADPH and pentose sugars and serves as the source for endogenous erythritol synthesis.

Glycaemic response: The change in blood glucose concentration following ingestion of a carbohydrate-containing food or sweetener, influencing insulin demand and metabolic control.

Erythronate: An oxidation product of erythritol formed in vivo, used as a marker of erythritol metabolism and pentose phosphate pathway activity.

References

1. Erythritol: An In-Depth Discussion of Its Potential to Be a Beneficial Dietary Component. Nutrients (2023).
2. Absorption and Metabolism of the Natural Sweeteners Erythritol and Xylitol in Humans: A Dose-Ranging Study. International Journal of Molecular Sciences (2022).
3. C2C12 Muscle Myotubes, but not Kidney Proximal Tubule HK-2 Cells, Elevate Erythritol Synthesis in Response to Oxidative Stress. Current Developments in Nutrition (2023).