Fructose and Diabetes

Historically, in the nutritional management of diabetes mellitus, the ingestion of fructose was recommended as a sweetener for diabetics because it causes smaller increases in blood glucose following ingestion compared to similar amounts of glucose, sucrose, or starches. In fact, fructose, in small quantities, increases the hepatic uptake of glucose and promotes glycogen storage, probably by stimulating the activity of hepatic glucokinase (EC 2.7.1.2). Also, in individuals with type 2 diabetes mellitus, the addition of a small amount of fructose to an oral glucose tolerance test improves the glycemic response, indicating improved glycemic control. It must be emphasized, however, that the consumption of large quantities of fructose is not recommended, particularly for diabetics who, as a group, are at increased risk for cardiovascular disease, because of potentially adverse effects of fructose on lipid metabolism, body weight regulation, and oxidative stress that may contribute to diabetic complications.

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