Sorbitol as a sweetener in the diet of insulin-dependent diabetes

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.