Primary (diet-induced) obesity: insulin, peptide YY, and GLP-1 secretion in response to erythritol intake

OBJECTIVE. To investigate postprandial secretion of insulin, peptide YY (PYY), and glucagon-like peptide-1 (GLP-1) following erythritol ingestion in patients with obesity, and to compare these responses with hormonal changes after sucrose intake and combined erythritol–sucrose administration.

MATERIALS AND METHODS. Adults aged 18–35 years with class I–II obesity (BMI 30–40 kg/m²) and without carbohydrate metabolism disorders were enrolled. Each participant completed three oral tests on separate days, receiving solutions containing either 75 g sucrose, 75 g erythritol, or 75 g sucrose plus 25 g erythritol, with washout intervals ≥48 hours. Plasma glucose, insulin, PYY, and GLP-1 were measured at baseline and at 30-, 60-, 90-, and 120-minutes post-ingestion. The protocol duplicated our prior study in healthy volunteers, enabling direct comparison of metabolic and incretin responses between the two populations.

RESULTS. Erythritol ingestion did not increase plasma glucose or insulin concentrations. Peak glucose after sucrose intake reached 7.55 [6.59; 8.07] mmol/L, compared with 7.20 [7.05; 7.66] mmol/L after the erythritol–sucrose mixture (p = 0.598). No increase in PYY was observed under any test condition. GLP-1 levels at 120 minutes were significantly higher after erythritol ingestion compared with sucrose (p=0.0017).

CONCLUSION. In patients with obesity, erythritol does not elevate plasma glucose or insulin levels but enhances GLP-1 secretion, which may contribute to improved satiety signaling and delayed gastric emptying. These data support erythritol as a safe and physiologically appropriate sugar substitute for individuals with obesity.

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