Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

POSTER DISCUSSION: Effects of the artificial sweetener, sucralose, on blood pressure, heart rate and superior mesenteric artery blood flow in healthy older subjects (#322)

Hung Pham 1 , Julie E Stevens 1 2 , Rachael S Rigda 1 , Kristen E Macaskill 2 , Tongzhi Wu 1 , Trygve Hausken 3 , Stijn Soenen 1 , Renuka Visvanathan 1 , Chris K Rayner 1 , Michael Horowitz 1 , Karen L Jones 1
  1. The University of Adelaide, Adelaide, SA, Australia
  2. School of Pharmacy, University of South Australia, Adelaide, SA, Australia
  3. Department of Gastroenterology, Haukeland University Hospital, Bergen, Norway

Introduction: Postprandial hypotension (PPH), a fall in blood pressure (BP) of >20mmHg after a meal, occurs frequently in older people and type 2 diabetes (T2DM) and is associated with increased morbidity and mortality. Current management is suboptimal. The rate of small intestinal nutrient delivery and changes in splanchnic blood flow play a role in PPH (1). Sucralose, a non-caloric artificial sweetener, is a popular alternative to carbohydrates in the management of obesity and diabetes. The effects of sucralose on postprandial BP and splanchnic blood flow have not been assessed.

Objectives: We evaluated the effects of intraduodenal (ID) sucralose on BP, heart rate (HR) and superior mesenteric artery (SMA) blood flow, compared to ID glucose and saline (control), in healthy older subjects.

Methods: 12 healthy subjects (6M, 6F; age: 66-79yr) had concurrent measurements of BP and HR (automated device), SMA blood flow (Doppler ultrasound) and blood glucose (glucometer) on 3 separate occasions during ID infusion of glucose (25%w/v ~1400mOsmol/L), sucralose (4mM, ~300mOsmol/L) or saline (0.9%w/v ~300mOsmol/L) at a rate of 3ml/min for 60min followed by ID saline for a further 60min.

Results: During ID glucose, there was a fall in mean arterial BP (P<0.001) e.g. baseline: 91.7mmHg vs t=60min: 85.9mmHg, but not with saline or sucralose. HR (P<0.0001) and SMA flow (P<0.0001) increased with glucose, but not with saline or sucralose. Similarly, blood glucose increased in response to glucose (P<0.0001) but not saline or sucralose.

Conclusions: In healthy older subjects, ID administration of the artificial sweetener, sucralose, is not associated with a fall in BP or rise in SMA flow. This proof of principle study suggests that artificial sweeteners may have a therapeutic role in the dietary management of PPH.

  1. Trahair LG, Horowitz M, Jones KL. Postprandial hypotension: a systematic review. J Am Med Dir Assoc 2014;15:394-409.