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

The effect of buffering high acid load meal with sodium bicarbonate on postprandial glucose metabolism in human – A randomized placebo-controlled study (#324)

Pinar Kozan 1 2 , Jackson C Blythe 1 3 , Jerry R Greenfield 1 2 4 , Dorit Samocha-Bonet 1 3
  1. Garvan Institute of Medical Research, Sydney, NSW, Australia
  2. Faculty of Medicine, University of New South Wales, Sydney, Australia
  3. School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
  4. Department of Endocrinology, St. Vincent’s Hospital, Sydney, Australia

Background & Aims: Recent large cohort epidemiological studies have reported associations between high dietary acid load and type 2 diabetes. However, the acute effect of buffering a high acid load meal with an alkalizing treatment on glucose metabolism has not been reported. We aimed to assess the acute effect of the alkalizing medication sodium bicarbonate (NaHCO3, 1680 mg) administered prior to a Western-style high acid load meal on body acidity and postprandial glucose metabolism in healthy men and women.

Methods: Non-diabetic normotensive participants (n=32, 20 men) were randomized to receive either NaHCO3 1680 mg or placebo, followed by a high acid load meal in a double-blind placebo-controlled crossover study. Thirty (n=30, 20 men) participants completed the study. Venous blood pH, serum bicarbonate, blood glucose, serum insulin, C-peptide, non-esterified fatty acid (NEFA), and plasma glucagon-like peptide-1 (GLP-1) concentrations were measured at baseline (fasting) and at 15-30 min intervals for 3 h post meal. The treatment and placebo studies were performed 1 to 4 weeks apart.

Results: The treatment was well tolerated. Venous blood pH declined in the first 15 min post meal with the placebo (p=0.007), but not with the sodium bicarbonate (p=0.86) and remained decreased with the placebo compared with the bicarbonate treatment for 3 h post meal (pinteraction=0.04). On average, blood pH incremental AUC increased with sodium bicarbonate and decreased with placebo (p=0.02). However, postprandial glucose, insulin, C-peptide, NEFA and GLP-1 were not different between sodium bicarbonate and placebo (pinteraction≥0.07).

Conclusions: These findings suggest that an alkalizing medication administered before a high acid load meal has no acute effect on glycaemia and insulin response in healthy individuals. Medium- and long- term alkalizing interventions in at-risk populations are necessary to investigate the sustained effect of alkalizing the body on insulin resistance and diabetes.