Endocrine Abstracts

Overweight and obese subjects often suffer from hypoglycaemic symptoms due to hyperinsulinemia. This increases subjects’ need to eat excessive amount of food enriched in sugar causing rebound hyperglycaemia which in turn stimulates endogenous insulin release perpetuating a vicious circle that limits weight loss under diet restriction programme. Two previous studies showed that administration of Glucose RapidSpray™ (GRS) in quantity of ~ 0.5 g increases blood glucose levels of approximately 5 mg/dl within few minutes and without stimulating endogenous insulin release, thus increasing compliance to a calorie-restricted diet.

In one of these studies 55 obese subjects were given a 1500 kcal diet (15% proteins, 55% carbohydrates, 30% lipids) and asked to exercise 150 min/week. Of 31 subjects were randomly assigned to make use of GRS, a solution of 100% glucose delivered by buccal spray. Each puff contains 50 mg of glucose. Subjects were asked to spray 10 oral puffs during early symptoms of hypoglycaemia and followed up for 60 days. At the end of follow-up there were no significant differences in body weight, waist circumference, glucose and insulin levels evaluated by OGTT. However, a significant reduction in prevalence of type 2 obesity (BMI 35.0–39.9 kg/m²), and consequent increase in prevalence of overweight (BMI 25–29.9 kg/m²) (c2: 7.859–P=0.01) was observed in GRS group. These changes were not significant in the control group.

Subjects were followed-up every 4 months for 12 months and after a year. 50% of subjects were lost to follow-up, however 13 subjects taking GRS had significantly lost weight (median −5.4 kg, 95% CI=−3.073 – −8.973 – P=0.01) with reduction of BMI – 2.3 (95% CI =−1.267 – −3.333 – P=0.01); such reduction was not significant in the control group (12 subjects).

In conclusion, GRS is a useful adjuvant in diet restriction programmes.