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.