Zùsto: A new sweetening agent with low glycemic index

Background & aims: Sweetening agents are sugar substitutes with a low glycemic index, used to obtain a better glycemic control in diabetes patients. However, they also may have a role in other subjects, as a high glycemic index is thought to cause many pathological conditions. Unfortunately, not all artificial sweeteners are perceived as sweet as sugar by patients. Consumers refer often to an after taste present in foods sweetened with intensive sweeteners. The objective of this study was to explore whether Zùsto ^® had a low glycemic index, to replace glucose as a sweetener. Methods: In this study, the glycemic index (GI) of a new sweetening agent, Zùsto ^®, is compared to that of glucose 25 g, a standard sugar-loaded drink used in the oral glucose tolerance test to detect diabetes, as primary endpoint. Zùsto ^® is composed of non-digestible, water soluble fibers and sweeteners. 10 healthy, female non-obese volunteers received glucose and Zùsto ^®, albeit by an interval of a week. Evolution of glycemia, C-peptide and insulin release was measured at different time-points after intake. Results: The results show that, when calculating the mean incremental Area Under the Curve (AUC), the AUC of glucose was around five times as high as that of Zùsto ^®; a GI of 22 for Zùsto ^® was calculated. Furthermore, Zùsto ^® had no significant effect on the glycemia, contrary to glucose, for at least 60'. This was also the case concerning C-peptide and insulin release, but the difference lasted even for 180'. Moreover, Zùsto ^® was perceived as sweet by all volunteers, with no particular aftertaste. Conclusion: Zùsto ^® could be a viable alternative for fast sugars and other sweetening agents, both for diabetic patients and other subjects, requiring however a larger trial to confirm these results. Clinicaltrials.gov: NCT02607345.