Cornstarch ingestion after oral glucose loading: effect on glucose concentrations, hormone response, and symptoms in patients with postprandial hypoglycemic syndrome

Abstract

In susceptible individuals ingestion of glucose can lead to clinical symptoms of hypoglycemia as well as a reflex rise of counterregulatory hormones. We hypothesized that cornstarch, a slowly absorbed starch, might prevent hypoglycemic-symptom episodes. Eight patients who had characteristic signs, symptoms, and reflex hormonal responses of hypoglycemia at the glucose nadir after ingesting 75 g glucose (OGTT) participated. Patients ingested 75 g glucose followed by 75 g raw cornstarch (OGTT + CS). None of the patients reported symptoms or had signs of hypoglycemia in response to OGTT + CS. The glucose nadir concentration during OGTT + CS (3.8 +/- 0.6 mmol/L) was significantly higher than during OGTT (3.2 +/- 0.6; P less than 0.03). The responses of cortisol (331 +/- 166 nmol) and epinephrine (491 +/- 589 pmol/L) at the glucose nadir during OGTT + CS were significantly lower than the responses of cortisol (524 +/- 193 nmol/L; P less than 0.003) and epinephrine 1834 +/- 1135 pmol/L (P less than 0.0005) during OGTT. A slowly absorbed starch such as cornstarch may be an effective component in dietary management of this disorder.