Acute Effect of Stevia on Glycemic and Insulin Responses in Obese Patients: A Randomized Double-Blind Placebo-Controlled Crossover Study

Objective: Artificial sweeteners like sucralose cause glucose intolerance in obese patients, whereas stevia, a natural sweetener, is metabolically inert. The present study aimed to assess the acute effects of stevia on glycemic and insulin responses in obese patients. Materials and Methods: Obese patients underwent a 75-gram oral glucose tolerance test (OGTT) preceded by consuming pills containing either 200 mg of stevia or a placebo for 60 minutes prior to the test on two separate occasions, one week apart, in a randomized crossover design. Blood samples were obtained for glucose and insulin at 0, 30, 60, 90, and 120 minutes. The area under the curve (AUC) of glucose and insulin responses was calculated. Indices for insulin sensitivity, the Matsuda index, and Insulin secretion, the insulinogenic index, were calculated using minimal models of glucose and insulin kinetics. Results: Twenty obese patients, with a BMI of 28.75±3.68 kg/m², were recruited to the study. There were no significant differences in AUC of glucose and insulin between stevia and placebo with glucose at 15,285±4,531 versus 15,101±3,955 (p=0.89) and insulin at 8,507±5,858 versus 7,652±5,020 (p=0.62). Insulin sensitivity derived from OGTT using Matsuda index was not significantly different between stevia and placebo at 4.74±1.86 versus 5.84±2.96 (p=0.09). Insulin secretion using Insulinogenic index was not significantly different between stevia and placebo (p=0.155). Conclusion: Stevia did not affect the acute glycemic and insulin responses to OGTT in obese patients. It is necessary to conduct a long-term ingestion study to ascertain these findings.