Antihyperglycemic effects of stevioside in type 2 diabetic subjects


      Stevioside is present in the plant Stevia rebaudiana Bertoni (SrB). Extracts of SrB have been used for the treatment of diabetes in, for example, Brazil, although a positive effect on glucose metabolism has not been unequivocally demonstrated. We studied the acute effects of stevioside in type 2 diabetic patients. We hypothesize that supplementation with stevioside to a test meal causes a reduction in postprandial blood glucose. Twelve type 2 diabetic patients were included in an acute, paired cross-over study. A standard test meal was supplemented with either 1 g of stevioside or 1 g of maize starch (control). Blood samples were drawn at 30 minutes before and for 240 minutes after ingestion of the test meal. Compared to control, stevioside reduced the incremental area under the glucose response curve by 18% (P = .013). The insulinogenic index (AUCi,insulin/AUCi,glucose) was increased by approximately 40% by stevioside compared to control (P < .001). Stevioside tended to decrease glucagon levels, while it did not significantly alter the area under the insulin, glucagon-like peptide 1, and glucose-dependent insulinotropic polypeptide curves. In conclusion, stevioside reduces postprandial blood glucose levels in type 2 diabetic patients, indicating beneficial effects on the glucose metabolism. Stevioside may be advantageous in the treatment of type 2 diabetes.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Metabolism - Clinical and Experimental
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Soejarto D.D
        • Kinghorn A.D
        • Farnsworth N.R
        Potential sweetening agent of plant origin III.
        J Nat Prod. 1982; 45: 590-599
        • Curi R
        • Alzarez M
        • Bazotte R.B
        • et al.
        Effect of Stevia rebaudiana on glucose tolerance in normal adult humans.
        Braz J Biol Res. 1986; 19: 771-774
        • Bridel M
        • Lavielle R
        Le principe a’saveur sucree′du Kaa′-he′-e′.
        Bull Soc Chim Biol. 1931; 13: 636-655
        • Schmeling G.A
        • Carvalho F.V
        • Espinosa A.D
        Stevia rebaudiana Bertoni. Avaliacao do efeito hipoglicemiante em coelhos aloxanizados.
        Ciencia Cultura. 1977; 29: 599-601
        • Jeppesen P.B
        • Gregersen S
        • Alstrup K.K
        • et al.
        Stevioside induces antihyperglycaemic, insulinotropic and glucagonostatic effects in vivo.
        Phytomedicine. 2002; 9: 9-14
        • Jeppesen P.B
        • Gregersen S
        • Rolfsen S.E.D
        • et al.
        Antihyperglycemic and blood pressure-reducing effects of stevioside in the diabetic Goto-Kakizaki (GK) rat.
        Metabolism. 2003; 52: 372-378
        • Jeppesen P.B
        • Gregersen S
        • Poulsen C.R
        • et al.
        Stevioside acts directly on pancreatic beta cells to secrete insulin.
        Metabolism. 2000; 49: 208-214
        • Leibowitz G
        • Cerasi E
        Sulphonylurea treatment of NIDDM patients with cardiovascular disease.
        Diabetologia. 1996; 39: 503-514
        • Chan P
        • Tomlinson B
        • Chen Y.J
        • et al.
        A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension.
        Br J Clin Pharmacol. 2000; 50: 215-220
        • Krarup T
        • Madsbad S
        • Moody A.J
        • et al.
        Diminished gastric inhibitory polypeptide (GIP) response to a meal in newly diagnosed type I (insulin dependent) diabetics.
        J Clin Endocrinol Metab. 1983; 56: 1306-1312
        • Holst J.J
        Evidence that enteroglucagon (II) is identical with the C-terminal sequence (residues 33–39) of glicentin.
        Biochem J. 1982; 207: 381-388
        • Ørkov C
        • Rabenhøj L
        • Kofod H
        • et al.
        Production and secretion of amidated and glycine-extended glucagon-like peptide-1 (GLP-1) in man.
        Diabetes. 1994; 43: 535-539
        • Melis M.S
        Renal excretion of stevioside in rats.
        J Nat Prod. 1992; 55: 688-690
        • Melis M.S
        Stevioside effect on renal function of normal and hypertensive rats.
        J Ethnopharmacol. 1992; 36: 213-217
        • Hubler M.O
        • Bracht A
        • Kelmer-Bracht A.M
        Influence of stevioside on hepatic glycogen levels in fasted rats.
        Res Commun Chem Pathol Pharmacol. 1994; 84: 111-118
        • Suanarunsawat T
        • Chaiyabutr N
        The effect of stevioside on glucose metabolism in rat.
        Can J Physiol Pharmacol. 1997; 75: 976-982
        • Usami M
        • Seino Y
        • Takai J
        • et al.
        Effect of cyclamate sodium, saccharin sodium and stevioside on arginine-induced insulin and glucagon secretion in the isolated perfused rat pancreas.
        Horm Metab Res. 1980; 12: 705-706
        • Baron A.D
        • Schaeffer L
        • Schragg P
        • et al.
        Role of hyperglucagonemia in maintenance of increased rates of hepatic glucose output in type II diabetics.
        Diabetes. 1987; 36: 274-283
        • Shah P
        • Vella A
        • Basu A
        • et al.
        Lack of suppression of glucagons contributes to post-prandial hyperglycaemia in subjects with type 2 diabetes mellitus.
        J Clin Endocrinol Metab. 2000; 85: 4053-4059
        • Wang L.F
        • Luo H
        • Miyoshi M
        • et al.
        Inhibitory effect of gymnemic acid on intestinal absorption of oleic acid in rats.
        Can J Physiol Pharmacol. 1998; 76: 1017-1023