Hydrogen and Methane Detection in Breath in Response to Two Different Types of Dietary Fiber and Its Relationship to Postprandial Glucose Concentration in Obese Patients with Type 2 Diabetes and Normoglycemic Subjects

Abstract

Background: The aim of this study was to investigate the relationship between postprandial glycemic levels based on flashmonitoring and the production of intestinal hydrogen (H2) and methane (CH4) gases based on the measurement of the amount of these gases in exhaled air. Materials and Methods: We studied 14 subjects with type 2 diabetes mellitus (T2DM) and 14 individuals without diabetes (control) with two food load tests, including two types of dietary fiber (inulin and guar gum), with the simultaneous determination of gases in exhaled air and the assessment of glucose levels. Results: All subjects in the control group had a significant increase in exhaled H2. OR for increased hydrogen production in patients with T2DM was 0.17 (95% CI 0.031–0.93, p = 0.043). The level of H2 in exhaled breath after food load in patients with T2DM was lower than in normoglycemic subjects. There was an inverse correlation between maximum glucose rise and maximum H2 in exhaled air after food load in normoglycemic subjects (r = −0.569, p = 0.034). Patients with T2DM had direct correlations between the level of CH4 in exhaled air and the parameters of postprandial glycemia in the lactulose test (p < 0.05). Conclusions: The confirmation of a causal relationship between decreased H2 production, increased intestinal CH4 production, and more severe postprandial glycemia may identify new therapeutic targets in the correction of postprandial glycemia in patients with T2DM.

Study details

Article type

Original Research

Disease / injury model

Type 2 Diabetes Mellitus (T2DM), Obesity, Normoglycemia (control)

Duration

5 days

Dose-dependent effect

No

Outcome

Neutral

Findings

The study found that exhaled hydrogen (H2) levels after food load were significantly lower in patients with type 2 diabetes mellitus (T2DM) compared to normoglycemic controls, while methane (CH4) levels in exhaled air directly correlated with postprandial glycemia in T2DM patients. In normoglycemic subjects, there was an inverse correlation between maximum glucose rise and maximum H2 in exhaled air after guar gum intake. These findings suggest a relationship between intestinal gas production and postprandial glycemia, with decreased H2 and increased CH4 associated with more severe postprandial glycemia in T2DM.