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The Effect of Alpha-Cyclodextrin on Postprandial Glucose Excursions: a Systematic Meta-Analysis
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Abstract
Alpha-cyclodextrin (αCD) is a bacterial product that is widely used as a food ingredient. In the European Union (EU), αCD is regulated as a dietary fiber with an authorized health claim "for contributing to the reduction of postprandial glycemic responses." In the US, αCD is generally recognized as save (GRAS), but on April 25, 2022, the U.S. Food and Drug Administration (FDA) rejected the inclusion of αCD in the list of dietary fibers because "the strength of the scientific evidence does not support a finding of a beneficial effect of αCD on postprandial blood glucose …" To evaluate the strength of this scientific evidence, this meta-analysis reviews clinical trials conducted to test the effect of αCD on the rise of blood glucose and insulin levels during three hours after consumption of a meal comprising carbohydrates, fats, and proteins. Several issues related to the standardization of the outcomes, the choice of the statistical methods in the cross-over studies conducted, and the choice of methods for the aggregation of P-values are discussed. It is concluded that the administration of αCD not only reduces the postprandial glycemic responses, but the absence of an increase in insulin levels suggests that αCD acts independently of increasing insulin production and, thus, the beneficial effect of αCD is not affected by insulin resistance.
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![Figure 1 PRISMA flow diagram Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 [7]](/paper-figures/96c88f153b144ced995a199953b3fef5/the-effect-of-alpha-cyclodextrin-on-postprandial-glucose-excursions-a-systematic-figure-1.jpg)
![Figure 2 Data extraction summary: effects of different doses of αCD on blood glucose profiles. In all studies, each of >8 patients was administered all doses (cross-over). Legend: ***: P < .001; *: P < .05; °: P < .37, Figures were derived (excerpted) under 17 U.S.C. § 107 (fair use in scholarship and research) from Buckley, et al. (2006, permission granted) [14], Sugahara, Inoue, et al. (2016) [21], Bär, Diamantis, et al. (2020, CC BY 4.0) [5] Fletcher, et al. (2014, dissertation) [17], Lytle, et al. (2018, redrawn) [11], Binou, et al. (2022, permission granted) [22,23], Gentilcore, et al. (2011, permission granted) [4]: To serve the purpose of scholarly criticism, figures have been scaled to have similar axes, scales were cropped at 180 min [4,11], colors and some misleading indicators of “significance” were removed, and information was added to their sub-legends. αCD: alpha-cyclodextrin](/paper-figures/4d6525d4d305451e8a596f4a287ea66a/the-effect-of-alpha-cyclodextrin-on-postprandial-glucose-excursions-a-systematic-figure-2.jpg)
![Figure 3 Data extraction summary: effects of different doses of αCD on serum insulin and TG Legend: ***: P < .001; *: P < .05; °: P < .37, figures were derived (excerpted) under 17 U.S.C. § 107 (fair use in scholarship and research) from Buckley, et al. (2006, permission granted) [14], Sugahara, Inoue, et al. (2016) [21], Bär, Diamantis, et al. (2020, CC BY 4.0) [5] Fletcher, et al. (2014, dissertation) [17], Lytle, et al. (2018, redrawn) [11], Binou, et al. (2022, permission granted) [22,23], Gentilcore, et al. (2011, permission granted) [4]: To serve the purpose of scholarly criticism, figures have been scaled to have similar axes, scales were cropped at 180 min [4,11], colors and some misleading indicators of “significance” were removed, and information was added to their sub-legends. αCD: alpha-cyclodextrin; TG: triglyceride](/paper-figures/366f61301433450dbdf8d88a50dcf379/the-effect-of-alpha-cyclodextrin-on-postprandial-glucose-excursions-a-systematic-figure-3.jpg)
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Cites
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The benefits of early intervention in obese diabetic patients with FBCx™ — a new dietary fibre
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The Beneficial Effects α‐Cyclodextrin on Blood Lipids and Weight Loss in Healthy Humans
Comerford, K. B., Artiss, J. D., Jen, K. ‐. C., & Karakas, S. E. (2010) · Obesity · doi:10.1038/oby.2010.280 · Cited by 69
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Randomized double blind clinical trial on the effect of oral α-cyclodextrin on serum lipids
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Research works printed but not linked: 1
- Effect of cyclodextrin on postprandial blood glucose and triglycerides. (2022). Accessed. 2022-09-01: https://www.semanticscholar.org/paper/Effect-of-cyclodextrin-on-postprandial-blood-and-Sugahara-Inoue/a8f2e5365a72faa....
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How Do Cyclodextrins and Dextrans Affect the Gut Microbiome? Review of Prebiotic Activity
Gościniak, A., Lainé, E., & Cielecka‐Piontek, J. (2024) · Molecules · doi:10.3390/molecules29225316 · Cited by 8
Văruț, R. M., Ciolofan, M. S., Veronica, M. E., Radivojević, K., Trașcă, D.-M., Popescu, C., Diaconu, O. A., & Singer, C. E. (2025) · Pharmaceutics · doi:10.3390/pharmaceutics17060752 · Cited by 6
Wittkowski, K. M. (2022) · doi:10.1101/2022.09.04.22279468 · Cited by 3
Self-citation
Metadata
- Authors
- Wittkowski, K. M.
- Corresponding author
- Wittkowski, Knut M
- ORCID
- Wittkowski, Knut M
- Venue
- Cureus
- Published
- 2022-11-06
- Volume
- 14
- Issue
- 11
- Pages
- e31160-e31160
- ISSN
- 2168-8184 (ISSN-L)
- PMC
- PMC9637372
- OpenAlex
- W4308317698
- Cited by
- 3
- References
- 22
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 1
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Cureus (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by-nd)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Natural Antidiabetic Agents Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Microbial Metabolites in Food Biotechnology
- Keywords
- α-cyclodextrin, postprandial glycemic response, blood glucose, insulin, dietary fiber, health claims, insulin resistance, carbohydrate digestion
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