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Abstract
Background: High dietary acid load relates to increased risk of type 2 diabetes in epidemiological studies. We aimed to investigate whether buffering a high acid load meal with an alkalising treatment changes post meal glucose metabolism. Methods: Non-diabetic participants (n=32) were randomized to receive either NaHCO3 1680mg or placebo, followed by a high acid load meal in a double-blind placebo-controlled crossover (1-4 weeks apart) study. Thirty (20 males) participants completed the study. Venous blood pH, serum bicarbonate, blood glucose, serum insulin, C-peptide, non-esterified fatty acid (NEFA), and plasma glucagon-like peptide-1 (GLP-1) concentrations were measured at baseline (fasting) and at 15-30min intervals for 3h post meal. Results: The treatment was well tolerated. Venous blood pH declined in the first 15min post meal with the placebo (p=0.001), but not with NaHCO3 (p=0.86) and remained lower with the placebo for 3h (pinteraction=0.04). The iAUC of pH was significantly higher following the NaHCO3 treatment versus the placebo (p=0.02). However, postprandial glucose, insulin, C-peptide, NEFA and GLP-1 were not different between treatments (pinteraction≥0.07). Conclusions: An alkalising medication administered pre-meal has no acute effect on glycaemia and insulin response in healthy individuals. Long-term interventions in at-risk populations are necessary to investigate the effect of sustained alkalisation on glucose metabolism.