Glycemic and Cardiometabolic Effects of Rare Sugars Allulose and Tagatose: A Systematic Review and Meta-Analysis of Controlled Human Intervention Trials.

Authors

Lauryn Osborn, Kaitlyn DuPuis, Simin Liu, Dennis Della Corte, Karen A Della Corte

Published in

The American journal of clinical nutrition. Pages 101314. Apr 13, 2026. Epub Apr 13, 2026.

Abstract

Allulose and tagatose are rare monosaccharides gaining attention as potential alternatives to added sugars. This systematic review and meta-analysis aimed to evaluate the effects of allulose and tagatose supplementation on glycemic, cardiometabolic, and anthropometric outcomes in adults.
The MEDLINE, EMBASE, and Cochrane libraries were searched through April 30, 2025, for controlled human intervention trials reporting the effects of tagatose or allulose on postprandial and fasting glucose and insulin levels, blood lipids, uric acid, and anthropometric measures of adiposity in adults. Meta-analyses were conducted using mean differences with random-effects models applied to all analyses. The risk of bias was evaluated using the Cochrane Risk of Bias 2 and ROBINS-I tools, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
Of 4,905 initial reports, 20 trials were identified (12 allulose trials and 8 tagatose trials; 1,033 participants). Allulose significantly reduced postprandial glucose (iAUC: SMD = -0.66; 95% CI -0.92, -0.39; moderate certainty) and insulin (SMD = -1.27 (-2.14, -0.40); I² = 96%; p = 0.03; moderate certainty), with no significant effects on HbA1c, fasting glucose or insulin, lipids, uric acid, or body composition (very low to moderate certainty). Tagatose intake similarly lowered postprandial glucose (SMD = -1.03 (-1.36, -0.71)) and insulin (SMD = -1.05 (-1.61, -0.49); both moderate certainty) and also reduced HbA1c (MD = -0.25 (-0.44, -0.06); moderate certainty) and fasting insulin (MD = -80.40 (-136.96, -23.84); very low certainty). No other significant pooled effects were observed.
Supplementation of allulose or tagatose attenuates postprandial glycemic and insulin responses, albeit with no improvements in blood lipids and body composition.
CRD42024567433; https://www.crd.york.ac.uk/prospero/.

PMID:
41985675
Bibliographic data and abstract were imported from PubMed on 16 Apr 2026.

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