sugar alcohols

Summary

Summary: Polyhydric alcohols having no more than one hydroxy group attached to each carbon atom. They are formed by the reduction of the carbonyl group of a sugar to a hydroxyl group.(From Dorland, 28th ed)

Top Publications

  1. Fatouros A, Osterberg T, Mikaelsson M. Recombinant factor VIII SQ--inactivation kinetics in aqueous solution and the influence of disaccharides and sugar alcohols. Pharm Res. 1997;14:1679-84 pubmed
    To investigate the influence of various nonreducing disaccharides and sugar alcohols on the inactivation kinetics of recombinant factor VIII SQ (r-VIII SQ) in aqueous solution not containing albumin as a stabiliser.
  2. Kozlov I, Zielinski M, Allart B, Kerremans L, Van Aerschot A, Busson R, et al. Nonenzymatic template-directed reactions on altritol oligomers, preorganized analogues of oligonucleotides. Chemistry. 2000;6:151-5 pubmed
    ..Activated ANA and HNA monomers do not oligomerize efficiently on DNA, RNA, HNA, or ANA templates...
  3. Nojiri S, Taguchi N, Oishi M, Suzuki S. Determination of sugar alcohols in confectioneries by high-performance liquid chromatography after nitrobenzoylation. J Chromatogr A. 2000;893:195-200 pubmed
    A method was developed for the determination of sugar alcohols, meso-erythritol, xylitol, D-glucitol, D-mannitol, maltitol and parachinit by high-performance liquid chromatography (HPLC)...
  4. Farré E, Tiessen A, Roessner U, Geigenberger P, Trethewey R, Willmitzer L. Analysis of the compartmentation of glycolytic intermediates, nucleotides, sugars, organic acids, amino acids, and sugar alcohols in potato tubers using a nonaqueous fractionation method. Plant Physiol. 2001;127:685-700 pubmed
    ..More than 60% of most sugars, sugar alcohols, organic acids, and amino acids were found in the vacuole, although the concentrations of these metabolites is ..
  5. Arrigoni E, Brouns F, Amado R. Human gut microbiota does not ferment erythritol. Br J Nutr. 2005;94:643-6 pubmed
    ..Since under in vivo conditions more easily fermentable substrates enter the colon continuously, it seems very unlikely that erythritol will be fermented in vivo...
  6. Noguchi Y, Tanaka H, Kanamaru K, Kato M, Kobayashi T. Xylose triggers reversible phosphorylation of XlnR, the fungal transcriptional activator of xylanolytic and cellulolytic genes in Aspergillus oryzae. Biosci Biotechnol Biochem. 2011;75:953-9 pubmed
    ..These results indicate that XlnR is highly phosphorylated when it is active in transactivation, implying that D-xylose-triggered reversible phosphorylation controls XlnR activity...
  7. Katayama M, Matsuda Y, Kobayashi K, Kaneko S, Ishikawa H. Simultaneous determination of glucose, 1,5-anhydro-d-glucitol and related sugar alcohols in serum by high-performance liquid chromatography with benzoic acid derivatization. Biomed Chromatogr. 2006;20:440-5 pubmed
    ..l-Fucose, fructose, d-lactose, l-rhamnose, arabinose and ascorbic acid were not reacted. Sugar alcohols (xylitol, erythritol, mannitol, sorbitol myo-inositol) were also derivatized with BA at 80 degrees C for 60 ..
  8. Sickmann H, Walls A, Schousboe A, Bouman S, Waagepetersen H. Functional significance of brain glycogen in sustaining glutamatergic neurotransmission. J Neurochem. 2009;109 Suppl 1:80-6 pubmed publisher
    ..Neurotransmitter release was affected by the presence of d-lactate indicating that glycogen derived energy is important not only in the astrocytic but also in the neuronal compartment...
  9. Haukioja A, Soderling E, Tenovuo J. Acid production from sugars and sugar alcohols by probiotic lactobacilli and bifidobacteria in vitro. Caries Res. 2008;42:449-53 pubmed publisher
    ..None of the bifidobacteria fermented sugar alcohols. As all the strains could be considered acidogenic, more long-term clinical trials are needed before ..

More Information

Publications62

  1. Nadwodnik J, Lohaus G. Subcellular concentrations of sugar alcohols and sugars in relation to phloem translocation in Plantago major, Plantago maritima, Prunus persica, and Apium graveolens. Planta. 2008;227:1079-89 pubmed publisher
  2. Fisher M, Abramov M, Van Aerschot A, Xu D, Juliano R, Herdewijn P. Inhibition of MDR1 expression with altritol-modified siRNAs. Nucleic Acids Res. 2007;35:1064-74 pubmed
    ..These observations suggest that altritol modifications may be helpful in developing siRNAs with enhanced pharmacological effectiveness...
  3. Silk J, Salio M, Reddy B, Shepherd D, Gileadi U, Brown J, et al. Cutting edge: nonglycosidic CD1d lipid ligands activate human and murine invariant NKT cells. J Immunol. 2008;180:6452-6 pubmed
    ..The ability of these compounds to assist the priming of Ag-specific immune responses while minimizing iNKT cell-dependent DC lysis makes them attractive adjuvants for vaccination strategies...
  4. Ouwehand A, Tiihonen K, Saarinen M, Putaala H, Rautonen N. Influence of a combination of Lactobacillus acidophilus NCFM and lactitol on healthy elderly: intestinal and immune parameters. Br J Nutr. 2009;101:367-75 pubmed publisher
    ..The results suggest that consumption of lactitol combined with L. acidophilus NCFM twice daily may improve some markers of the intestinal microbiota composition and mucosal functions...
  5. Kuno Y, Kojima M, Ando S, Nakagami H. Evaluation of rapidly disintegrating tablets manufactured by phase transition of sugar alcohols. J Control Release. 2005;105:16-22 pubmed
    ..It is concluded that a combination of low and high melting point sugar alcohols, as well as a phase transition in the manufacturing process, are important for making RD tablets without any ..
  6. Maier T, Przylas I, Strater N, Herdewijn P, Saenger W. Reinforced HNA backbone hydration in the crystal structure of a decameric HNA/RNA hybrid. J Am Chem Soc. 2005;127:2937-43 pubmed
    ..The reinforced backbone hydration is suggested to contribute significantly to the exceptional stability of HNA-containing duplexes and might be one of the causes for the evolutionary preference for ribose-derived nucleic acids...
  7. Reidel E, Rennie E, Amiard V, Cheng L, Turgeon R. Phloem loading strategies in three plant species that transport sugar alcohols. Plant Physiol. 2009;149:1601-8 pubmed publisher
    Many plants translocate sugar alcohols in the phloem. However, the mechanism(s) of sugar alcohol loading in the minor veins of leaves are debated...
  8. Liu T, Zhang H, Liu F, Wu Q, Shen X, Yang Q. Structural determinants of an insect beta-N-Acetyl-D-hexosaminidase specialized as a chitinolytic enzyme. J Biol Chem. 2011;286:4049-58 pubmed publisher
  9. Payne A, Chassard C, Lacroix C. Gut microbial adaptation to dietary consumption of fructose, artificial sweeteners and sugar alcohols: implications for host-microbe interactions contributing to obesity. Obes Rev. 2012;13:799-809 pubmed publisher
    ..A concomitant rise in the consumption of fructose and sugar substitutes such as sugar alcohols, artificial sweeteners, even rare sugars, has mirrored this trend, as both probable contributor and solution ..
  10. Akel E, Metz B, Seiboth B, Kubicek C. Molecular regulation of arabinan and L-arabinose metabolism in Hypocrea jecorina (Trichoderma reesei). Eukaryot Cell. 2009;8:1837-44 pubmed publisher
    ..jecorina for growth on arabinan requires an early pathway intermediate (L-arabinitol or L-arabinose), the first enzyme of the pathway XYL1, and in the case of abf2 and bxl1 also the function of the cellulase regulator XYR1...
  11. Majumder A, Sultan A, Jersie Christensen R, Ejby M, Schmidt B, Lahtinen S, et al. Proteome reference map of Lactobacillus acidophilus NCFM and quantitative proteomics towards understanding the prebiotic action of lactitol. Proteomics. 2011;11:3470-81 pubmed publisher
    ..This first comprehensive proteome analysis of L. acidophilus NCFM provides insights into protein abundance changes elicited by the prebiotic lactitol...
  12. Gibbs M, Anderson D, Hertz L. Inhibition of glycogenolysis in astrocytes interrupts memory consolidation in young chickens. Glia. 2006;54:214-22 pubmed
  13. Suzuki A, Stern S, Bozdagi O, Huntley G, Walker R, Magistretti P, et al. Astrocyte-neuron lactate transport is required for long-term memory formation. Cell. 2011;144:810-23 pubmed publisher
    ..We conclude that astrocyte-neuron lactate transport is required for long-term memory formation...
  14. Yang Y, Liu T, Yang Y, Wu Q, Yang Q, Yu B. Synthesis, evaluation, and mechanism of N,N,N-trimethyl-D-glucosamine-(1?4)-chitooligosaccharides as selective inhibitors of glycosyl hydrolase family 20 ?-N-acetyl-D-hexosaminidases. Chembiochem. 2011;12:457-67 pubmed publisher
    ..Inhibitory kinetics and molecular docking showed that TMG-(GlcNAc)(2), is as active as TMG-chitotriomycin [TMG-(GlcNAc)(3)]. The selective inhibition mechanism of TMG-chitotriomycin was also explained...
  15. Link T, Lohaus G, Heiser I, Mendgen K, Hahn M, Voegele R. Characterization of a novel NADP(+)-dependent D-arabitol dehydrogenase from the plant pathogen Uromyces fabae. Biochem J. 2005;389:289-95 pubmed
    ..ARD1p may therefore play an important role in carbohydrate metabolism and in establishing and/or maintaining the biotrophic interaction in U. fabae...
  16. Fisher M, Abramov M, Van Aerschot A, Rozenski J, Dixit V, Juliano R, et al. Biological effects of hexitol and altritol-modified siRNAs targeting B-Raf. Eur J Pharmacol. 2009;606:38-44 pubmed publisher
    ..The basis for the increased effectiveness of the hexitol-modified siRNAs is not fully understood but may be partly due to increased stability to nucleases...
  17. Akinterinwa O, Khankal R, Cirino P. Metabolic engineering for bioproduction of sugar alcohols. Curr Opin Biotechnol. 2008;19:461-7 pubmed publisher
    b>Sugar alcohols find applications in pharmaceuticals, oral and personal care products, and as intermediates in chemical synthesis...
  18. Ichikawa T, Yano Y, Fujita Y, Kashiwabara T, Nagao K. The enhancement effect of three sugar alcohols on the fungicidal effect of benzethonium chloride toward Candida albicans. J Dent. 2008;36:965-8 pubmed publisher
    The purpose of this study was to evaluate if the sugar alcohols erythritol, xylitol and sorbitol enhance the fungicidal effect of benzethonium chloride (BTC) toward in vitro candidal biofilms.
  19. Palkovits R, Tajvidi K, Ruppert A, Procelewska J. Heteropoly acids as efficient acid catalysts in the one-step conversion of cellulose to sugar alcohols. Chem Commun (Camb). 2011;47:576-8 pubmed publisher
    ..Thereby, heteropoly acids together with supported ruthenium catalysts show not only high activity but also remarkable selectivity to sugar alcohols reaching up to 81% yield of C(4) to C(6) sugar alcohols in only 7 h at 160 °C.
  20. Kadoya S, Fujii K, Izutsu K, Yonemochi E, Terada K, Yomota C, et al. Freeze-drying of proteins with glass-forming oligosaccharide-derived sugar alcohols. Int J Pharm. 2010;389:107-13 pubmed publisher
    Physical properties and protein-stabilizing effects of sugar alcohols in frozen aqueous solutions and freeze-dried solids were studied...
  21. Walls A, Sickmann H, Brown A, Bouman S, Ransom B, Schousboe A, et al. Characterization of 1,4-dideoxy-1,4-imino-d-arabinitol (DAB) as an inhibitor of brain glycogen shunt activity. J Neurochem. 2008;105:1462-70 pubmed publisher
    ..Based on the experimental findings, DAB can be used to evaluate glycogen shunt activity and its functional importance in intact brain tissue and cells at a concentration of 300-1000 muM and a pre-incubation period of 1 h...
  22. Steiner A, Stütz A, Tarling C, Withers S, Wrodnigg T. Iminoalditol-amino acid hybrids: synthesis and evaluation as glycosidase inhibitors. Carbohydr Res. 2007;342:1850-8 pubmed
    ..All fluorescent iminoalditol-amino acid hybrids prepared in this study exhibited glycosidase inhibitory activities better than or comparable to the parent compounds'...
  23. Biebl H, Schwab Hanisch H, Sproer C, Lunsdorf H. Propionispora vibrioides, nov. gen., nov. sp., a new gram-negative, spore-forming anaerobe that ferments sugar alcohols. Arch Microbiol. 2000;174:239-47 pubmed
    ..Clostridium quercicolum), morphologically different. It is therefore proposed to classify strain FKBS1 as a new genus and species, Propionispora vibrioides...
  24. Fredlund E, Broberg A, Boysen M, Kenne L, Schnurer J. Metabolite profiles of the biocontrol yeast Pichia anomala J121 grown under oxygen limitation. Appl Microbiol Biotechnol. 2004;64:403-9 pubmed
    ..The levels of these metabolites were generally significantly higher in treatment (B) than in (A), indicating their importance for P. anomala during severe oxygen limitation/anaerobic conditions...
  25. Hanko V, Rohrer J. Determination of carbohydrates, sugar alcohols, and glycols in cell cultures and fermentation broths using high-performance anion-exchange chromatography with pulsed amperometric detection. Anal Biochem. 2000;283:192-9 pubmed
    ..Carbohydrates serve as carbon sources for many microorganisms, while sugar alcohols (alditols), glycols (glycerol), and alcohols (methanol and ethanol) are metabolic products...
  26. Abramov M, Marchand A, Calleja Marchand A, Herdewijn P. Synthesis of D-altritol nucleosides with a 3'-O-tert-butyldimethylsilyl protecting group. Nucleosides Nucleotides Nucleic Acids. 2004;23:439-55 pubmed
    ..For the introduction of the 3'-O-silyl protecting group, long reaction times and several equivalents of tert-butyldimethylsilyl chloride are needed...
  27. van Loveren C. Sugar alcohols: what is the evidence for caries-preventive and caries-therapeutic effects?. Caries Res. 2004;38:286-93 pubmed
    The most widely used sugar alcohols are: xylitol, sorbitol, mannitol, maltitol, lactitol and the products Lycasin and Palatinit. It is often claimed that xylitol is superior to the other sugar alcohols for caries control...
  28. Kayingo G, Kilian S, Prior B. Conservation and release of osmolytes by yeasts during hypo-osmotic stress. Arch Microbiol. 2001;177:29-35 pubmed
    ..The kinetics and patterns of osmolyte export suggest the involvement of channel proteins, but the molecular nature of this export pathway in yeasts, with exception of S. cerevisiae, remains to be established...
  29. Watari J, Kobae Y, Yamaki S, Yamada K, Toyofuku K, Tabuchi T, et al. Identification of sorbitol transporters expressed in the phloem of apple source leaves. Plant Cell Physiol. 2004;45:1032-41 pubmed publisher
    ..In addition, in situ hybridization revealed that all MdSOTs were expressed to high levels in phloem of minor veins in source leaves. These results suggest that these MdSOTs are involved in sorbitol loading in Rosaceae...
  30. Langer M, Holtje M, Urbanetz N, Brandt B, Holtje H, Lippold B. Investigations on the predictability of the formation of glassy solid solutions of drugs in sugar alcohols. Int J Pharm. 2003;252:167-79 pubmed
    ..the present study focuses on the evaluation of factors that govern the miscibility of molten drugs and sugar alcohols as carriers...
  31. Kang H, Fisher M, Xu D, Miyamoto Y, Marchand A, Van Aerschot A, et al. Inhibition of MDR1 gene expression by chimeric HNA antisense oligonucleotides. Nucleic Acids Res. 2004;32:4411-9 pubmed
    ..Thus, HNA gapmers may provide a valuable additional tool for antisense-based investigations and therapeutic approaches...
  32. Abadias M, Teixido N, Usall J, Vinas I, Magan N. Solute stresses affect growth patterns, endogenous water potentials and accumulation of sugars and sugar alcohols in cells of the biocontrol yeast Candida sake. J Appl Microbiol. 2000;89:1009-17 pubmed
    ..996-0.92) of a molasses medium with different solutes (glycerol, glucose, NaCl, proline or sorbitol) on growth, intracellular water potentials (psi(c)) and endogenous accumulation of polyols/sugars in the biocontrol yeast Candida sake...
  33. Carbonero E, Cordeiro L, Mellinger C, Sassaki G, Stocker Wörgötter E, J Gorin P, et al. Galactomannans with novel structures from the lichen Roccella decipiens Darb. Carbohydr Res. 2005;340:1699-705 pubmed
    ..RFS contained a similar alpha-D-Manp core structure, but with side chains containing nonreducing end, 5-O-, 6-O-, and 5,6-di-O-substituted beta-D-Galf units. Such polysaccharide structures have not been previously reported...
  34. Gostner A, Schaffer V, Theis S, Menzel T, Luhrs H, Melcher R, et al. Effects of isomalt consumption on gastrointestinal and metabolic parameters in healthy volunteers. Br J Nutr. 2005;94:575-81 pubmed
    ..This suggests that isomalt is well tolerated and that consumption of isomalt does not impair metabolic function or induce hypercalciuria. In addition, the study data indicate that isomalt could be useful in improving bowel function...
  35. Tanabe G, Otani T, Cong W, Minematsu T, Ninomiya K, Yoshikawa M, et al. Biological evaluation of 3'-O-alkylated analogs of salacinol, the role of hydrophobic alkyl group at 3' position in the side chain on the ?-glucosidase inhibitory activity. Bioorg Med Chem Lett. 2011;21:3159-62 pubmed publisher
    ..Thus, introduction of a hydrophobic moiety at the C3' position of this new class of inhibitor was found beneficial for onset of stronger inhibition against these enzymes...
  36. Mužíková J, Pavlasová V. Energy evaluation of the compaction process of directly compressible isomalt. Ceska Slov Farm. 2011;60:11-6 pubmed
  37. Tanabe G, Yoshikai K, Hatanaka T, Yamamoto M, Shao Y, Minematsu T, et al. Biological evaluation of de-O-sulfonated analogs of salacinol, the role of sulfate anion in the side chain on the alpha-glucosidase inhibitory activity. Bioorg Med Chem. 2007;15:3926-37 pubmed
    ..These results indicated that the O-sulfonate anion moiety of 1a is not essential for the inhibitory activity...
  38. Onorato A, Pavlik C, Invernale M, Berghorn I, Sotzing G, Morton M, et al. Polymer-mediated cyclodehydration of alditols and ketohexoses. Carbohydr Res. 2011;346:1662-70 pubmed publisher
    ..A cascade reaction with ketohexoses is observed in toluene via cyclodehydration followed by Friedel-Crafts alkylation of the initially formed benzylic alcohol to give 16...
  39. Ovaere M, Van Aerschot A, Abramov M, Herdewijn P, Van Meervelt L. Crystallization and preliminary X-ray study of the D-altritol oligonucleotide GTGTACAC. Acta Crystallogr Sect F Struct Biol Cryst Commun. 2010;66:460-2 pubmed publisher
    ..Diffraction data were recorded on SLS beamline X06DA and processed to 3.0 A resolution. The crystals belonged to the hexagonal space group P6(1)22 or P6(5)22, with unit-cell parameters a = 25.05, c = 117.58 A...
  40. Tan Y, Li K, Hu L, Chen S, Gai Y, Jiang X. Fast and simple droplet sampling of sap from plant tissues and capillary microextraction of soluble saccharides for picogram-scale quantitative determination with GC-MS. J Agric Food Chem. 2010;58:9931-5 pubmed publisher
    ..The method is suitable and applicable to analysis of soluble monosaccharides in fresh tissues and other aqueous samples in wide fields of agriculture, food science, biological sciences, and even medical studies...
  41. Allscher T, Klüfers P. Carbohydrate chelation in neutral aqueous solution: the threo-tetritolato-Pd(4) butterfly motif. Chemistry. 2012;18:10571-84 pubmed publisher
    Alditols ("sugar alcohols", "glycitols") form palladium(II) complexes in neutral aqueous solution if they can provide the threitol partial structure...
  42. Garrabou X, Gómez L, Joglar J, Gil S, Parella T, Bujons J, et al. Structure-guided minimalist redesign of the L-fuculose-1-phosphate aldolase active site: expedient synthesis of novel polyhydroxylated pyrrolizidines and their inhibitory properties against glycosidases and intestinal disaccharidases. Chemistry. 2010;16:10691-706 pubmed publisher
  43. Jesus A, Tomé L, Rosado M, Leitão M, Redinha J. Conformational study of erythritol and threitol in the gas state by density functional theory calculations. Carbohydr Res. 2005;340:283-91 pubmed
    ..The weighted mean enthalpy of both diastereomers in the gas state at 298.15 K was obtained from the thermodynamic data and Boltzmann populations of the low-energy conformers...
  44. Das S, Reddy K, Narasimha Rao Krovvidi V, Mukkanti K. InCl3 as a powerful catalyst for the acetylation of carbohydrate alcohols under microwave irradiation. Carbohydr Res. 2005;340:1387-92 pubmed
    ..Indium(III) chloride catalyzed microwave assisted acetylation of different carbohydrates is an efficient synthesis of per-O-acetyl derivatives and provides the products in good to excellent yields...
  45. Gullapalli P, Takata G, Poonperm W, Rao D, Morimoto K, Akimitsu K, et al. Bioproduction of D-psicose from allitol with Enterobacter aerogenes IK7: a new frontier in rare ketose production. Biosci Biotechnol Biochem. 2007;71:3048-54 pubmed
    ..Finally, the product was crystallized and confirmed to be D-psicose by analytical methods...
  46. Quilez J, Bullo M, Salas Salvado J. Improved postprandial response and feeling of satiety after consumption of low-calorie muffins with maltitol and high-amylose corn starch. J Food Sci. 2007;72:S407-11 pubmed
    ..These metabolic properties are useful in normal and overweight persons. However, further research is needed on the effects of this type of products in individuals with impaired glucose tolerance...
  47. de Paz M, Zamora F, Begines B, Ferris C, Galbis J. Glutathione-mediated biodegradable polyurethanes derived from L-arabinitol. Biomacromolecules. 2010;11:269-76 pubmed publisher
    ..02 and 37 degrees C). The degradation pattern of the copolymers depended not only on the dithiodiethanol (DiT) reactive units ratio in the polymer backbone, but also on the crystallinity of the macromolecule...
  48. Walters K, Pan Q, Serianni A, Duman J. Cryoprotectant biosynthesis and the selective accumulation of threitol in the freeze-tolerant Alaskan beetle, Upis ceramboides. J Biol Chem. 2009;284:16822-31 pubmed publisher
  49. Aizawa S, Miyasawa Hori H, Nakajo K, Washio J, Mayanagi H, Fukumoto S, et al. Effects of alpha-amylase and its inhibitors on acid production from cooked starch by oral streptococci. Caries Res. 2009;43:17-24 pubmed publisher
    ..In terms of the acidogenic potential of cooked starch, S. sanguinis and S. mitis were comparable to S. mutans and S. sobrinus. Alpha-amylase inhibitors and xylitol might moderate this activity...
  50. Abramov M, Herdewijn P. Synthesis of altritol nucleoside phosphoramidites for oligonucleotide synthesis. Curr Protoc Nucleic Acid Chem. 2007;Chapter 1:Unit 1.18 pubmed publisher
    ..The cytosine nucleoside is synthesized starting from the uracil congener. The 3'-hydroxyl function of hexitol sugar is protected with the benzoyl group...
  51. Daimon T, Taguchi T, Meng Y, Katsuma S, Mita K, Shimada T. Beta-fructofuranosidase genes of the silkworm, Bombyx mori: insights into enzymatic adaptation of B. mori to toxic alkaloids in mulberry latex. J Biol Chem. 2008;283:15271-9 pubmed publisher
    ..This anomalous presence of the beta-fructofuranosidase gene in the B. mori genome may partly explain why the silkworm can circumvent the mulberry's defense system...
  52. Chheda J, Huber G, Dumesic J. Liquid-phase catalytic processing of biomass-derived oxygenated hydrocarbons to fuels and chemicals. Angew Chem Int Ed Engl. 2007;46:7164-83 pubmed
  53. Park J, Yoon J, Min S, Hong S, Park J, Jang E, et al. [A case of recurrent pneumatosis cystoides intestinalis associated with recurrent pneumoperitoneum]. Korean J Gastroenterol. 2007;50:188-92 pubmed
    ..We report a case of recurrent pneumatosis cystoides intestinalis associated with benign recurrent pneumoperitoneum developed probably secondary to lactitol therapy...