A Randomized Cross-Over Trial of the Postprandial Effects of Three Different Diets in Patients with Type 2 DiabetesReport as inadecuate

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In the clinic setting both fasting levels of glucose and the area under the curve AUC of glucose, by determination of HbA1c levels, are used for risk assessments, in type 2 diabetes NIDDM. However little is known about postprandial levels, and hence AUC, regarding other traditional risk factors such as insulin and blood-lipids and how this is affected by different diets.


To study postprandial effects of three diets, during a single day, in NIDDM.


A low-fat diet 45–56 energy-% from carbohydrates, and a low-carbohydrate diet 16–24 energy-% from carbohydrates was compared with a Mediterranean-style diet black coffee for breakfast and the same total-caloric intake as the other two diets for lunch with red wine, 32–35 energy−% from carbohydrates in a randomized cross-over design. Total-caloric intake-test-day at the clinic from food was 1025–1080 kCal in men and 905–984 kCal in women. The test meals were consumed at a diabetes ward under supervision.


Twenty-one participants were recruited and 19 completed the studies. The low-carbohydrate diet induced lower insulin and glucose excursions compared with the low-fat diet p<0.0005 for both AUC. The insulin-response following the single Mediterranean-style lunch-meal was more pronounced than during the low-fat diet lunch insulin increase-ratio of the low-fat diet: 4.35±2.2, of Mediterranean-style diet: 8.12±5.2, p = 0.001 while postprandial glucose levels were similar. The increase-ratio of insulin correlated with the elevation of the incretin glucose-dependent insulinotropic-polypeptide following the Mediterranean-style diet lunch Spearman, r = 0.64, p = 0.003.


The large Mediterranean-style lunch-meal induced similar postprandial glucose-elevations as the low-fat meal despite almost double amount of calories due to a pronounced insulin-increase. This suggests that accumulation of caloric intake from breakfast and lunch to a single large Mediterranean style lunch-meal in NIDDM might be advantageous from a metabolic perspective.

Trial Registration

ClinicalTrials.gov NCT01522157 NCT01522157

Author: Hanna Fernemark , Christine Jaredsson , Bekim Bunjaku, Ulf Rosenqvist, Fredrik H. Nystrom, Hans Guldbrand

Source: http://plos.srce.hr/


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