A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes.
<h4>Background</h4>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...
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0079324&type=printable |
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| author | Hanna Fernemark Christine Jaredsson Bekim Bunjaku Ulf Rosenqvist Fredrik H Nystrom Hans Guldbrand |
| author_facet | Hanna Fernemark Christine Jaredsson Bekim Bunjaku Ulf Rosenqvist Fredrik H Nystrom Hans Guldbrand |
| author_sort | Hanna Fernemark |
| collection | DOAJ |
| description | <h4>Background</h4>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.<h4>Objective</h4>To study postprandial effects of three diets, during a single day, in NIDDM.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusions</h4>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.<h4>Trial registration</h4>ClinicalTrials.gov NCT01522157 NCT01522157. |
| format | Article |
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| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-c3177dc054bd449e8e9f3a87e21f0c1c2025-08-20T02:20:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01811e7932410.1371/journal.pone.0079324A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes.Hanna FernemarkChristine JaredssonBekim BunjakuUlf RosenqvistFredrik H NystromHans Guldbrand<h4>Background</h4>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.<h4>Objective</h4>To study postprandial effects of three diets, during a single day, in NIDDM.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusions</h4>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.<h4>Trial registration</h4>ClinicalTrials.gov NCT01522157 NCT01522157.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0079324&type=printable |
| spellingShingle | Hanna Fernemark Christine Jaredsson Bekim Bunjaku Ulf Rosenqvist Fredrik H Nystrom Hans Guldbrand A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes. PLoS ONE |
| title | A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes. |
| title_full | A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes. |
| title_fullStr | A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes. |
| title_full_unstemmed | A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes. |
| title_short | A randomized cross-over trial of the postprandial effects of three different diets in patients with type 2 diabetes. |
| title_sort | randomized cross over trial of the postprandial effects of three different diets in patients with type 2 diabetes |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0079324&type=printable |
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