A randomized controlled trial of fruit meal sequence with low, moderate, and high glycemic indexes among type 2 diabetes mellitus patients

Summary: Aim: We aimed to study the low, moderate, and high glycemic indexes of fruit meal sequence among T2DM patients in Indonesia by measuring Fasting Blood Glucose (FBG) and insulin levels, Homeostasis model assessment of β-cell function (HOMA-β), and Dipeptidyl peptidase-4 (DPP4) activity. Met...

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Main Authors: Dono Indarto, Nuraini Fitri, Fitria Umagapi, Sudrajah Warajati Kisnawaty, Yohanes Cakrapradipta Wibowo, Melani Ratih Mahanani
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Clinical Nutrition Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667268524000871
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author Dono Indarto
Nuraini Fitri
Fitria Umagapi
Sudrajah Warajati Kisnawaty
Yohanes Cakrapradipta Wibowo
Melani Ratih Mahanani
author_facet Dono Indarto
Nuraini Fitri
Fitria Umagapi
Sudrajah Warajati Kisnawaty
Yohanes Cakrapradipta Wibowo
Melani Ratih Mahanani
author_sort Dono Indarto
collection DOAJ
description Summary: Aim: We aimed to study the low, moderate, and high glycemic indexes of fruit meal sequence among T2DM patients in Indonesia by measuring Fasting Blood Glucose (FBG) and insulin levels, Homeostasis model assessment of β-cell function (HOMA-β), and Dipeptidyl peptidase-4 (DPP4) activity. Methods: A randomized controlled trial (RCT), which included 48 participants, was conducted from November 2018 to March 2019. The meal sequence treatments were done in two intervals: 1–7 days fruit last meal (FL) and 14–21 days fruit first meal (FF). Results: Significant differences in insulin and HOMA-β between control and low GI were observed in both intervals. However, no significant changes in Insulin level (5.16±3.47 vs. 5.51±6.16 μIU/ml, p=0.819) and HOMA-β (17.61±11.33 vs. 20.65±17.88, p=0.465) were observed from low GI in two different intervals. Conclusions: Our study clearly uncovered that low GI fruit consumption is beneficial in increasing insulin levels and HOMA-β but is independent of fruit meal sequence. Moderate and high GI fruits showed beneficial effects on insulin levels and HOMA-β only if consumed after the main meal. Although a significant decrease in FBG levels after 7 and 21 days was observed, the analysis on intervals (day 7-1 and 21-14) showed no changes in FBG levels after fruit sequence after or before meal. Further studies are needed to investigate the long-term effects of fruit meal sequence on glycemic parameters.This study provides evidence on how fruit meal sequence can directly affect the FBG level, insulin level, and HOMA-β. Given the essential effects of fruit meal sequence, this study gives insight into the integration of optimization of fiber intake from fruits and the meal sequence in T2DM management.
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spelling doaj-art-fabf24b67f06406c8f6d29dc41f965392025-08-20T02:50:09ZengElsevierClinical Nutrition Open Science2667-26852024-12-0158697910.1016/j.nutos.2024.09.005A randomized controlled trial of fruit meal sequence with low, moderate, and high glycemic indexes among type 2 diabetes mellitus patientsDono Indarto0Nuraini Fitri1Fitria Umagapi2Sudrajah Warajati Kisnawaty3Yohanes Cakrapradipta Wibowo4Melani Ratih Mahanani5Department of Physiology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia; Postgraduate Program of Nutrition Sciences, Universitas Sebelas Maret, Surakarta, Indonesia; Biomedical Laboratory, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia; Corresponding author. Department of Physiology, Faculty of Medicine Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, 57126, Indonesia.Postgraduate Program of Nutrition Sciences, Universitas Sebelas Maret, Surakarta, Indonesia; Tanjung Medan Primary Health Care, Bengkalis, Riau, IndonesiaPostgraduate Program of Nutrition Sciences, Universitas Sebelas Maret, Surakarta, IndonesiaPostgraduate Program of Nutrition Sciences, Universitas Sebelas Maret, Surakarta, IndonesiaBiomedical Laboratory, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, IndonesiaDisease Control Research Group, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, IndonesiaSummary: Aim: We aimed to study the low, moderate, and high glycemic indexes of fruit meal sequence among T2DM patients in Indonesia by measuring Fasting Blood Glucose (FBG) and insulin levels, Homeostasis model assessment of β-cell function (HOMA-β), and Dipeptidyl peptidase-4 (DPP4) activity. Methods: A randomized controlled trial (RCT), which included 48 participants, was conducted from November 2018 to March 2019. The meal sequence treatments were done in two intervals: 1–7 days fruit last meal (FL) and 14–21 days fruit first meal (FF). Results: Significant differences in insulin and HOMA-β between control and low GI were observed in both intervals. However, no significant changes in Insulin level (5.16±3.47 vs. 5.51±6.16 μIU/ml, p=0.819) and HOMA-β (17.61±11.33 vs. 20.65±17.88, p=0.465) were observed from low GI in two different intervals. Conclusions: Our study clearly uncovered that low GI fruit consumption is beneficial in increasing insulin levels and HOMA-β but is independent of fruit meal sequence. Moderate and high GI fruits showed beneficial effects on insulin levels and HOMA-β only if consumed after the main meal. Although a significant decrease in FBG levels after 7 and 21 days was observed, the analysis on intervals (day 7-1 and 21-14) showed no changes in FBG levels after fruit sequence after or before meal. Further studies are needed to investigate the long-term effects of fruit meal sequence on glycemic parameters.This study provides evidence on how fruit meal sequence can directly affect the FBG level, insulin level, and HOMA-β. Given the essential effects of fruit meal sequence, this study gives insight into the integration of optimization of fiber intake from fruits and the meal sequence in T2DM management.http://www.sciencedirect.com/science/article/pii/S2667268524000871Type 2 diabetesMeal sequencesGlycemic indexInsulinGlucose levelDPP4 activity
spellingShingle Dono Indarto
Nuraini Fitri
Fitria Umagapi
Sudrajah Warajati Kisnawaty
Yohanes Cakrapradipta Wibowo
Melani Ratih Mahanani
A randomized controlled trial of fruit meal sequence with low, moderate, and high glycemic indexes among type 2 diabetes mellitus patients
Clinical Nutrition Open Science
Type 2 diabetes
Meal sequences
Glycemic index
Insulin
Glucose level
DPP4 activity
title A randomized controlled trial of fruit meal sequence with low, moderate, and high glycemic indexes among type 2 diabetes mellitus patients
title_full A randomized controlled trial of fruit meal sequence with low, moderate, and high glycemic indexes among type 2 diabetes mellitus patients
title_fullStr A randomized controlled trial of fruit meal sequence with low, moderate, and high glycemic indexes among type 2 diabetes mellitus patients
title_full_unstemmed A randomized controlled trial of fruit meal sequence with low, moderate, and high glycemic indexes among type 2 diabetes mellitus patients
title_short A randomized controlled trial of fruit meal sequence with low, moderate, and high glycemic indexes among type 2 diabetes mellitus patients
title_sort randomized controlled trial of fruit meal sequence with low moderate and high glycemic indexes among type 2 diabetes mellitus patients
topic Type 2 diabetes
Meal sequences
Glycemic index
Insulin
Glucose level
DPP4 activity
url http://www.sciencedirect.com/science/article/pii/S2667268524000871
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