High-energy breakfast with low-energy dinner decreases overall daily hyperglycaemia in type 2 diabetic patients: a randomised clinical trial
High-energy breakfast with low-energy dinner decreases overall daily hyperglycaemia in type 2 diabetic patients: a randomised clinical trial
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DOI：
10.1007/s00125-015-3524-9
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发表时间：
2015-05-01
期刊：
影响因子：
8.2
通讯作者：
Froy, Oren
中科院分区：
文献类型：
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作者：
Jakubowicz, Daniela;Wainstein, Julio;Froy, Oren
目的/假设高能量早餐和低能量晚餐（Bdiet）显著降低肥胖非糖尿病个体的餐后高血糖。我们的目的是测试与高能量晚餐和低能量早餐（Ddiet）相比，这种膳食计划是否通过提高肠促胰岛素和胰岛素水平来降低2型糖尿病患者的餐后高血糖（PPHG）。18名接受二甲双胍和/或饮食治疗的2型糖尿病患者（年龄30 - 70岁，体重指数22 - 35 kg/m2）接受Bdiet或Ddiet治疗7天。参与者由一名未参与研究的人使用抛硬币进行随机分配。评估餐后血糖、胰岛素、C肽以及完整和总胰高血糖素样肽-1（iGLP-1和tGLP-1）水平。早餐2,946 kJ，午餐2,523 kJ，晚餐858 kJ。Ddiet包括858 kJ早餐，2,523 kJ午餐和2,946 kJ dinner.Results 22个人进行了随机化和18个分析。B饮食全天的葡萄糖AUC（AUC（葡萄糖））比D饮食低20%，而AUC（胰岛素）、AUC（C肽）和AUC（tGLP-1）比D饮食高20%。B饮食后葡萄糖AUC（0 - 180min）及其峰值均比D饮食后低24%，而胰岛素AUC（0 - 180min）比D饮食后高11%。这伴随着tGLP-1水平升高30%和iGLP-1水平升高16%。尽管饮食是等能量的，午餐导致较低的葡萄糖（21 - 25%）和较高的胰岛素（23%）与Bdiet vs Ddiet.Conclusions/interpretation高能量摄入在早餐与糖尿病患者在整个一天的整体PPHG显着减少。这种饮食调整可能具有实现最佳代谢控制的治疗优势，并可能具有预防心血管和2型糖尿病其他并发症的潜力。
Aims/hypothesis High-energy breakfast and reduced-energy dinner (Bdiet) significantly reduces postprandial glycaemia in obese non-diabetic individuals. Our objective was to test whether this meal schedule reduces postprandial hyperglycaemia (PPHG) in patients with type 2 diabetes by enhancing incretin and insulin levels when compared with high-energy dinner and reduced-energy breakfast (Ddiet).Methods In a randomised, open label, crossover design performed in a clinic setting, 18 individuals (aged 30-70 years with BMI 22-35 kg/m(2)) with type 2 diabetes (< 10 years duration) treated with metformin and/or diet were given either Bdiet or Ddiet for 7 days. Participants were randomised by a person not involved in the study using a coin flip. Postprandial levels of plasma glucose, insulin, C-peptide and intact and total glucagon-like peptide-1 (iGLP-1 and tGLP-1) were assessed. The Bdiet included 2,946 kJ breakfast, 2,523 kJ lunch and 858 kJ dinner. The Ddiet comprised 858 kJ breakfast, 2,523 kJ lunch and 2,946 kJ dinner.Results Twenty-two individuals were randomised and 18 analysed. The AUC for glucose (AUC(glucose)) throughout the day was 20% lower, whereas AUC(insulin), AUC(C-peptide) and AUC(tGLP-1) were 20% higher for the Bdiet than the Ddiet. Glucose AUC(0-180min) and its peak were both lower by 24%, whereas insulin AUC(0-180min) was 11% higher after the Bdiet than the Ddiet. This was accompanied by 30% higher tGLP-1 and 16% higher iGLP-1 levels. Despite the diets being isoenergetic, lunch resulted in lower glucose (by 21-25%) and higher insulin (by 23%) with the Bdiet vs Ddiet.Conclusions/interpretation High energy intake at breakfast is associated with significant reduction in overall PPHG in diabetic patients over the entire day. This dietary adjustment may have a therapeutic advantage for the achievement of optimal metabolic control and may have the potential for being preventive for cardiovascular and other complications of type 2 diabetes.