The second-meal phenomenon in type 2 diabetes.

The second-meal phenomenon in type 2 diabetes.
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DOI:
10.2337/dc08-2196
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发表时间:
2009-07
期刊:
影响因子:
16.2
通讯作者:
Taylor R
Taylor R
中科院分区:
医学1区
文献类型:
--
作者:
Jovanovic A;Gerrard J;Taylor R

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在健康情况下,如果吃早餐,午餐后葡萄糖的上升较少。我们评估了2型糖尿病患者的第二餐效应。比较8例肥胖2型糖尿病患者午餐后3天的代谢变化:吃早餐、不吃早餐、不吃早餐但在午餐前1小时静脉注射精氨酸。尽管胰岛素水平相当,但如果吃了早餐,午餐后血浆葡萄糖的上升幅度要小得多(0.68±1.49 vs. 12.32±1.73 vs. 7.88±1.03 mmol·h−1·l−1;P < 0.0001)。精氨酸处理几乎使午餐时血糖升高减半(12.32±1.73 vs. 7.88±1.03 mmol·h−1·l−1)。午餐时血浆游离脂肪酸浓度与午餐后血糖升高有直接关系(r = 0.67, P = 0.0005)。第二餐效应在2型糖尿病中仍然存在。餐前使用非糖胰岛素促分泌剂可使餐后血糖升高减半,具有治疗潜力。
In health, the rise in glucose after lunch is less if breakfast is eaten. We evaluated the second-meal effect in type 2 diabetes. Metabolic changes after lunch in eight obese type 2 diabetic subjects were compared on 3 days: breakfast eaten, no breakfast, and no breakfast but intravenous arginine 1 h before lunch. Despite comparable insulin levels, the rise in plasma glucose after lunch was considerably less if breakfast had been eaten (0.68 ± 1.49 vs. 12.32 ± 1.73 vs. 7.88 ± 1.03 mmol · h−1 · l−1; P < 0.0001). Arginine administration almost halved the lunch rise in plasma glucose (12.32 ± 1.73 vs. 7.88 ± 1.03 mmol · h−1 · l−1). The plasma free fatty acid concentration at lunchtime directly related to plasma glucose rise after lunch (r = 0.67, P = 0.0005). The second-meal effect is preserved in type 2 diabetes. Premeal administration of a nonglucose insulin secretagogue results in halving the postprandial glucose rise and has therapeutic potential.
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