High-energy breakfast with low-energy dinner decreases overall daily hyperglycaemia in type 2 diabetic patients: a randomised clinical trial

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• 作者：Daniela Jakubowicz ; Julio Wainstein ; Bo Ahrén ; Yosefa Bar-Dayan…
• 关键词：Breakfast ; Clock ; Diabetes ; Dinner ; GLP ; 1 ; Insulin ; Timing
• 刊名：Diabetologia
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：58
• 期：5
• 页码：912-919
• 全文大小：389 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Internal Medicine
  Metabolic Diseases
  Human Physiology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0428

文摘

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 30-0?years with BMI 22-5?kg/m2) with type 2 diabetes (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 (AUCglucose) throughout the day was 20% lower, whereas AUCinsulin, AUCC-peptide and AUCtGLP-1 were 20% higher for the Bdiet than the Ddiet. Glucose AUC0-80min and its peak were both lower by 24%, whereas insulin AUC0-80min 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 21-5%) 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. Trial registration ClinicalTrials.gov NCT01977833 Funding No specific funding was received for the study.