Association of the glucose patterns after a single non-standardized meal with the habitual diet composition and features of the daily glucose profile in individuals without diabetes

Abstract

BackgroundThe postprandial glucose response (PPGR), contributing to the glycemic variability (GV), is positively associated with cardiovascular risk in people without diabetes, and can thus represent a target for cardiometabolic prevention strategies. ObjectiveThe study aimed to distinguish patterns of PPGR after a single non-standardized meal and to evaluate their relationship with the habitual diet and the daily glucose profile (DGP) in individuals at high-cardiometabolic risk. MethodsBaseline four-day continuous glucose monitoring (CGM) was performed in 159 adults recruited in the MEDGI-Carb trial. After a non-standardized breakfast, parameters of the PPGR were estimated by a mechanistic model: baseline glucose; amplitude – the magnitude of post-meal glucose concentrations; frequency – the velocity of post-meal glucose oscillations; damping – the rate of post-meal glucose decay. PPGR patterns were identified by cluster analysis. Differences between clusters and the relationship between PPGR parameters and individual features were explored by one-way ANOVA and correlation analysis, respectively. ResultsTwo patterns of PPGR emerged. Pattern A had higher baseline, amplitude, frequency, and damping than B. Individuals in cluster A compared to B had a higher energy (2,002±526 vs. 1,766±455 Kcal, p=0.025), protein (82±22 vs. 72±21 g, p=0.028) and fat (87±30 vs. 75±22 g, p=0.041), but not carbohydrate habitual intake. Pattern A associated with a higher average daily glucose (6.12±0.50 vs. 5.88±0.62 mmol/L, p=0.019) and lower GV (11.67±3.52 vs. 13.43±3.78%, p=0.010). Mean daily glucose correlated directly with baseline (rs=0.419, p<0.001) and amplitude (rs=0.189, p=0.022) of the PPGR, while DGP variability correlated directly with amplitude (rs=0.218, p=0.008), frequency (rs=-0.179, p=0.031) and damping (rs=-0.309, p<0.001). ConclusionsTwo PPGR patterns after a single non-standardized breakfast were identified in high-cardiometabolic risk individuals. The habitual diet was associated with the patterns and their dynamic parameters, which, in turn, could predict the individuals’ DGP. Our findings could support the implementation of dietary strategies targeting the PPGR to ameliorate the cardiometabolic risk profile.Clinical Trial ID: NCT03410719