Abstract
ObjectiveLarge preloads of protein and fat have been shown to lower glucose after a carbohydrate-rich meal in people with type 2 diabetes but add a considerable energy burden. Low calorie preloads [<5% of daily energy intake] have been tested in this study in people with prediabetes and with type 2 diabetes.Research design and methodsThis was an unblinded randomised crossover study with two placebo days and two active treatment days. Glucose was measured for 3 hours with fingerprick samples as well as continuous glucose monitoring [CGMS]. Twenty-four subjects with pre-diabetes or moderately controlled type 2 diabetes [fasting glucose < 10 and HbA1c < 8.5%] were recruited. The preload contained 17 g whey protein plus 3 g lactose and 5 g guar, and 1 g flavour material [including sucralose] dissolved in 150 ml cold water or 150 ml cold water with no additives. The breakfast test meal consisted of 2 slices of bread, margarine and jam [3 slices for men] with the test drink 15 minutes beforehand.ResultsPeak fingerprick glucose was reduced by 2.1 mmol/L at 45 min [p < 0.0001]. Average fingerprick glucose over 3 hours was reduced by 0.8 mmol/L [p = 0.0003]. There was no difference between those with diabetes or prediabetes or those on medication or not on medication.ConclusionsAn 80 kcal whey protein/fibre preload can lower average glucose over 3 hours by 0.8 mmol/L. If used long term before at least two carbohydrate-rich meals/day this preload could lower HbA1c by up to 1%.Trial registrationThe trial was registered with the Australian New Zealand Clinical Trials Registry number ACTRN12612001251819.
Highlights
At least 50% of people with type 2 diabetes have poor glucose control despite drug treatment and are often faced with the prospect of the addition of another oral drug or insulin
Peak fingerprick glucose was reduced by 2.1 mmol/L at 45 min [p < 0.0001]
Average fingerprick glucose over 3 hours was reduced by 0.8 mmol/L [p = 0.0003]
Summary
At least 50% of people with type 2 diabetes have poor glucose control despite drug treatment and are often faced with the prospect of the addition of another oral drug or insulin. Medical nutrition therapy involving lifestyle modification is recommended as the first line of management for this disease [1] but can have significant effects on glucose control later in the disease [2]. Dietary strategies include modifications in fat and complex carbohydrate intake or low glycaemic index (GI) diets, We speculated that dramatically lowering the amount of whey and replacing some of the protein with guar would be just as effective at lowering postprandial glucose as 55 g of whey alone. Guar alone in dose of 4 g twice daily has been shown in one study to lower Hba1c by 0.6% suggesting that flattening of the postprandial glycemic profile can lead to clinical useful effects [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
