Abstract
Macro-nutrient preloads given 30 min before regular meals may improve metabolism. The aim was to investigate how type 2 diabetic patients react to a preload consisting of a blend of macro-nutrients with a low-glycemic index (Inzone Preload(®)). In a before-after study design, 30 subjects with type 2 diabetes mellitus (T2DM) were enrolled in a 12-week program. All subjects were given Inzone Preload (43% proteins, 29% carbohydrates, 10% lipids, and 9% fibers, 71 kcal), 30 min before each meal during 12 weeks. Fasting glucose and postprandial 2 h glucose were monitored every second week. Body weight (BW) and waist circumference were measured each month. Fasting plasma glucose, glycosylated hemoglobin, serum lipids, fasting insulin, C-reactive protein, and homeostasis model assessment were evaluated before and after the intervention. Subjective appetite was monitored using visual analogue scales after the Inzone Preload. The dietary intervention significantly influenced several metabolic parameters compared to base line. Inzone Preload treatment reduced mean postprandial plasma glucose levels (12.2 ± 1.2 vs. 10.5 ± 2.0 mmol/L), HbA1c (7.4 ± 0.3 vs. 7.1 ± 0.2%), mean total cholesterol (4.8 ± 0.9 vs. 4.3 ± 0.8 mmol/L), low-density lipoprotein cholesterol (2.8 ± 0.6 vs. 2.5 ± 0.4 mmol/L), and CRP (1.5 ± 1.4 vs. 0.7 ± 0.7 mg/L). BW loss of more than 3% was seen in 13 participants (43%). Feelings of satiety were significantly higher after Inzone Preload than after habitual breakfast (p < 0.05). No significant changes in fasting blood glucose, high-density lipoprotein and total triacylglycerol, HOMA-IR, and HOMA-β were observed. A macro-nutrient preload treatment reduces postprandial glucose, inflammatory markers, and serum lipids in patients with T2DM. Approximately half of the study group also displayed reduced BW.
Highlights
Diabetes mellitus is a serious chronic disease threatening human health
Body weight (BW) loss of more than 3% was seen in 13 participants (43%)
For patients with mild-to-moderate hyperglycemia, postprandial blood glucose is a better predictor of HbAlc than fasting blood glucose (FBG)
Summary
Diabetes mellitus is a serious chronic disease threatening human health. It is estimated that 382 million people worldwide are affected and that the numbers will continue to increase to 471 million by 2035 [1]. The majority of patients with impaired glycemic control do not meet the recommended criteria for pharmacological treatment, exposing them to risks of sustained hyperglycemia [2]. Major determinants of postprandial blood glucose concentrations are the rate of gastric emptying and the postprandial insulin response [6]. Modulation of gastric emptying and enhancement of insulin effects to minimize dietary postprandial glucose elevation has a potential to optimize glycemic control in diabetes. Several studies have demonstrated that low-glycemic index (GI) diets are useful in the protection of diabetes [11,12,13], and low-GI foods are thought to increase satiety by prolonging the availability of glucose in the post-absorptive state and by producing a lower insulin response; this association remains controversial [14]
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