Abstract
BackgroundRestriction of fat intake has been effective in improving insulin sensitivity in obese and type 2 diabetic subjects, but what effects the recommended diet (less than 30% of total calories from fat) have not been elucidated in subjects with type 2 diabetes. The purpose of this study was to test the effects of oral fat challenge, composing 30% calories of a meal, on blood glucose, insulin, lipid, leptin, plasminogen activator inhibitor-1 (PAI-1) and tumor necrosis factor-α (TNF-α).Design and MethodsBlood glucose, insulin, lipid, leptin, TNF-α and PAI-1 were compared in 14 type 2 diabetic patients and 10 normal subjects after an oral fat challenge upto 2 hours (fasting, 15 min, 30 min, 45 min, 60 min, 90 min and 120 min).ResultsPostprandial glucose, total cholesterol, leptin, PAI-1 levels did not differ significantly from levels at fasting. Serum triglyceride increased significantly from baseline only in diabetic patients (P = 0.042). Serum insulin increased postprandially in both groups (P = 0.028 in diabetic group and P = 0.055 in normal group), with displaying a prolonged insulin response in diabetic subjects. TNF-α decreased postprandially in both groups without significant difference, although diabetic patients have higher baseline levels (P = 0.024 compared to normal subjects).ConclusionsOral fat load does not have an acute effect on blood glucose, total cholesterol, leptin and PAI-1 levels in both type 2 diabetic and normal subjects. TNF-α value showed decreased trend in both diabetic and normal subjects. The tendency of a delayed postprandial insulin response and elevated serum triglyceride level in diabetic subjects might be related to insulin resistance at the level of adipose tissue. Additional research is needed to assess the impact of the use of fat contents on the macronutrient composition of the diet, and potentially healthy and nutritional benefits for patients with diabetes.
Highlights
The incidence of diabetes mellitus has been increasing rapidly in the past 2 decades and this is accompanied by the notably high prevalence of associated disorders, such as hypertension, atherogenic lipid profile and metabolic syndrome, which lead to significantly high cardiovascular morbidity and mortality in diabetic patients
There were no significant differences on blood glucose and cholesterol levels after oral fat challenge in both normal and type 2 diabetic subjects. (See figure 1) Concerning blood triglyceride concentration, there was steady increased triglyceride concentration and achieved significantly statistical difference in type 2 diabetic subjects (P = 0.042)
There were no significant differences in both normal and type 2 diabetic subjects in leptin and tumor necrosis factor-α (TNF-α) levels, it seemed to decline after oral fat challenge, especially TNF-α in type 2 diabetic subjects (p = 0.12). (See figure 3)
Summary
The incidence of diabetes mellitus has been increasing rapidly in the past 2 decades and this is accompanied by the notably high prevalence of associated disorders, such as hypertension, atherogenic lipid profile and metabolic syndrome, which lead to significantly high cardiovascular morbidity and mortality in diabetic patients. For reducing the risk of developing cardiovascular disease in type 2 diabetic patients, there have been longstanding recommendations to reduce saturated fat intake to
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