Abstract
Background: Postprandial plasma glucose concentration is an important diabetes management target. Glycemia-targeted specialized-nutrition (GTSN) beverages, containing various quantities and types of carbohydrates (CHO), have been formulated to blunt postprandial hyperglycemia. The objective of this research was to evaluate the effectiveness of these products on postprandial glycemic and hormonal responses based on comparisons of GTSN with differing carbohydrate quantities or types. Methods: In two randomized, double-blind, crossover studies, participants (mean age 61 years) with type 2 diabetes consumed GTSN in a meal tolerance test. In the CHO Quantity Study, a standard nutritional beverage (STD) was compared to a low carbohydrate nutritional beverage with tapioca dextrin (GTSN-TDX) and a balanced carbohydrate nutritional beverage containing a blend of the slowly-digesting carbohydrates maltodextrin and sucromalt (GTSN-SDC). In the CHO Type Study, the GTSN beverages had similar carbohydrate quantities but varied in carbohydrate composition with GTSN-SDC compared to a formula with tapioca starch and fructose (GTSN-TS&F), and one with isomaltulose and resistant starch (GTSN-I&RS). Postprandial (0-240 min) concentrations of blood glucose, insulin (CHO Quantity Study only) and glucagon-like-peptide (GLP)-1 (CHO Quantity Study only) were measured. Results: Despite having substantially different carbohydrate quantities, the GTSN blunted the glucose positive area under the curve (AUC0-240 min) by 65% to 82% compared to the STD formulation (p 0-240 min (p 0-240 min tended to be lower for GTSN-SDC (1477 ± 460) than GTSN-TS&F (2203 ± 412; p = 0.062) and GTSN-I&RS (2190 ± 412; p = 0.076). No differences were observed between GTSN-TS&F and GTSN-I&RS. Conclusions: These results demonstrate the effectiveness of several GTSN products and suggest that both CHO quantity and type play important roles in postprandial glycemic response in men and women with type 2 diabetes. Furthermore, GTSN products containing slow-digesting carbohydrates can blunt postmeal glucose and insulin concentration despite delivering greater total grams of CHO, which provides a dietary benefit for people with diabetes.
Highlights
In 2007, pre-diabetes and diabetes cost the United States (US) an estimated $218 billion in medical expenditures and lost productivity [1]
These results demonstrate the effectiveness of several Glycemia-targeted specialized-nutrition (GTSN) products and suggest that both CHO quantity and type play important roles in postprandial glycemic response in men and women with type 2 diabetes
Epidemiological observations suggest that the risk of developing these complications, those related to the macro- and microvasculature, in individuals with type 2 diabetes as well impaired glucose tolerance can be dramatically reduced by improving glycemic control [3,4,5]
Summary
In 2007, pre-diabetes and diabetes cost the United States (US) an estimated $218 billion in medical expenditures and lost productivity [1]. Epidemiological observations suggest that the risk of developing these complications, those related to the macro- and microvasculature, in individuals with type 2 diabetes as well impaired glucose tolerance can be dramatically reduced by improving glycemic control [3,4,5]. Both fasting and postprandial glucose concentrations are important targets for improving long-term outcomes [3,4,5,6,7,8,9,10]. GTSN products containing slow-digesting carbohydrates can blunt postmeal glucose and insulin concentration despite delivering greater total grams of CHO, which provides a dietary benefit for people with diabetes
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