D Tricò1, E Filice2, S Baldi2, S Frascerra2, A Mari3, A Natali2. 1. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: domenico.trico@for.unipi.it. 2. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. 3. National Research Council, Institute of Neuroscience, Padua, Italy.
Abstract
BACKGROUND: Small amounts of nutrients given as a 'preload' can reduce post-meal hyperglycaemic peaks in type 2 diabetes (T2D) patients by activating a number of mechanisms involved in glucose homoeostasis. This study was undertaken to ascertain whether this positive effect extends to the late absorptive phase and to identify the main mechanisms involved. MATERIAL AND METHODS:Eight well-controlled T2D patients, aged 40-70 years, were randomized to consume a 'preload' of either water or non-glucidic nutrients (50g of Parmesan cheese, one boiled egg) 30min before a 300-min oral glucose tolerance test. RESULTS: After the nutrient preload, significant reductions were observed in peak glucose (-49%; P<0.02), total plasma glucose (iAUC: -28%; P<0.03), exogenous glucose (iAUC: -30%; P<0.03) and insulin clearance (-28%; P<0.04), with enhancement of insulin secretion (iAUC: +22%; P<0.003). These effects were associated with higher plasma levels of GLP-1 (iAUC: +463%; P<0.002), GIP (iAUC: +152%; P<0.0003) and glucagon (iAUC: +144%; P<0.0002). CONCLUSION: In T2D patients, a protein and lipid preload improves glucose tolerance throughout the whole post-absorptive phase mainly by reducing the appearance of oral glucose, and improving both beta-cell function and insulin bioavailability.
RCT Entities:
BACKGROUND: Small amounts of nutrients given as a 'preload' can reduce post-meal hyperglycaemic peaks in type 2 diabetes (T2D) patients by activating a number of mechanisms involved in glucose homoeostasis. This study was undertaken to ascertain whether this positive effect extends to the late absorptive phase and to identify the main mechanisms involved. MATERIAL AND METHODS: Eight well-controlled T2D patients, aged 40-70 years, were randomized to consume a 'preload' of either water or non-glucidic nutrients (50g of Parmesan cheese, one boiled egg) 30min before a 300-min oral glucose tolerance test. RESULTS: After the nutrient preload, significant reductions were observed in peak glucose (-49%; P<0.02), total plasma glucose (iAUC: -28%; P<0.03), exogenous glucose (iAUC: -30%; P<0.03) and insulin clearance (-28%; P<0.04), with enhancement of insulin secretion (iAUC: +22%; P<0.003). These effects were associated with higher plasma levels of GLP-1 (iAUC: +463%; P<0.002), GIP (iAUC: +152%; P<0.0003) and glucagon (iAUC: +144%; P<0.0002). CONCLUSION: In T2D patients, a protein and lipid preload improves glucose tolerance throughout the whole post-absorptive phase mainly by reducing the appearance of oral glucose, and improving both beta-cell function and insulin bioavailability.
Authors: Domenico Tricò; Alessandro Mengozzi; Lorenzo Nesti; Mensud Hatunic; Rafael Gabriel Sanchez; Thomas Konrad; Katarina Lalić; Nebojša M Lalić; Andrea Mari; Andrea Natali Journal: Diabetologia Date: 2019-11-01 Impact factor: 10.122