Do all patients with type 2 diabetes need breakfast?

Objectives: To evaluate if an improved daily glycemic profile could be achieved in patients with type 2 diabetes by withholding breakfast, but maintaining the same total daily intake of calorie and the same composition of carbohydrates, fat and protein. Methods: Thirteen type 2 diabetic patients participated in this randomized crossover study. Following an initial fasting night the study consisted of 4 consecutive days. Patients were randomized to diets including breakfast days 1 and 3, and excluding breakfast days 2 and 4, or vice versa. Results: The mean plasma glucose level was 0.24 mmol/l higher after the breakfast diet compared with the non-breakfast diet, but reflected only a tendency (P = 0.066). The standard deviation based on plasma glucose was 32% higher after the breakfast diet compared with the non-breakfast diet (P<0.0001). Conclusions: Not all patients with type 2 diabetes may need breakfast. Moreover, a non-breakfast diet reduces glycemic variability. European Journal of Clinical Nutrition (2011) 65, 761-763; doi:10.1038/ejcn.2011.18; published online 23 February 2011