Late-night-dinner deteriorates postprandial glucose and insulin whereas consuming dinner dividedly ameliorates them in patients with type 2 diabetes: A randomized crossover clinical trial

Background and Objectives: The aims of this study is to explore the acute effect of consuming dinner at different timing on postprandial glucose and hormone in patients with type 2 diabetes. Methods and Study Design: Eight patients (age 70.8 +/- 1.9 years, HbA1c 7.6 +/- 0.6 %, BMI 23.3 +/- 3.2, mean +/- SD) were randomly assigned in this crossover study. Patients consumed the test meals of dinner at 18:00 on the first day, and dinner at 21:00 or divided dinner (vegetable and rice at 18:00 and vegetable and the main dish at 21:00) on the second or third day. Postprandial glucose, insulin, glucagon, free fatty acid (FFA), active glucagon-like peptide-1 (GLP-1), and active glucose-dependent insulinotropic polypeptide (GIP) concentration after dinner were evaluated. Results: Both incremental area under the curve (IAUC) 2h for glucose and insulin were higher in dinner at 21:00 than those in dinner at 18:00 (IAUC glucose: 449 +/- 83 vs 216 +/- 43 mmol/Lxmin, p<0.01, IAUC insulin:772 +/- 104 vs 527 +/- 107 mu U/mLxmin, p<0.01, mean +/- SEM). However, in divided dinner both IAUC 4h for glucose and insulin tended to be lower than those of dinner at 21:00 (IAUC glucose: 269 +/- 76 mmol/Lxmin, p=0.070, IAUC insulin: 552 +/- 114 mu U/mLxmin, p=0.070). IAUC of active GLP-1 and active GIP demonstrated no difference among different dinner regimen. Conclusions: Consuming late-night-dinner (21:00) deteriorates postprandial glucose and insulin compared with those of early-evening-dinner (18:00) whereas consuming dinner dividedly ameliorates them.