Divided consumption of late-night-dinner improves glycemic excursions in patients with type 2 diabetes: A randomized cross-over clinical trial

Aims: To explore the acute effect of late-night-dinner and divided dinner on postprandial glucose levels in patients with type 2 diabetes. Methods: Sixteen patients were randomly assigned to this cross-over study. Each patient wore a continuous glucose monitor for 5 days and consumed identical test meals for 3 days. Patients consumed the test meals of dinner at 2100 h (D21) or divided dinner (vegetable and rice at 1800 h and the vegetable and the main dish at 2100 h) on the second or fourth day, and dinner at 1800 h (D18) on the third day. The daily glucose parameters were compared within-patient for 3 days. Results: D21 demonstrated significantly higher values of incremental area under the curve (IAUC) for glucose 2300 to 0800 h (644 +/- 156 vs. 147 +/- 63 mmol/L x min, p < 0.01, mean +/- standard error of the mean) and incremental glucose peak (IGP) after dinner (6.78 +/- 0.79 vs. 3.09 +/- 0.62 mmol/L, p < 0.01) compared to those of D18. Moreover, the mean amplitude of glycemic excursion (MAGE) of D21 tended to be higher than that of D18 (6.99 +/- 0.60 vs. 5.35 +/- 0.51 mmol/L, p = 0.077). However, the divided dinner significantly reduced IAUC 2300 to 0800 h (142 +/- 60 mmol/L x min, p < 0.01), IGP after dinner (3.75 +/- 0.58 mmol/L, p < 0.01), and MAGE (5.33 +/- 0.41 mmol/L, p < 0.01) compared to those of D21. Conclusion: Our findings demonstrated that consuming late-night-dinner led to postprandial hyperglycemia, and this postprandial hyperglycemia can be ameliorated by consuming a divided dinner. (C) 2017 The Authors. Published by Elsevier Ireland Ltd.