A carbohydrate-reduced high-protein diet acutely decreases postprandial and diurnal glucose excursions in type 2 diabetes patients

被引:9
作者
Samkani, Amirsalar [1 ]
Skytte, Mads J. [1 ]
Kandel, Daniel [1 ]
Kjaer, Stine [1 ]
Astrup, Arne [2 ]
Deacon, Carolyn F. [3 ]
Holst, Jens J. [3 ,4 ]
Madsbad, Sten [5 ]
Rehfeld, Jens F. [6 ]
Haugaard, Steen B. [1 ]
Krarup, Thure [1 ]
机构
[1] Copenhagen Univ Hosp, Dept Endocrinol, DK-2400 Copenhagen, Denmark
[2] Univ Copenhagen, Dept Nutr Exercise & Sports, DK-2200 Copenhagen, Denmark
[3] Univ Copenhagen, Endocrinol Res Sect, Dept Biomed Sci, DK-2200 Copenhagen, Denmark
[4] Univ Copenhagen, Sect Translat Physiol, Ctr Basic Metab Res, DK-2200 Copenhagen, Denmark
[5] Copenhagen Univ Hosp, Dept Endocrinol, DK-2650 Hvidovre, Denmark
[6] Copenhagen Univ Hosp, Dept Clin Biochem, Rigshosp, DK-2200 Copenhagen, Denmark
关键词
Diabetes; Carbohydrates; Postprandial glucose; GLUCAGON-LIKE PEPTIDE-1; INSULIN-SECRETION; BLOOD-GLUCOSE; PLASMA-GLUCOSE; HYPERINSULINEMIA; MEAL; CHOLECYSTOKININ; HYPERGLYCEMIA; SENSITIVITY; METABOLISM;
D O I
10.1017/S0007114518000521
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
The aim of the study was to assess whether a simple substitution of carbohydrate in the conventionally recommended diet with protein and fat would result in a clinically meaningful reduction in postprandial hyperglycaemia in subjects with type 2 diabetes mellitus (T2DM). In all, sixteen subjects with T2DM treated with metformin only, fourteen male, with a median age of 65 (43-70) years, HbA(1c) of 6.5 % (47 mmol/l) (5.5-8.3 % (37-67 mmol/l)) and a BMI of 30 (sd 4.4) kg/m(2) participated in the randomised, cross-over study. A carbohydrate-reduced high-protein (CRHP) diet was compared with an iso-energetic conventional diabetes (CD) diet. Macronutrient contents of the CRHP/CD diets consisted of 31/54 % energy from carbohydrate, 29/16 % energy from protein and 40/30 % energy from fat, respectively. Each diet was consumed on 2 consecutive days in a randomised order. Postprandial glycaemia, pancreatic and gut hormones, as well as satiety, were evaluated at breakfast and lunch. Compared with the CD diet, the CRHP diet reduced postprandial AUC of glucose by 14 %, insulin by 22 % and glucose-dependent insulinotropic polypeptide by 17 % (all P < 0.001), respectively. Correspondingly, glucagon AUC increased by 33 % (P < 0.001), cholecystokinin by 24 % (P = 0.004) and satiety scores by 7 % (P = 0.035), respectively. A moderate reduction in carbohydrate with an increase in fat and protein in the diet, compared with an energy-matched CD diet, greatly reduced postprandial glucose excursions and resulted in increased satiety in patients with well-controlled T2DM.
引用
收藏
页码:910 / 917
页数:8
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