4.6 Article

Effects of carbohydrate restriction on postprandial glucose metabolism, β-cell function, gut hormone secretion, and satiety in patients with Type 2 diabetes

出版社

AMER PHYSIOLOGICAL SOC
DOI: 10.1152/ajpendo.00165.2020

关键词

appetite regulatory hormones; incretin hormones; nutritional therapy; Type 2 diabetes mellitus; beta-cell function

资金

  1. Arla Food for Health, Institute of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
  2. Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
  3. Dept. of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
  4. Copenhagen University Hospital Bispebjerg

向作者/读者索取更多资源

Research suggests that a 6-week carbohydrate-restricted diet can significantly reduce postprandial glucose fluctuations, improve insulin secretion, and increase subjective satiety in patients with Type 2 diabetes.
Dietary carbohydrate restriction may improve the phenotype of Type 2 diabetes (T2D) patients. We aimed to investigate 6 wk of carbohydrate restriction on postprandial glucose metabolism, pancreatic alpha and beta-cell function, gut hormone secretion, and satiety in T2D patients. Methods In a crossover design, 28 T2D patients (mean HbA(1c): 60 mmol/mol) were randomized to 6 wk of carbohydrate-reduced high-protein (CRHP) diet and 6 wk of conventional diabetes (CD) diet (energy-percentage carbohydrate/protein/fat: 30/30/40 vs. 50/17/33). Twenty-four-hour continuous glucose monitoring (CGM) and mixed-meal tests were undertaken and fasting intact proinsulin (IP), 32,33 split proinsulin concentrations (SP), and postprandial insulin secretion rates (ISR), insulinogenic index (IGI), (3-cell sensitivity to glucose (B-up), glucagon, and gut hormones were measured. Gastric emptying was evaluated by postprandial paracetamol concentrations and satiety by visual analog scale ratings. A CRHP diet reduced postprandial glucose area under curve (net AUC) by 60% (P < 0.001), 24 h glucose by 13% (P < 0.001), fasting IP and SP concentrations (both absolute and relative to C-peptide, P < 0.05), and postprandial ISR (24%, P = 0.015), while IGI and B-up improved by 31% and 45% (both P < 0.001). The CRHP diet increased postprandial glucagon net AUC by 235% (P < 0.001), subjective satiety by 18% (P = 0.03), delayed gastric emptying by 15 min (P < 0.001), decreased gastric inhibitory polypeptide net AUC by 29% (P < 0.001), but had no significant effect on glucagon-like-peptide-1, total peptide YY, and cholecystokinin responses. A CRHP diet reduced glucose excursions and improved beta-cell function, including proinsulin processing, and increased subjective satiety in patients with T2D.

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