Effects of carbohydrate restriction on postprandial glucose metabolism, β-cell function, gut hormone secretion, and satiety in patients with Type 2 diabetes
| Autor: | Keith Burling, Jan Frystyk, Steen B. Haugaard, Arne Astrup, Thomas Larsen, Mads J. Skytte, Mogens Fenger, Thure Krarup, Jens J. Holst, Jens F. Rehfeld, Mads N. Thomsen, Sten Madsbad, Amirsalar Samkani |
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| Rok vydání: | 2021 |
| Předmět: |
Appetite regulatory hormones
B -cell function medicine.medical_specialty Physiology Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Type 2 diabetes 030204 cardiovascular system & hematology Carbohydrate metabolism Glucagon Nutritional therapy 03 medical and health sciences 0302 clinical medicine Gastric inhibitory polypeptide Physiology (medical) Internal medicine Type 2 diabetes mellitus Medicine Proinsulin Gastric emptying business.industry medicine.disease Incretin hormones Endocrinology Postprandial Peptide YY business |
| Zdroj: | Skytte, M J, Samkani, A, Astrup, A, Frystyk, J, Rehfeld, J F, Holst, J J, Madsbad, S, Burling, K, Fenger, M, Thomsen, M N, Larsen, T M, Krarup, T & Haugaard, S B 2021, ' Effects of carbohydrate restriction on postprandial glucose metabolism, b-cell function, gut hormone secretion, and satiety in patients with Type 2 diabetes ', American Journal of Physiology-Endocrinology and Metabolism, vol. 320, no. 1, pp. E7-E18 . https://doi.org/10.1152/AJPENDO.00165.2020 |
| ISSN: | 1522-1555 0193-1849 |
| DOI: | 10.1152/ajpendo.00165.2020 |
| Popis: | 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 α- and β-cell function, gut hormone secretion, and satiety in T2D patients. Methods In a crossover design, 28 T2D patients (mean HbA1c: 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), β-cell sensitivity to glucose ( Bup), 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 Bup 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 β-cell function, including proinsulin processing, and increased subjective satiety in patients with T2D. |
| Databáze: | OpenAIRE |
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