Reduction in Glycated Hemoglobin and Daily Insulin Dose Alongside Circadian Clock Upregulation in Patients With Type 2 Diabetes Consuming a Three-Meal Diet: A Randomized Clinical Trial
| Autor: | Maayan Barnea, Bo Ahrén, Julio Wainstein, Miriam Menaged, Tali Ganz, Naomi Mor, Itamar Raz, Zohar Landau, Yosefa Bar-Dayan, Oren Froy, Daniela Jakubowicz, Shani Tsameret, Nava Chapnik |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment CLOCK Proteins Type 2 diabetes chemistry.chemical_compound Insulin resistance Weight loss Circadian Clocks Internal medicine Diabetes mellitus Diet Diabetic Weight Loss Internal Medicine medicine Humans Hypoglycemic Agents Insulin Meals Glycemic Glycated Hemoglobin Advanced and Specialized Nursing business.industry Blood Glucose Self-Monitoring Fasting Middle Aged medicine.disease Up-Regulation Treatment Outcome Endocrinology Diabetes Mellitus Type 2 chemistry Hyperglycemia Female Glycated hemoglobin medicine.symptom business Weight gain |
| Zdroj: | Diabetes Care. 42:2171-2180 |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | OBJECTIVE In type 2 diabetes, insulin resistance and progressive β-cell failure require treatment with high insulin doses, leading to weight gain. Our aim was to study whether a three-meal diet (3Mdiet) with a carbohydrate-rich breakfast may upregulate clock gene expression and, as a result, allow dose reduction of insulin, leading to weight loss and better glycemic control compared with an isocaloric six-meal diet (6Mdiet). RESEARCH DESIGN AND METHODS Twenty-eight volunteers with diabetes (BMI 32.4 ± 5.2 kg/m2 and HbA1c 8.1 ± 1.1% [64.5 ± 11.9 mmol/mol]) were randomly assigned to 3Mdiet or 6Mdiet. Body weight, glycemic control, continuous glucose monitoring (CGM), appetite, and clock gene expression were assessed at baseline, after 2 weeks, and after 12 weeks. RESULTS 3Mdiet, but not 6Mdiet, led to a significant weight loss (−5.4 ± 0.9 kg) (P < 0.01) and decreased HbA1c (−12 mmol/mol [−1.2%]) (P < 0.0001) after 12 weeks. Fasting glucose and daily and nocturnal glucose levels were significantly lower on the 3Mdiet. CGM showed a significant decrease in the time spent in hyperglycemia only on the 3Mdiet. Total daily insulin dose was significantly reduced by 26 ± 7 units only on the 3Mdiet. There was a significant decrease in the hunger and cravings only in the 3Mdiet group. Clock genes exhibited oscillation, increased expression, and higher amplitude on the 3Mdiet compared with the 6Mdiet. CONCLUSIONS A 3Mdiet, in contrast to an isocaloric 6Mdiet, leads to weight loss and significant reduction in HbA1c, appetite, and overall glycemia, with a decrease in daily insulin. Upregulation of clock genes seen in this diet intervention could contribute to the improved glucose metabolism. |
| Databáze: | OpenAIRE |
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