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High-energy breakfast with low-energy dinner decreases overall daily hyperglycaemia in type 2 diabetic patients: a randomised clinical trial

Jakubowicz, Daniela; Wainstein, Julio; Ahrén, Bo LU ; Bar-Dayan, Yosefa; Landau, Zohar; Rabinovitz, Hadas R. and Froy, Oren (2015) In Diabetologia 58(5). p.912-919
Abstract
Aims/hypothesis High-energy breakfast and reduced-energy dinner (Bdiet) significantly reduces postprandial glycaemia in obese non-diabetic individuals. Our objective was to test whether this meal schedule reduces postprandial hyperglycaemia (PPHG) in patients with type 2 diabetes by enhancing incretin and insulin levels when compared with high-energy dinner and reduced-energy breakfast (Ddiet). Methods In a randomised, open label, crossover design performed in a clinic setting, 18 individuals (aged 30-70 years with BMI 22-35 kg/m(2)) with type 2 diabetes (< 10 years duration) treated with metformin and/or diet were given either Bdiet or Ddiet for 7 days. Participants were randomised by a person not involved in the study using a coin... (More)
Aims/hypothesis High-energy breakfast and reduced-energy dinner (Bdiet) significantly reduces postprandial glycaemia in obese non-diabetic individuals. Our objective was to test whether this meal schedule reduces postprandial hyperglycaemia (PPHG) in patients with type 2 diabetes by enhancing incretin and insulin levels when compared with high-energy dinner and reduced-energy breakfast (Ddiet). Methods In a randomised, open label, crossover design performed in a clinic setting, 18 individuals (aged 30-70 years with BMI 22-35 kg/m(2)) with type 2 diabetes (< 10 years duration) treated with metformin and/or diet were given either Bdiet or Ddiet for 7 days. Participants were randomised by a person not involved in the study using a coin flip. Postprandial levels of plasma glucose, insulin, C-peptide and intact and total glucagon-like peptide-1 (iGLP-1 and tGLP-1) were assessed. The Bdiet included 2,946 kJ breakfast, 2,523 kJ lunch and 858 kJ dinner. The Ddiet comprised 858 kJ breakfast, 2,523 kJ lunch and 2,946 kJ dinner. Results Twenty-two individuals were randomised and 18 analysed. The AUC for glucose (AUC(glucose)) throughout the day was 20% lower, whereas AUC(insulin), AUC(C-peptide) and AUC(tGLP-1) were 20% higher for the Bdiet than the Ddiet. Glucose AUC(0-180min) and its peak were both lower by 24%, whereas insulin AUC(0-180min) was 11% higher after the Bdiet than the Ddiet. This was accompanied by 30% higher tGLP-1 and 16% higher iGLP-1 levels. Despite the diets being isoenergetic, lunch resulted in lower glucose (by 21-25%) and higher insulin (by 23%) with the Bdiet vs Ddiet. Conclusions/interpretation High energy intake at breakfast is associated with significant reduction in overall PPHG in diabetic patients over the entire day. This dietary adjustment may have a therapeutic advantage for the achievement of optimal metabolic control and may have the potential for being preventive for cardiovascular and other complications of type 2 diabetes. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breakfast, Clock, Diabetes, Dinner, GLP-1, Insulin, Timing
in
Diabetologia
volume
58
issue
5
pages
912 - 919
publisher
Springer Verlag
external identifiers
  • wos:000352644200006
  • scopus:84939935967
ISSN
1432-0428
DOI
10.1007/s00125-015-3524-9
language
English
LU publication?
yes
id
77b9a7b3-8156-4e77-85b5-379df34cb438 (old id 5386037)
date added to LUP
2015-06-01 09:27:06
date last changed
2017-09-10 03:20:08
@article{77b9a7b3-8156-4e77-85b5-379df34cb438,
  abstract     = {Aims/hypothesis High-energy breakfast and reduced-energy dinner (Bdiet) significantly reduces postprandial glycaemia in obese non-diabetic individuals. Our objective was to test whether this meal schedule reduces postprandial hyperglycaemia (PPHG) in patients with type 2 diabetes by enhancing incretin and insulin levels when compared with high-energy dinner and reduced-energy breakfast (Ddiet). Methods In a randomised, open label, crossover design performed in a clinic setting, 18 individuals (aged 30-70 years with BMI 22-35 kg/m(2)) with type 2 diabetes (&lt; 10 years duration) treated with metformin and/or diet were given either Bdiet or Ddiet for 7 days. Participants were randomised by a person not involved in the study using a coin flip. Postprandial levels of plasma glucose, insulin, C-peptide and intact and total glucagon-like peptide-1 (iGLP-1 and tGLP-1) were assessed. The Bdiet included 2,946 kJ breakfast, 2,523 kJ lunch and 858 kJ dinner. The Ddiet comprised 858 kJ breakfast, 2,523 kJ lunch and 2,946 kJ dinner. Results Twenty-two individuals were randomised and 18 analysed. The AUC for glucose (AUC(glucose)) throughout the day was 20% lower, whereas AUC(insulin), AUC(C-peptide) and AUC(tGLP-1) were 20% higher for the Bdiet than the Ddiet. Glucose AUC(0-180min) and its peak were both lower by 24%, whereas insulin AUC(0-180min) was 11% higher after the Bdiet than the Ddiet. This was accompanied by 30% higher tGLP-1 and 16% higher iGLP-1 levels. Despite the diets being isoenergetic, lunch resulted in lower glucose (by 21-25%) and higher insulin (by 23%) with the Bdiet vs Ddiet. Conclusions/interpretation High energy intake at breakfast is associated with significant reduction in overall PPHG in diabetic patients over the entire day. This dietary adjustment may have a therapeutic advantage for the achievement of optimal metabolic control and may have the potential for being preventive for cardiovascular and other complications of type 2 diabetes.},
  author       = {Jakubowicz, Daniela and Wainstein, Julio and Ahrén, Bo and Bar-Dayan, Yosefa and Landau, Zohar and Rabinovitz, Hadas R. and Froy, Oren},
  issn         = {1432-0428},
  keyword      = {Breakfast,Clock,Diabetes,Dinner,GLP-1,Insulin,Timing},
  language     = {eng},
  number       = {5},
  pages        = {912--919},
  publisher    = {Springer Verlag},
  series       = {Diabetologia},
  title        = {High-energy breakfast with low-energy dinner decreases overall daily hyperglycaemia in type 2 diabetic patients: a randomised clinical trial},
  url          = {http://dx.doi.org/10.1007/s00125-015-3524-9},
  volume       = {58},
  year         = {2015},
}