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Göteborgs universitets publikationer

Breakfast glycaemic response in patients with type 2 diabetes: effects of bedtime dietary carbohydrates.

Författare och institution:
Mette Axelsen (Institutionen för invärtesmedicin, Avdelningen för internmedicin); Ragnhild Arvidsson Lenner (Institutionen för invärtesmedicin, Avdelningen för klinisk näringslära); Peter Lönnroth (Institutionen för invärtesmedicin, Avdelningen för internmedicin); Ulf Smith (Institutionen för invärtesmedicin, Avdelningen för internmedicin)
Publicerad i:
European journal of clinical nutrition, 53 ( 9 ) s. 706-10
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
OBJECTIVES: Bedtime carbohydrate (CHO) intake in patients with type-2 diabetes may improve glucose tolerance at breakfast the next morning. We examined the 'overnight second-meal effect' of bedtime supplements containing 'rapid' or 'slow' CHOs. DESIGN: Randomized cross-over study with three test-periods, each consisting of two days on a standardized diet, followed by a breakfast tolerance test on the third morning. SETTING: The Lundberg Laboratory for Diabetes Research, Sahlgrenska University Hospital, Göteborg, Sweden. SUBJECTS: Sixteen patients with type 2 diabetes on oral agents and/or diet. INTERVENTIONS: Two different bedtime (22.00 h) CHO supplements (0.46 g available CHO/kg body weight) were compared to a starch-free placebo ('normal' food regimen). The CHOs were provided as uncooked cornstarch (slow-release CHOs) or white bread (rapid CHOs). RESULTS: On the mornings after different bedtime meals we found similar fasting glucose, insulin, free fatty acid and lactate levels. However, the glycaemic response after breakfast was 21% less after uncooked cornstarch compared to placebo ingestion at bedtime (406 +/- 46 vs 511 +/- 61 mmol min l(-1), P < 0.01). In contrast, it did not differ when the evening meal consisted of white bread (451 +/- 57 mmol min l(-1)) compared to placebo. According to an in vitro analysis, uncooked cornstarch contained approximately 4 times more slowly digestible starch as compared to white bread. CONCLUSIONS: A bedtime meal providing uncooked cornstarch improved breakfast tolerance the next morning while, in contrast, this was not found following a bedtime meal of white bread. The results are consistent, therefore, with the concept that an increased intake of slowly digestible carbohydrates exert an overnight second-meal effect in patients with type 2 diabetes.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
Endokrinologi och diabetes ->
Hälsovetenskaper ->
Adult, Aged, Blood Glucose, metabolism, Cross-Over Studies, Diabetes Mellitus, Type 2, blood, Dietary Carbohydrates, administration & dosage, metabolism, Digestion, Fatty Acids, Nonesterified, blood, Female, Humans, Insulin, blood, Lactates, blood, Male, Middle Aged, Starch, administration & dosage, metabolism, Time Factors
Postens nummer:
Posten skapad:
2007-11-01 11:50
Posten ändrad:
2010-01-19 17:51

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