- A low energy first meal may be desirable for postprandial glucose and insulin regulation in adults with prediabetes during periods of prolonged sitting, particularly in the hours leading to lunch.
- However, high energy first meal produced exaggerated plasma insulin and glucose responses until lunch, although 24-hour glycaemic control was not impaired.
Why this matters
- No study has evaluated the effect of energy intake on daily glucose and insulin levels and the effect of meal size during prolonged periods of sittings in adults with diabetes.
- Participants with diabetes completed 2 trial conditions in a randomised order separated by >10 days (n=13; mean±SD age, 60±6 years; BMI, 33±4 kg/m2; 2-hour oral glucose tolerance test: 8.9±1.1 mmol/L).
- 3 meals were incorporated with different energy distribution: high-energy breakfast (HE-BF: breakfast, 50%; lunch, 30%; dinner, 20% energy intake) and low-energy breakfast (LE-BF: 20%/30%/50% energy intake).
- Blood was collected hourly and 30 minutes post each meal.
- Funding: Novo Nordisk Foundation Challenge Grant.
- Mean plasma glucose concentration (+0.5 mmol/L; P=.014) and total plasma glucose area under the curve (AUC; +5.7 mmol/L/h; P=.019) was greater in the HE-BF group compared with LE-BF group.
- In the HE-BF condition, postprandial glycaemic response, measured by incremental AUC (iAUC) was 44%±59% greater vs LE-BF (+2.9 mmol/h/L; P=.03).
- However, in the LE-BF condition, a 55%±36% greater iAUC in the 4-hour post-lunch meal period was observed (+4.8 mmol/h/L; P=.02).
- In the HE-BF, insulin was higher until 2-hour post-lunch (P<.03 and was elevated above baseline from hour post-meal for the entire day vs le-bf condition.>
- Total insulin AUC was higher in the HE-BF vs LE-BF condition (P<.01>
- 24-hour continuous glucose monitor showed no difference in mean glucose and total AUC between 2 trial conditions.
- Lack of venous sampling after 1800 hours.