Altering source or amount of dietary carbohydrate has acute and chronic effects on postprandial glucose and triglycerides in type 2 diabetes: canadian trial of carbohydrates in diabetes (ccd)

Wolever TMS et al. – Low–GI and low–CHO diets have both acute and chronic effects on postprandial glucose and triglycerides in T2DM subjects. Thus, the composition of the acute test–meal and the habitual diet should be considered when interpreting the nutritional implications of different postprandial responses.

Methods

• Subjects with diet–alone–treated T2DM were randomly assigned to high–CHO/high–GI (H), high–CHO/low–GI (L), or low–CHO/high–monounsaturated–fat (M) diets for 12–months.
• At week–0 (Baseline) postprandial responses after H–meals (55% CHO, GI = 61) were measured from 0800 h to 1600 h.
• After 12 mo subjects were randomly assigned to H–meals or study diet meals (L, 57% CHO, GI = 50; M, 44% CHO, GI = 61).
• This yielded 5 groups: H diet with H–meals (HH, n = 34); L diet with H– (LH, n = 17) or L–meals (LL, n = 16); and M diet with H– (MH, n = 18) or M meals (MM, n = 19).

Results

• Postprandial glucose fluctuations were lower in LL than all other groups (p < 0.001).
• Changes in postprandial–triglycerides differed among groups (p < 0.001).
• After 12 mo in HH and MM both fasting– and postprandial–triglycerides were similar to Baseline while in MH postprandial–triglycerides were significantly higher than at Baseline (p = 0.028).
• In LH, triglycerides were consistently (0.18–0.34 mmol/L) higher than Baseline throughout the day, while in LL the difference from Baseline varied across the day from 0.04 to 0.36 mmol/L (p < 0.001).

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