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Effect of a low dose whey/guar preload on glycemic control in people with type 2 diabetes--a randomised controlled trial.

Clifton PM, Galbraith C, Coles L - Nutr J (2014)

Bottom Line: Peak fingerprick glucose was reduced by 2.1 mmol/L at 45 min [p < 0.0001].Average fingerprick glucose over 3 hours was reduced by 0.8 mmol/L [p = 0.0003].If used long term before at least two carbohydrate-rich meals/day this preload could lower HbA1c by up to 1%.

View Article: PubMed Central - PubMed

Affiliation: University of South Australia, North Terrace, GPO Box 2471, Adelaide, SA 5001, Australia. peter.clifton@unisa.edu.au.

ABSTRACT

Objective: Large preloads of protein and fat have been shown to lower glucose after a carbohydrate-rich meal in people with type 2 diabetes but add a considerable energy burden. Low calorie preloads [<5% of daily energy intake] have been tested in this study in people with prediabetes and with type 2 diabetes.

Research design and methods: This was an unblinded randomised crossover study with two placebo days and two active treatment days. Glucose was measured for 3 hours with fingerprick samples as well as continuous glucose monitoring [CGMS]. Twenty-four subjects with pre-diabetes or moderately controlled type 2 diabetes [fasting glucose < 10 and HbA1c < 8.5%] were recruited. The preload contained 17 g whey protein plus 3 g lactose and 5 g guar, and 1 g flavour material [including sucralose] dissolved in 150 ml cold water or 150 ml cold water with no additives. The breakfast test meal consisted of 2 slices of bread, margarine and jam [3 slices for men] with the test drink 15 minutes beforehand.

Results: Peak fingerprick glucose was reduced by 2.1 mmol/L at 45 min [p < 0.0001]. Average fingerprick glucose over 3 hours was reduced by 0.8 mmol/L [p = 0.0003]. There was no difference between those with diabetes or prediabetes or those on medication or not on medication.

Conclusions: An 80 kcal whey protein/fibre preload can lower average glucose over 3 hours by 0.8 mmol/L. If used long term before at least two carbohydrate-rich meals/day this preload could lower HbA1c by up to 1%.

Trial registration: The trial was registered with the Australian New Zealand Clinical Trials Registry number ACTRN12612001251819.

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Related in: MedlinePlus

Blood glucose over 180 min by finger prick. Fingerpricks were taken before the test drink and then at 15, 30, 45, 60, 90, 120 and 180 minutes. The two control and two treatment test days were averaged. All time points except 120 minutes were significantly different between the curves and the repeated measures ANOVA was significantly different (Treatment p < 0.001, time p < 0.001, time by treatment p < 0.001).
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Fig1: Blood glucose over 180 min by finger prick. Fingerpricks were taken before the test drink and then at 15, 30, 45, 60, 90, 120 and 180 minutes. The two control and two treatment test days were averaged. All time points except 120 minutes were significantly different between the curves and the repeated measures ANOVA was significantly different (Treatment p < 0.001, time p < 0.001, time by treatment p < 0.001).

Mentions: The control and treatment curves were different by repeated measures ANOVA (Figure 1, Treatment p < 0.001, time p < 0.001, time by treatment p < 0.001). Blood glucose was reduced by 1.1 mmol/l at 15 min (p = 0.003), 1.3 mmol/L at 30 min (p = 0.001), 2.1 mmol/L at 45 min (p = 7 × 10-5) and 1.7 mmol/L at 60 minutes (p = 0.0007) and 1 mmol/L at 90 min (p = 0.02). It was higher by 0.25 mmol/L at 120 min (NS) and 0.84 mmol/L at 180 min (p = 0.003). Peak glucose was reduced by 1.4 mmol/L (p < 0.001) and the summated peak was shifted by 30 minutes. Average glucose over 3 hours was reduced by 0.77 mmol/L (p = 0.0003).Figure 1


Effect of a low dose whey/guar preload on glycemic control in people with type 2 diabetes--a randomised controlled trial.

Clifton PM, Galbraith C, Coles L - Nutr J (2014)

Blood glucose over 180 min by finger prick. Fingerpricks were taken before the test drink and then at 15, 30, 45, 60, 90, 120 and 180 minutes. The two control and two treatment test days were averaged. All time points except 120 minutes were significantly different between the curves and the repeated measures ANOVA was significantly different (Treatment p < 0.001, time p < 0.001, time by treatment p < 0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4216833&req=5

Fig1: Blood glucose over 180 min by finger prick. Fingerpricks were taken before the test drink and then at 15, 30, 45, 60, 90, 120 and 180 minutes. The two control and two treatment test days were averaged. All time points except 120 minutes were significantly different between the curves and the repeated measures ANOVA was significantly different (Treatment p < 0.001, time p < 0.001, time by treatment p < 0.001).
Mentions: The control and treatment curves were different by repeated measures ANOVA (Figure 1, Treatment p < 0.001, time p < 0.001, time by treatment p < 0.001). Blood glucose was reduced by 1.1 mmol/l at 15 min (p = 0.003), 1.3 mmol/L at 30 min (p = 0.001), 2.1 mmol/L at 45 min (p = 7 × 10-5) and 1.7 mmol/L at 60 minutes (p = 0.0007) and 1 mmol/L at 90 min (p = 0.02). It was higher by 0.25 mmol/L at 120 min (NS) and 0.84 mmol/L at 180 min (p = 0.003). Peak glucose was reduced by 1.4 mmol/L (p < 0.001) and the summated peak was shifted by 30 minutes. Average glucose over 3 hours was reduced by 0.77 mmol/L (p = 0.0003).Figure 1

Bottom Line: Peak fingerprick glucose was reduced by 2.1 mmol/L at 45 min [p < 0.0001].Average fingerprick glucose over 3 hours was reduced by 0.8 mmol/L [p = 0.0003].If used long term before at least two carbohydrate-rich meals/day this preload could lower HbA1c by up to 1%.

View Article: PubMed Central - PubMed

Affiliation: University of South Australia, North Terrace, GPO Box 2471, Adelaide, SA 5001, Australia. peter.clifton@unisa.edu.au.

ABSTRACT

Objective: Large preloads of protein and fat have been shown to lower glucose after a carbohydrate-rich meal in people with type 2 diabetes but add a considerable energy burden. Low calorie preloads [<5% of daily energy intake] have been tested in this study in people with prediabetes and with type 2 diabetes.

Research design and methods: This was an unblinded randomised crossover study with two placebo days and two active treatment days. Glucose was measured for 3 hours with fingerprick samples as well as continuous glucose monitoring [CGMS]. Twenty-four subjects with pre-diabetes or moderately controlled type 2 diabetes [fasting glucose < 10 and HbA1c < 8.5%] were recruited. The preload contained 17 g whey protein plus 3 g lactose and 5 g guar, and 1 g flavour material [including sucralose] dissolved in 150 ml cold water or 150 ml cold water with no additives. The breakfast test meal consisted of 2 slices of bread, margarine and jam [3 slices for men] with the test drink 15 minutes beforehand.

Results: Peak fingerprick glucose was reduced by 2.1 mmol/L at 45 min [p < 0.0001]. Average fingerprick glucose over 3 hours was reduced by 0.8 mmol/L [p = 0.0003]. There was no difference between those with diabetes or prediabetes or those on medication or not on medication.

Conclusions: An 80 kcal whey protein/fibre preload can lower average glucose over 3 hours by 0.8 mmol/L. If used long term before at least two carbohydrate-rich meals/day this preload could lower HbA1c by up to 1%.

Trial registration: The trial was registered with the Australian New Zealand Clinical Trials Registry number ACTRN12612001251819.

Show MeSH
Related in: MedlinePlus