Frequency of meals, insulin, and glucose responses
in [Diabetes Management]
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From: Jefferson on 6 Jul 2008 23:38 This collection of articles is an attempt to see the impact of meals on glucose and insulin in people with normal glucose tolerance. Figure 1 gives the levels of glucose and insulin with a 3 meal and snack versus 1 large meal at dinner. Fasting glucose was 86 mg/dl for the normal meal pattern. Breakfast ~ 130, lunch ~ 140, snack ~ 120, and dinner ~ 150 mg/dl (#1 below). In the thread "What is Normal Glucose? Glucose Monitoring Data from Healthy Subjects" http://www.diabetes-symposium.org/index.php?menu=view&chart=6&id=322, fasting blood glucose was closer to 82 mg/dl and breakfast BG was about 125 mg/dl. Likewise lunch was ~ 118 and dinner ~ 120 mg/dl. The 1 large meal at dinner (#1) trigger very significant insulin secretion compared to the more normal meal pattern while after dinner glucose levels were not that different in both groups. In #2 below, the nibbling diet resulted in reduced insulin secretion compared to the 3 meal diet. For T2DM subjects (with reduced insulin secretion capacity) more frequent meals with the same total nutrients appears to be easier on the pancreatic beta cells. 1. "Mean glucose and insulin levels over the 12 h of frequent sampling on the third day of the diets are shown for the normal and binge diets in Fig. 1. On the normal diet, glucose and insulin rose as expected after each meal and gradually declined after dinner. On the binge diet, glucose and insulin levels fell gradually across the day, rising after the evening meal.Fasting glucose was significantly higher on the binge diet on both days 3 and 4 (day 3: normal, 86 ± 2 mg/dL; binge, 94 ± 2 mg/dL; P = 0.003). The mean glucose level across the duration of the study was significantly lower in the binge patients because they did not have postprandial increases after breakfast and lunch (normal mean, 107 ± 2; binge, 97 ± 2 mg/dL; P = 0.003). However, the glucose response to the evening meal (sum glucose from 1815–2200 h) was remarkably similar between the two diets (normal, 896 ± 48; binge, 879 ± 80 mg/dL; P = 0.37) considering that more than twice as many calories were ingested for the binge dinner. Fasting insulin levels were not significantly different on either the third or fourth day of either diet (normal, 3.5 ± 0.8; binge, 3.6 ± 1.1 µU/mL; P = 0.89). Similarly, the mean insulin levels from the entire frequent sampling study did not differ between the diets (normal, 13.0 ± 2.1; binge, 13.1 ± 2.4 µU/mL; P = 0.94). However, the insulin response to the evening meal (sum of insulin measurements from 1815–2200 h) was strikingly increased after the binge dinner (normal, 258.2 ± 49; binge, 559.0 ± 122.4 µU/mL; P = 0.01) despite virtually identical glucose responses." Figure 1. Mean glucose and insulin levels (±SEM) from 0800–2200 h during the normal (open circles) and binge (filled circles) diets. Inverted triangles identify each time point at which levels are significantly different between the two diets, based on paired t testing. http://jcem.endojournals.org/cgi/content/full/84/2/428/F1 Impact of Binge Eating on Metabolic and Leptin Dynamics in Normal Young Women - http://jcem.endojournals.org/cgi/content/full/84/2/428 --------- 2. "Although the mean blood glucose level ... similar during both diets, during the nibbling diet the mean serum insulin level decreased by 27.9 +/- 6.3 percent (P less than 0.01) and the mean 24-hour urinary C-peptide output decreased by 20.2 +/- 5.6 percent (P less than 0.02)." Source: Nibbling versus gorging: metabolic advantages of increased meal frequency - http://content.nejm.org/cgi/content/abstract/321/14/929 -------- 3. "The insulin-glucose curve measured over 3 h in the evening after the evening meal was flatter for the nine meals, but the areas under the curves were not significantly different. [...]There was no significant difference in the glucose and insulin results and insulin-glucose ratio because of the treatment(three or nine meals per day) nor any significant interaction between treatment and time. In addition there was no difference in the areas under the insulin-glucose curves on three and nine meals per day when calculated by using the trapezoidal rule (5970 ± 3856 and 5970 ± 4534 ıtmol . mot' . h', respectively). When insulin and glucose were measured over a 3-h period in the evening the insulin-glucose curve was flatter on the nine meal per day diet in comparison with the three-meal per day diet (Fig I). However as with the glucose tolerance test there was no significant difference in the glucose, insulin, and insulin glucose ratio results because of the treatment or any interaction between treatment and time (Table 3). TABLE 3 Glucose and insulin concentrations and insulin-glucose ratios after the evening meal*" Source: Effect of isoenergetic intake of three or nine meals on plasma lipoproteins and glucose metabolism - http://tinyurl.com/6b9em4 ------ 4. "Variations in plasma glucose concentration were small and random for subjects in each group over the measurement interval(Fig 2). FIG 2. Plasma glucose concentrations of subjects consuming evenly spaced (ES)(-) and diurnal (DI)(---) meals over the study period. Subjects' plasma insulin concentrations are shown in Figure 3. FIG 3. Plasma insulin concentrations of subjects consuming evenly spaced (-) and diurnal (---) meals over the study period. The lower detection limit of the assay was 6 pmol/L: thus, values below this concentration were taken as zero. Insulin values for the ES group remained mostly < 60 pmol/L across the measurement period. In the DI group these concentrations were significantly (P < 0.05) elevated over those of the ES group, coinciding with meal consumption and peaking during daylight hours." Source: Meal-frequency effects on plasma hormone concentrations and cholesterol synthesis in humans - http://tinyurl.com/629wls Frank |