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The effect of a low-carbohydrate high-fat breakfast on glycemic control in type 2 diabetes Chang, Courtney Rochelle
Abstract
Improving overall glycemia by targeting postprandial glucose spikes, particularly at the breakfast meal when insulin resistance is the highest in type 2 diabetes (T2D), may help to prevent diabetes complications. The purpose of this thesis was to determine whether consuming a low- carbohydrate high-fat breakfast was superior to a breakfast with the dietary guidelines recommended nutrient profile for improving postprandial and 24-hour blood glucose responses to mixed meals in individuals with T2D. Adults with physician diagnosed T2D (N=23, 59 ± 11y, A1c: 6.7 ± 0.6%, BMI: 31 ± 7kg/m2) completed two 24-h isocaloric intervention periods, in a random order. Participants consumed either i) a low-carbohydrate high-fat breakfast [LC-BF; <10% energy from carbohydrate (CHO), 85% energy from fat (FAT), and 15% energy from protein (PRO)], or ii) a breakfast with the dietary guidelines recommended nutrient profile (GL- BF; 55%CHO/30%FAT/15%PRO), with the same lunch and dinner provided (both 55%CHO/30%FAT/15%PRO). Continuous glucose monitoring assessed postprandial glucose responses to each meal (incremental area under the curve; iAUC) and the mean 24-h glucose during each intervention. The postprandial glucose excursion (3h iAUC) after the LC-BF was ~80% lower than the GL-BF (p<0.01). Overall postprandial hyperglycemia (measured as the sum of the 3h iAUC of breakfast, lunch and dinner), and glycemic variability (mean amplitude of glycemic excursions [MAGE]) were significantly reduced with the LC-BF compared to the GL- BF (3h iAUC: -100 ± 116 mmol/L•9h, p<0.01; MAGE: -0.4 ± 0.8 mmol/L•24h, p=0.03). However, the mean 24-h blood glucose was not significantly reduced (LC-BF: 7.2 ± 1.1 mmol/L vs. GL-BF: 7.5 ± 1.5 mmol/L, p=0.09). Restricting carbohydrate at breakfast reduces postprandial hyperglycemia in individuals with T2D. A low-carbohydrate high-fat breakfast may be a simple and effective strategy to reduce the development of diabetes complications in T2D and long-term interventions are warranted.
Item Metadata
Title |
The effect of a low-carbohydrate high-fat breakfast on glycemic control in type 2 diabetes
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Creator | |
Publisher |
University of British Columbia
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Date Issued |
2017
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Description |
Improving overall glycemia by targeting postprandial glucose spikes, particularly at the breakfast meal when insulin resistance is the highest in type 2 diabetes (T2D), may help to prevent diabetes complications. The purpose of this thesis was to determine whether consuming a low- carbohydrate high-fat breakfast was superior to a breakfast with the dietary guidelines recommended nutrient profile for improving postprandial and 24-hour blood glucose responses to mixed meals in individuals with T2D. Adults with physician diagnosed T2D (N=23, 59 ± 11y, A1c: 6.7 ± 0.6%, BMI: 31 ± 7kg/m2) completed two 24-h isocaloric intervention periods, in a random order. Participants consumed either i) a low-carbohydrate high-fat breakfast [LC-BF; <10% energy from carbohydrate (CHO), 85% energy from fat (FAT), and 15% energy from protein (PRO)], or ii) a breakfast with the dietary guidelines recommended nutrient profile (GL- BF; 55%CHO/30%FAT/15%PRO), with the same lunch and dinner provided (both 55%CHO/30%FAT/15%PRO). Continuous glucose monitoring assessed postprandial glucose responses to each meal (incremental area under the curve; iAUC) and the mean 24-h glucose during each intervention. The postprandial glucose excursion (3h iAUC) after the LC-BF was ~80% lower than the GL-BF (p<0.01). Overall postprandial hyperglycemia (measured as the sum of the 3h iAUC of breakfast, lunch and dinner), and glycemic variability (mean amplitude of glycemic excursions [MAGE]) were significantly reduced with the LC-BF compared to the GL- BF (3h iAUC: -100 ± 116 mmol/L•9h, p<0.01; MAGE: -0.4 ± 0.8 mmol/L•24h, p=0.03). However, the mean 24-h blood glucose was not significantly reduced (LC-BF: 7.2 ± 1.1 mmol/L vs. GL-BF: 7.5 ± 1.5 mmol/L, p=0.09). Restricting carbohydrate at breakfast reduces postprandial hyperglycemia in individuals with T2D. A low-carbohydrate high-fat breakfast may be a simple and effective strategy to reduce the development of diabetes complications in T2D and long-term interventions are warranted.
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Genre | |
Type | |
Language |
eng
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Date Available |
2018-06-20
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Provider |
Vancouver : University of British Columbia Library
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Rights |
Attribution-NonCommercial-NoDerivatives 4.0 International
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DOI |
10.14288/1.0362309
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URI | |
Degree | |
Program | |
Affiliation | |
Degree Grantor |
University of British Columbia
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Graduation Date |
2018-02
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Campus | |
Scholarly Level |
Graduate
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Rights URI | |
Aggregated Source Repository |
DSpace
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Rights
Attribution-NonCommercial-NoDerivatives 4.0 International