RESUMEN
Dietary fiber improves hyperglycemia in patients with type 2 diabetes through its physicochemical properties and possible modulation of gut hormone secretion, such as glucagon-like peptide 1 (GLP-1). We assessed the effect of dietary fiber-enriched cereal flakes (DC) on postprandial hyperglycemia and gut hormone secretion in patients with type 2 diabetes. Thirteen participants ate isocaloric meals based on either DC or conventional cereal flakes (CC) in a crossover design. DC or CC was provided for dinner, night snack on day 1 and breakfast on day 2, followed by a high-fat lunch. On day 2, the levels of plasma glucose, GLP-1, glucose-dependent insulinotropic polypeptide (GIP), and insulin were measured. Compared to CC, DC intake exhibited a lower post-breakfast 2-hours glucose level (198.5±12.8 vs. 245.9±15.2 mg/dL, P<0.05) and a lower incremental peak of glucose from baseline (101.8±9.1 vs. 140.3±14.3 mg/dL, P<0.001). The incremental area under the curve (iAUC) of glucose after breakfast was lower with DC than with CC (P<0.001). However, there were no differences in the plasma insulin, glucagon, GLP-1, and GIP levels. In conclusion, acute administration of DC attenuates postprandial hyperglycemia without any significant change in the representative glucose-regulating hormones in patients with type 2 diabetes (ClinicalTrials.gov. NCT 01997281).
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Área Bajo la Curva , Glucemia/análisis , Estudios Cruzados , Diabetes Mellitus Tipo 2/complicaciones , Fibras de la Dieta/uso terapéutico , Polipéptido Inhibidor Gástrico/sangre , Glucagón/sangre , Péptido 1 Similar al Glucagón/sangre , Hemoglobina Glucada/análisis , Hiperglucemia/complicaciones , Insulina/sangre , Intestinos/metabolismo , Curva ROCRESUMEN
The pancreatic beta-cell response to stimulation with glucose and GIP, single and combined, was studied in acromegalics and in normal subjects. Acromegalics had higher IRI and GIP basal values with glucose levels and glucose disposal in the normal range. Further, acromegalics showed a greater IRI response to glucose, GIP and glucose combined with GIP. The results suggested that high growth hormone levels cause a greater activity of the entero-insular axis both in the basal state and after meal ingestion, as mimicked by GIP infusion. From these and previous observations, it can be assumed that growth hormone induces a facilitation of the IRI response to metabolite substrates and hormones