Lipid, glycemic, and insulin responses to meals rich in saturated, cis-monounsaturated, and polyunsaturated (n-3 and n-6) fatty acids in subjects with type 2 diabetes
ABSTRACT The recommendations for dietary fats in patients with type 2 diabetes are based largely on the impact of fatty acids on fasting serum lipid and glucose concentrations. How fatty acids affect postprandial insulin, glucose, and triglyceride concentrations, however, remains unclear. The objective of this study was to study the effect of fatty acids on postprandial insulin, glucose, and triglyceride responses.
Test meals rich in palmitic acid, linoleic acid, oleic acid, and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and containing 1,000 kcal each were administered in a randomized crossover design to 11 type 2 diabetic subjects. Serum insulin, glucose, and triglyceride concentrations were measured for 360 min. All subjects received an isoenergetic diet of constant composition throughout the study.
According to repeated-measures ANOVA, the insulin (P = 0.0002) but not glucose (P = 0.10) response was significantly different between meals. The insulin response was lower to meals rich in oleic acid or EPA and DHA than to meals rich in palmitic acid or linoleic acid (P < 0.01). The triglyceride response did not reach statistical significance (P = 0.06) but tended to be lower with EPA and DHA than with the other fatty acids. Similar trends were seen for area under the curve (AUC) and incremental AUC for serum insulin and triglycerides, but the differences were not significant.
In comparison with palmitic acid and linoleic acid, oleic acid or EPA and DHA may modestly lower insulin response in patients with type 2 diabetes without deteriorating the glucose response. EPA and DHA may also reduce the triglyceride response.
SourceAvailable from: Masoumeh Akhlaghi[Show abstract] [Hide abstract]
ABSTRACT: Background: We investigated adherence to healthy diet guidelines in patients with diabetes clinical inertia. Methods: This cross-sectional observational study was performed on 200 patients with diabetes (mostly type 2 diabetes) involved in poor glycemic control. The patients were recruited from a Diabetes Care Clinic in Iran. Biographic and medical information obtained by interview. A semi-quantitative food frequency questionnaire was used to estimate consumption of food items. Data on plasma glucose and lipids was obtained from patients’ dossiers in the clinic. Individuals were excluded if their laboratory tests had been carried out earlier than 3 months prior to the study. Results: Mean hemoglobin A1c (HbA1c) was 8.3 ± 1.9%, 62.7% of the patients had HbA1c ≥ 7.5%, and 88.5% had at least one form of dyslipidemia. Consumption of dairy, fruit, and vegetables was lower than dietary recommendations for healthy individuals in 55%, 54.5%, and 83%, respectively, but 72% consumed high-fiber breads. Among the investigated dietary factors only consumption of high-fiber breads was significantly associated with lower HbA1c (P=0.03). Consumption of none of dietary items was associated with low- and high- density lipoproteins, but there were significant associations between with triglycerides and consumption of vegetables (P=0.004), fish (P=0.02), soy (P=0.02), vegetable oils (P=0.047), and high-fiber breads (P=0.04). Conclusions: The patients adhered poorly to the guidelines of healthy diet. However, even if following these guidelines is not effective in the control of hyperglycemia in patients with diabetes clinical inertia, it may help to attenuate hypertriglyceridemia.
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ABSTRACT: Chronic diseases have become one of the most important public health problems, due to their high costs for treatment and prevention. Until now, researchers have considered that the etiology of Type 2 diabetes mellitus (T2DM) is multifactorial. Recently, the study of the innate immune system has offered an explanation model of the pathogenesis of T2DM. On the other hand, there is evidence about the beneficial effect of polyunsaturated fatty acids (PUFA) n-3 and n-6 in patients with chronic inflammatory diseases including diabetes. Furthermore, high vitamin D plasmatic concentrations have been associated with the best performance of pancreatic β cells and the improving of this disease. In conclusion, certain fatty acids in the adequate proportion as well as 25-hydroxivitamin D can modulate the inflammatory response in diabetic people, modifying the evolution of this disease.Journal of Immunology Research 02/2014; 2014:860703. DOI:10.1155/2014/860703 · 2.93 Impact Factor
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ABSTRACT: Dietary fatty acids play a role in glucose homeostasis. The aim of this study was to assess the individual relationship between dietary saturated (SFA), monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids with postprandial β-cell function and insulin sensitivity in subjects with normal and high fasting triglycerides. We assessed postprandial β-cell function (by the insulinogenic index and the ratio of the insulin to glucose areas under the time-concentration curve) and insulin sensitivity (by the oral glucose and the minimal model insulin sensitivity indices) over four nonconsecutive, randomly assigned, high-fat meals containing a panel of SFA (palmitic and stearic acids), MUFA (palmitoleic and oleic acids) and PUFA (linoleic and α-linolenic acids) in 14 subjects with normal and in 14 subjects with high fasting triglycerides. The proportions of each fatty acid in the meals and the values for surrogate measures of postprandial β-cell function and insulin sensitivity were subjected to a Pearson correlation and hierarchical cluster analysis, which revealed two classes of dietary fatty acids for regulating postprandial glucose homeostasis. We successfully discriminated the adverse effects of SFA palmitic acid from the beneficial effects of MUFA oleic acid on postprandial β-cell function (r ≥ 0.84 for SFA palmitic acid and r ≥ -0.71 for MUFA oleic acid; P < 0.05) and insulin sensitivity (r ≥ -0.92 for SFA palmitic acid and r ≥ 0.89 for MUFA oleic acid; P < 0.001) both in subjects with normal and high fasting triglycerides. In conclusion, dietary MUFA oleic acid, in contrast to SFA palmitic acid, favours the tuning towards better postprandial glycaemic control in subjects with normal and high fasting triglycerides.04/2014; 5(7). DOI:10.1039/c4fo00067f