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Given the importance of prevention of complications in type 2 diabetes (T2D), we aimed to examine changes over time in consumption of fruits, vegetables and juice among men who were diagnosed with T2D in comparison with men without diabetes. The prospective Cohort of Swedish Men, aged 45-79 years in 1997, was used to examine changes in diet after diagnosis of T2D. Dietary intake was assessed using FFQ in 1997 and 2009. In all, 23 953 men who were diabetes free at baseline (1997) and completed both FFQ were eligible to participate in the study. Diagnosis of T2D was reported by subjects and ascertained through registers. Multivariable linear mixed models were used to examine changes in mean servings/week over time. In total, 1741 men developed T2D during the study period. Increased consumption of vegetables and fruits was observed among those who developed T2D (equivalent to 1·6 servings/week, 95 % CI 1·08, 2·03) and men who remained diabetes free (0·7 servings/week, 95 % CI 0·54, 0·84). Consumption of juice decreased by 0·6 servings/week (95 % CI −0·71, −0·39) among those who developed T2D and increased by 0·1 servings/week (95 % CI 0·05, 0·15) in those who were diabetes free. Changes over time and between groups were statistically significant. Although improvements in diet were observed, only 36 % of those with T2D and 35 % of those without diabetes consumed ≥5 servings of fruits and vegetables/d in 2009.Key words: Diets: Change in diet: Type 2 diabetes: Prospective studies: Cohort studies Diet is an important and effective component in the treatment of type 2 diabetes (T2D) as it contributes to improved metabolic control and reduced risk of complications related to T2D (1)(2)(3) . Energy balance, metabolic goal and individual dietary preferences are recommended to be taken into account when supporting a healthy eating pattern (1)(2)(3) .Existing data indicate that the vast majority of those diagnosed with T2D do not make major lifestyle changes (4)(5)(6) and do not meet dietary recommendations (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) . However, cross-sectional studies also indicate that individuals with T2D differ from the general population with regard to diet (11)(12)(13)(14)(15)(16)18) . Individuals with diabetes tend to have a higher intake of protein and a lower intake of carbohydrates (11)(12)(13)(14)(15) , and they acquire more energy from fat (13,15,16) compared with individuals without diabetes. Moreover, those with diabetes have a higher intake of fruits (12,15,16) and vegetables (16,18) and a lower intake of juice (18) . To the best of our knowledge, the only studies exploring possible changes in diet due to the diagnosis of T2D in longitudinal settings observed that women in the Nurses' Health Study began consuming high-fat and low-sucrose diets after T2D diagnosis (15) , whereas no change in diet quality (using Alternative Healthy Eating Index) was observed among men and women in the Whitehall II study (19) . Even though reported differences in dietary patterns may point towards an atte...

Aim:The influence of dietary carbohydrates and fats on weight gain is inconclusively understood. We studied the acute impact of these nutrients on the overall metabolic state utilizing the insulin:glucagon ratio (IGR).Methods: Following in vitro glucose and palmitate treatment, insulin and glucagon secretion from islets isolated from C57Bl/6J mice was measured. Our human in vivo study included 21 normoglycaemia (mean age 51.9 ± 16.5 years, BMI 23.9 ± 3.5 kg/m 2 , and HbA1c 36.9 ± 3.3 mmol/mol) and 20 type 2 diabetes (T2D) diagnosed individuals (duration 12 ± 7 years, mean age 63.6 ± 4.5 years, BMI 29.1 ± 2.4 kg/m 2 , and HbA1c 52.3 ± 9.5 mmol/mol). Individuals consumed a carbohydrate-rich or fat-rich meal (600 kcal) in a cross-over design. Plasma insulin and glucagon levels were measured at −30, −5, and 0 min, and every 30 min until 240 min after meal ingestion. Results:The IGR measured from mouse islets was determined solely by glucose levels. The palmitate-stimulated hormone secretion was largely glucose independent in the analysed mouse islets. The acute meal tolerance test demonstrated that insulin and glucagon secretion is dependent on glycaemic status and meal composition, whereas the IGR was dependent upon meal composition. The relative reduction in IGR elicited by the fat-rich meal was more pronounced in obese individuals. This effect was blunted in T2D individuals with elevated HbA1c levels. Conclusion:The metabolic state in normoglycaemic individuals and T2Ddiagnosed individuals is regulated by glucose. We demonstrate that consumption of a low carbohydrate diet, eliciting a catabolic state, may be beneficial for weight loss, particularly in obese individuals. K E Y W O R D Salpha cell, beta cell, glucagon, insulin, insulin/glucagon ratio See related editorial: Pesta D, Jordan J 2022. Macronutrient composition and metabolic regulation: Do our islets care what we eat? Acta Physiol (Oxf). e13895.

Background Fructose intake may lead to hyperuricaemia, which is associated with increased risk and progression of kidney disease. We aimed to explore the acute effects of fructose loading from different sources, with and without a pizza, on levels of serum uric acid in patients with chronic kidney disease (CKD), type 2 diabetes (T2D) without CKD, and in healthy subjects (HS). Methods The study included six HS, and three CKD stage 4‐5 and seven T2D patients. Drinks consumed were blueberry drink (17.5 g fructose), Coca‐Cola (18 g fructose) and fructose drink (35 g fructose). The drinks were also combined with pizza, in total six interventions. Serum samples were collected fasting and 30, 60, 90 and 120 minutes after intake and also 240 minutes after drink + pizza, and analysed for fructose, uric acid and triglycerides. Postprandial responses were explored using repeated‐measure ANOVA. Results Baseline serum uric acid levels were increased in CKD (P = 0.037). There were significant differences in serum fructose and serum uric levels over time between drinks and drinks + pizza for all groups (P < 0.001 and P < 0.05, respectively). The highest peak in serum fructose followed the fructose drink interventions and the lowest the blueberry drink. The fructose drink interventions gave the highest responses in serum uric acid and the lowest responses followed the blueberry drink. Triglycerides increased following pizza interventions (P < 0.001). Conclusions Intake of fructose increases serum uric acid. The fructose intake via a blueberry drink induced lowest increase and thus may be protective.