Impact of Diabetes-Specific Nutritional Formulas versus Oatmeal on Postprandial Glucose, Insulin, GLP-1 and Postprandial Lipidemia

Abstract

Diabetes-specific nutritional formulas (DSNFs) are frequently used as part of medical nutrition therapy for patients with diabetes. This study aims to evaluate postprandial (PP) effects of 2 DSNFs; Glucerna (GL) and Ultra Glucose Control (UGC) versus oatmeal (OM) on glucose, insulin, glucagon-like peptide-1 (GLP-1), free fatty acids (FFA) and triglycerides (TG). After an overnight fast, 22 overweight/obese patients with type 2 diabetes were given 200 kcal of each of the three meals on three separate days in random order. Blood samples were collected at baseline and at 30, 60, 90, 120, 180 and 240 min. Glucose area under the curve (AUC0–240) after GL and UGC was lower than OM (p < 0.001 for both). Insulin positive AUC0–120 after UGC was higher than after OM (p = 0.02). GLP-1 AUC0–120 and AUC0–240 after GL and UGC was higher than after OM (p < 0.001 for both). FFA and TG levels were not different between meals. Intake of DSNFs improves PP glucose for 4 h in comparison to oatmeal of similar caloric level. This is achieved by either direct stimulation of insulin secretion or indirectly by stimulating GLP-1 secretion. The difference between their effects is probably related to their unique blends of amino acids, carbohydrates and fat.

Effects of nutrition therapy on HbA1c and cardiovascular disease risk factors in overweight and obese patients with type 2 diabetes

“…Several explanations could be presumed. Participants in structured NT groups consumed more protein and fiber, which are known to improve postprandial blood glucose levels [ 21 – 24 ]. Use of structured menus and snacks provided consistent ratio of macronutrients and energy intake per meals that might reduce blood glucose variability.…”

“…Use of structured menus and snacks provided consistent ratio of macronutrients and energy intake per meals that might reduce blood glucose variability. Use of DSNFs, within the total daily energy intake, had its own benefit on glycemic control, [ 25 ] insulin and GLP-1 secretion, [ 21 ] and body weight [ 26 , 27 ]. Taken together, these factors might explain the improvement in glycemic control, body weight, body composition and insulin sensitivity in response to structured NT.…”

The Role of Dietary Carbohydrates in Gestational Diabetes

“…Specialized diabetes-specific formulas (DSF) are designed using low glycemic index and slowly digested carbohydrates and monosaturated fatty acids to support glycemic control [81][82][83]. Systematic reviews and meta-analyses have shown that DSF as part of lifestyle interventions effectively improves glycemic control and reduces cardiometabolic risks [84,85].…”

Weight Management in Patients with Type 2 Diabetes: a Multidisciplinary Real-world Approach

“…Several meal replacement formulas have been tested for weight management [ 47 ]. We previously showed that patients with T2D who consumed DSF for breakfast had a lower glucose excursion compared to oatmeal with the same calorie content [ 48 ]. Several DSFs were used in both the Look AHEAD study and the Why WAIT program for the initial 6–20 weeks to enhance initial weight reduction [ 39 ].…”