PMID- 10509766
OWN - NLM
STAT- MEDLINE
DCOM- 19991116
LR  - 20191103
IS  - 0954-3007 (Print)
IS  - 0954-3007 (Linking)
VI  - 53
IP  - 9
DP  - 1999 Sep
TI  - Breakfast glycaemic response in patients with type 2 diabetes: effects of bedtime 
      dietary carbohydrates.
PG  - 706-10
AB  - OBJECTIVES: Bedtime carbohydrate (CHO) intake in patients with type-2 diabetes 
      may improve glucose tolerance at breakfast the next morning. We examined the 
      'overnight second-meal effect' of bedtime supplements containing 'rapid' or 
      'slow' CHOs. DESIGN: Randomized cross-over study with three test-periods, each 
      consisting of two days on a standardized diet, followed by a breakfast tolerance 
      test on the third morning. SETTING: The Lundberg Laboratory for Diabetes 
      Research, Sahlgrenska University Hospital, Goteborg, Sweden. SUBJECTS: Sixteen 
      patients with type 2 diabetes on oral agents and/or diet. INTERVENTIONS: Two 
      different bedtime (22.00 h) CHO supplements (0.46 g available CHO/kg body weight) 
      were compared to a starch-free placebo ('normal' food regimen). The CHOs were 
      provided as uncooked cornstarch (slow-release CHOs) or white bread (rapid CHOs). 
      RESULTS: On the mornings after different bedtime meals we found similar fasting 
      glucose, insulin, free fatty acid and lactate levels. However, the glycaemic 
      response after breakfast was 21% less after uncooked cornstarch compared to 
      placebo ingestion at bedtime (406 +/- 46 vs 511 +/- 61 mmol min l(-1), P < 0.01). 
      In contrast, it did not differ when the evening meal consisted of white bread 
      (451 +/- 57 mmol min l(-1)) compared to placebo. According to an in vitro 
      analysis, uncooked cornstarch contained approximately 4 times more slowly 
      digestible starch as compared to white bread. CONCLUSIONS: A bedtime meal 
      providing uncooked cornstarch improved breakfast tolerance the next morning 
      while, in contrast, this was not found following a bedtime meal of white bread. 
      The results are consistent, therefore, with the concept that an increased intake 
      of slowly digestible carbohydrates exert an overnight second-meal effect in 
      patients with type 2 diabetes.
FAU - Axelsen, M
AU  - Axelsen M
AD  - The Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, 
      Sahlgrenska University Hospital, Goteborg, Sweden.
FAU - Arvidsson Lenner, R
AU  - Arvidsson Lenner R
FAU - Lonnroth, P
AU  - Lonnroth P
FAU - Smith, U
AU  - Smith U
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Clin Nutr
JT  - European journal of clinical nutrition
JID - 8804070
RN  - 0 (Blood Glucose)
RN  - 0 (Dietary Carbohydrates)
RN  - 0 (Fatty Acids, Nonesterified)
RN  - 0 (Insulin)
RN  - 0 (Lactates)
RN  - 9005-25-8 (Starch)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Glucose/*metabolism
MH  - Cross-Over Studies
MH  - Diabetes Mellitus, Type 2/*blood
MH  - Dietary Carbohydrates/*administration & dosage/*metabolism
MH  - Digestion
MH  - Fatty Acids, Nonesterified/blood
MH  - Female
MH  - Humans
MH  - Insulin/blood
MH  - Lactates/blood
MH  - Male
MH  - Middle Aged
MH  - Starch/administration & dosage/metabolism
MH  - Time Factors
EDAT- 1999/10/06 00:00
MHDA- 1999/10/06 00:01
CRDT- 1999/10/06 00:00
PHST- 1999/10/06 00:00 [pubmed]
PHST- 1999/10/06 00:01 [medline]
PHST- 1999/10/06 00:00 [entrez]
AID - 10.1038/sj.ejcn.1600837 [doi]
PST - ppublish
SO  - Eur J Clin Nutr. 1999 Sep;53(9):706-10. doi: 10.1038/sj.ejcn.1600837.