PMID- 25724569 OWN - NLM STAT- MEDLINE DCOM- 20160120 LR - 20181113 IS - 1432-0428 (Electronic) IS - 0012-186X (Linking) VI - 58 IP - 5 DP - 2015 May TI - High-energy breakfast with low-energy dinner decreases overall daily hyperglycaemia in type 2 diabetic patients: a randomised clinical trial. PG - 912-9 LID - 10.1007/s00125-015-3524-9 [doi] AB - AIMS/HYPOTHESIS: High-energy breakfast and reduced-energy dinner (Bdiet) significantly reduces postprandial glycaemia in obese non-diabetic individuals. Our objective was to test whether this meal schedule reduces postprandial hyperglycaemia (PPHG) in patients with type 2 diabetes by enhancing incretin and insulin levels when compared with high-energy dinner and reduced-energy breakfast (Ddiet). METHODS: In a randomised, open label, crossover design performed in a clinic setting, 18 individuals (aged 30-70 years with BMI 22-35 kg/m(2)) with type 2 diabetes (<10 years duration) treated with metformin and/or diet were given either Bdiet or Ddiet for 7 days. Participants were randomised by a person not involved in the study using a coin flip. Postprandial levels of plasma glucose, insulin, C-peptide and intact and total glucagon-like peptide-1 (iGLP-1 and tGLP-1) were assessed. The Bdiet included 2,946 kJ breakfast, 2,523 kJ lunch and 858 kJ dinner. The Ddiet comprised 858 kJ breakfast, 2,523 kJ lunch and 2,946 kJ dinner. RESULTS: Twenty-two individuals were randomised and 18 analysed. The AUC for glucose (AUCglucose) throughout the day was 20% lower, whereas AUCinsulin, AUCC-peptide and AUCtGLP-1 were 20% higher for the Bdiet than the Ddiet. Glucose AUC0-180min and its peak were both lower by 24%, whereas insulin AUC0-180min was 11% higher after the Bdiet than the Ddiet. This was accompanied by 30% higher tGLP-1 and 16% higher iGLP-1 levels. Despite the diets being isoenergetic, lunch resulted in lower glucose (by 21-25%) and higher insulin (by 23%) with the Bdiet vs Ddiet. CONCLUSIONS/INTERPRETATION: High energy intake at breakfast is associated with significant reduction in overall PPHG in diabetic patients over the entire day. This dietary adjustment may have a therapeutic advantage for the achievement of optimal metabolic control and may have the potential for being preventive for cardiovascular and other complications of type 2 diabetes. Trial registration ClinicalTrials.gov NCT01977833 Funding No specific funding was received for the study. FAU - Jakubowicz, Daniela AU - Jakubowicz D AD - Diabetes Unit, E. Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Holon, 58100, Israel, daniela.jak@gmail.com. FAU - Wainstein, Julio AU - Wainstein J FAU - Ahren, Bo AU - Ahren B FAU - Bar-Dayan, Yosefa AU - Bar-Dayan Y FAU - Landau, Zohar AU - Landau Z FAU - Rabinovitz, Hadas R AU - Rabinovitz HR FAU - Froy, Oren AU - Froy O LA - eng SI - ClinicalTrials.gov/NCT01977833 PT - Journal Article PT - Randomized Controlled Trial DEP - 20150301 PL - Germany TA - Diabetologia JT - Diabetologia JID - 0006777 RN - 0 (Blood Glucose) RN - 0 (C-Peptide) RN - 0 (Insulin) SB - IM CIN - Diabetologia. 2015 Jun;58(6):1372-3. PMID: 25835726 MH - Adult MH - Aged MH - Blood Glucose/*metabolism MH - *Breakfast MH - C-Peptide/blood MH - Diabetes Mellitus, Type 2/blood/*diet therapy MH - Energy Intake/*physiology MH - Female MH - Humans MH - Hyperglycemia/blood/*diet therapy MH - Insulin/blood MH - Male MH - *Meals MH - Middle Aged MH - Postprandial Period MH - Treatment Outcome EDAT- 2015/03/01 06:00 MHDA- 2016/01/21 06:00 CRDT- 2015/03/01 06:00 PHST- 2014/11/23 00:00 [received] PHST- 2015/01/28 00:00 [accepted] PHST- 2015/03/01 06:00 [entrez] PHST- 2015/03/01 06:00 [pubmed] PHST- 2016/01/21 06:00 [medline] AID - 10.1007/s00125-015-3524-9 [doi] PST - ppublish SO - Diabetologia. 2015 May;58(5):912-9. doi: 10.1007/s00125-015-3524-9. Epub 2015 Mar 1.