PMID- 36732571 OWN - NLM STAT- MEDLINE DCOM- 20230511 LR - 20231211 IS - 1476-5640 (Electronic) IS - 0954-3007 (Print) IS - 0954-3007 (Linking) VI - 77 IP - 5 DP - 2023 May TI - Beneficial effects of premeal almond load on glucose profile on oral glucose tolerance and continuous glucose monitoring: randomized crossover trials in Asian Indians with prediabetes. PG - 586-595 LID - 10.1038/s41430-023-01263-1 [doi] AB - BACKGROUND: Rapid conversion from prediabetes to diabetes and frequent postprandial hyperglycemia (PPHG) is seen in Asian Indians. These should be the target of dietary strategies. OBJECTIVES: We hypothesized that dietary intervention of preloading major meals with almonds in participants with prediabetes will decrease overall glycemia and PPHG. DESIGN: The study included two phases: (1) an oral glucose tolerance test (OGTT)-based crossover randomized control study, the effect of a single premeal almond load (20 g) given before OGTT was evaluated (n = 60, 30 each period). (2) The continuous glucose monitoring system (CGMS)-based study for 3 days including premeal almond load before three major meals was a free-living, open-labeled, crossover randomized control trial, where control and premeal almond load diets were compared for glycaemic control (n = 60, 30 in each period). The study was registered at clinicaltrials.gov (registration no. NCT04769726). RESULTS: In the OGTT-based study phase, the overall AUC for blood glucose, serum insulin, C-peptide, and plasma glucagon post-75 g oral glucose load was significantly lower for treatment vs. control diet (p < 0.001). Specifically, with the former diet, PPHG was significantly lower (18.05% in AUC on OGTT, 24.8% at 1-h, 28.9% at 2-h post OGTT, and 10.07% during CGMS). The CGMS data showed that premeal almond load significantly improved 24-glucose variability; SD of mean glucose concentration and mean of daily differences. Daily glycaemic control improved significantly as per the following: mean 24-h blood glucose concentration (M), time spent above 7.8 mmol/L of blood glucose, together with the corresponding AUC values. Premeal almond load significantly decreased following: overall hyperglycemia (glucose AUC), PPHG, peak 24-h glycaemia, and minimum glucose level during night. CONCLUSION: Incorporation of 20 g of almonds, 30 min before each major meal led to a significant decrease in PPHG (as revealed in OGTT-based study phase) and also improved insulin, C-peptide, glucagon levels, and improved glucose variability and glycemic parameters on CGMS in participants with prediabetes. CLINICAL TRIAL REGISTRY: The study was registered at clinicaltrials.gov (registration no. NCT04769726). CI - (c) 2023. The Author(s). FAU - Gulati, Seema AU - Gulati S AUID- ORCID: 0000-0003-3814-1434 AD - Diabetes Foundation (India), New Delhi, India. AD - National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India. AD - Center of Nutrition & Metabolic Research (C-NET), New Delhi, India. FAU - Misra, Anoop AU - Misra A AUID- ORCID: 0000-0001-5785-5833 AD - Diabetes Foundation (India), New Delhi, India. anoopmisra@gmail.com. AD - National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India. anoopmisra@gmail.com. AD - Center of Nutrition & Metabolic Research (C-NET), New Delhi, India. anoopmisra@gmail.com. AD - Fortis C-DOC Centre for Excellence for Diabetes, Metabolic Disease, and Endocrinology, New Delhi, India. anoopmisra@gmail.com. FAU - Tiwari, Rajneesh AU - Tiwari R AUID- ORCID: 0000-0002-4343-5966 AD - National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India. FAU - Sharma, Meenu AU - Sharma M AD - National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India. FAU - Pandey, Ravindra M AU - Pandey RM AD - All India Institute of Medical Sciences, New Delhi, India. FAU - Upadhyay, Ashish Datt AU - Upadhyay AD AD - All India Institute of Medical Sciences, New Delhi, India. FAU - Sati, Hem Chandra AU - Sati HC AD - All India Institute of Medical Sciences, New Delhi, India. LA - eng SI - ClinicalTrials.gov/NCT04769726 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20230202 PL - England TA - Eur J Clin Nutr JT - European journal of clinical nutrition JID - 8804070 RN - IY9XDZ35W2 (Glucose) RN - 0 (Blood Glucose) RN - 9007-92-5 (Glucagon) RN - 0 (C-Peptide) RN - 0 (Insulin) SB - IM MH - Humans MH - Glucose Tolerance Test MH - Glucose/metabolism MH - Blood Glucose/metabolism MH - *Prediabetic State MH - *Prunus dulcis/metabolism MH - Glucagon MH - *Diabetes Mellitus, Type 2 MH - Cross-Over Studies MH - C-Peptide MH - Blood Glucose Self-Monitoring MH - *Hyperglycemia MH - Insulin MH - Postprandial Period PMC - PMC10169634 COIS- The authors declare no competing interests. EDAT- 2023/02/03 06:00 MHDA- 2023/05/11 06:42 PMCR- 2023/02/02 CRDT- 2023/02/02 23:44 PHST- 2022/07/04 00:00 [received] PHST- 2023/01/11 00:00 [accepted] PHST- 2022/12/29 00:00 [revised] PHST- 2023/05/11 06:42 [medline] PHST- 2023/02/03 06:00 [pubmed] PHST- 2023/02/02 23:44 [entrez] PHST- 2023/02/02 00:00 [pmc-release] AID - 10.1038/s41430-023-01263-1 [pii] AID - 1263 [pii] AID - 10.1038/s41430-023-01263-1 [doi] PST - ppublish SO - Eur J Clin Nutr. 2023 May;77(5):586-595. doi: 10.1038/s41430-023-01263-1. Epub 2023 Feb 2.