From Nutrients to Meals–How Food Affects Diabetes Control
The Effect of Drequency of Meals on β-Cell Function in Subjects with Type 2 Diabetes
6/23/2013 8:15:00 AM
6/23/2013 8:30:00 AM
, LENKA BELINOVA, ANDREA TURA, MILAN HAJEK, MONIKA DEZORTOVA, MARTIN HILL, TEREZIE PELIKANOVA,
The aim of our study was to compare the effect of six vs. two meals a day with the same caloric restriction on β-cell function in subjects with type 2 diabetes (T2D).
In a randomized, crossover study, we assigned 54 patients with T2D to follow 2 regimens of a hypocaloric diet (-500 kcal/day), each for 12 weeks: six meals a day (A), and two meals a day, breakfast and lunch (B). The diet in both regimens had the same macronutrient and energy content. All subjects were examined at weeks 0, 12 and 24. Insulin secretory rate (ISR) and β-cell function were assessed during the standard meal tests. ISR was calculated by C-peptide deconvolution, and β-cell function was quantified with a mathematical model. Insulin sensitivity (OGIS) was calculated, which quantifies glucose clearance per unit change of insulin. Hepatic fat content (HFC) was measured by the proton magnetic resonance spectroscopy performed by 3T MR scanner (Magnetom - Trio Siemens). For statistical analysis, 2x2 crossover ANOVA was used.
Insulin secretion at the reference level and glucose sensitivity increased (p<0.05) comparably in both regimens. OGIS increased in both regimens (p<0.01), more in B (+8.2; 95% CI +3.4 to +13.1 ml.min−1m−2 in A vs. +21.0; 95% CI +16.1 to +26.0 ml.min−1m−2 in B; p<0.01). BMI decreased in both regimens (p<0.001), more in B (-0.82; 95% CI -0.94 to -0.69 kg.m-2 in A vs. -1.23; 95% CI -1.4 to -1.17 kg.m-2 in B; p<0.001). HFC decreased in response to both regimens (p<0.001), more in B (-3.4; 95% CI -3.8 to -3.1 % in A vs. -4.2; 95% CI -4.5 to -3.8% in B; p=0.03). Changes in glucose sensitivity and OGIS correlated negatively with changes in HFC (r=-0.28; p=0.02 and r=-0.47; p<0.001, respectively). After adjustment for changes in BMI the correlations were no longer significant.
Two meals a day led to a greater decrease in BMI and HFC and a greater increase in OGIS. Insulin secretion and glucose sensitivity increased comparably in both regimens. Our data suggest that eating fewer larger meals may be more beneficial than more frequent meals for patients with T2D.
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