Dietary carbohydrate modification enhances insulin secretion in persons with the metabolic syndrome

Laaksonen, David E.; Toppinen, Leena; Juntunen, Kaisa; Autio, Karin; Liukkonen, Kirsi‐Helena; Poutanen, Kaisa; Niskanen, Leo; Mykkänen, Hannu

doi:10.1093/ajcn/82.6.1218

Cited by 105 publications

(72 citation statements)

References 49 publications

(60 reference statements)

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“…Nevertheless, we did detect a significant time× treatment interaction for MIS×II. Also, our results are consistent with those of several previous studies showing that low-glycaemic-index starchy foods improve beta cell function or insulin secretion in persons without diabetes [10,31].…”

Section: Discussionsupporting

confidence: 93%

Low glycaemic index diet and disposition index in type 2 diabetes (the Canadian trial of Carbohydrates in Diabetes): a randomised controlled trial

Wolever

Mehling²,

Chiasson

et al. 2008

Diabetologia

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Aims/hypothesis We recently found that oral glucose tolerance over 1 year in type 2 diabetic patients declined to a significantly lesser degree on a low-glycaemic-index than on a reduced-carbohydrate diet. Here, we examined whether that finding was associated with an improvement in disposition index, an index of beta cell function defined as the product of insulin sensitivity and insulin secretion. Since this is a report of secondary analysis on a previously published trial, the results should be considered as hypothesis-generating. Methods Type 2 diabetic patients treated by diet alone (n=162) were randomised by computer to high-carbohydrate/highglycaemic index (High-GI, n=52), high-carbohydrate/lowglycaemic index (Low-GI, n=56) or low-carbohydrate/ high-monounsaturated-fat (Low-CHO, n= 54) diets for 1 year in a multi-centre, parallel-design clinical trial conducted at University teaching hospitals. At baseline and at 3, 6 and 12 months participants underwent 75 g OGTTs; 27 participants dropped out or were excluded. Indices of insulin sensitivity, insulin secretion and disposition index, derived from the OGTT, were compared among diets. Those assessing the outcomes were blinded to group assignment. Results Neither muscle insulin sensitivity index nor insulinogenic index differed significantly among diets. However, a significant time×diet interaction existed for disposition index (muscle insulin sensitivity index×insulinogenic index) (p=0.036). After 3 months, disposition index tended to be higher on Low-CHO than on Low-GI diets, namely by 0.07 h −1 (95% CI −0.04, 0.18). However, by 12 months this reversed and disposition index became higher on Low-GI than on Low-CHO, namely by 0.12 h −1 (0.01, 0.23; p< 0.05, baseline disposition index 0.23 h −1 ). There were no important adverse effects associated with the treatments. Conclusions/interpretation These results suggest that, in patients with type 2 diabetes on diet alone, a Low-GI diet for 1 year increases disposition index, an index of beta cell function, compared with a Low-CHO diet.

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Section: Discussionsupporting

confidence: 93%

Low glycaemic index diet and disposition index in type 2 diabetes (the Canadian trial of Carbohydrates in Diabetes): a randomised controlled trial

Wolever

Mehling²,

Chiasson

et al. 2008

Diabetologia

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“…Regular physical activity may diminish glycemic stress by improving insulin sensitivity of target tissues (18). While the mechanisms of improved ␤-cell function in response to lifestyle interventions are still largely unknown, several studies suggest that physical activity (5, 11), diet (19,26), weight loss (45), or their combination (21) may directly improve the first-phase insulin secretion that is an indicator of the ␤-cell function.…”

Section: Discussionmentioning

confidence: 99%

Physical activity modifies the effect of SNPs in theSLC2A2(GLUT2) andABCC8(SUR1) genes on the risk of developing type 2 diabetes

Kilpeläinen

Lakka

Laaksonen

et al. 2007

Physiological Genomics

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-Single nucleotide polymorphisms (SNPs) in two genes regulating insulin secretion, SLC2A2 (encoding GLUT2) and ABCC8 (encoding SUR1), were associated with the conversion from impaired glucose tolerance (IGT) to type 2 diabetes (T2D) in the Finnish Diabetes Prevention Study (DPS). We determined whether physical activity (PA), assessed annually with a questionnaire, modified the association of SNPs in SLC2A2 and ABCC8 with the conversion to T2D in the combined intervention and control groups of the DPS. Finnish overweight subjects with IGT (N ϭ 479) were followed for an average of 4.1 yr. The interaction of the SNPs with the change in PA on the conversion to T2D was assessed using Cox regression with adjustments for the other components of the intervention (dietary changes, weight reduction). The carriers of the common homozygous genotype of rs5393, rs5394, or rs5404 of SLC2A2 and rs3758947 of ABCC8 who were in the lower third of the change in moderate-to-vigorous PA during the follow-up had a 2.6-to 3.7-fold increased risk of developing T2D compared with the upper third, whereas the rare allele carriers seemed to be unresponsive to changes in moderate-to-vigorous PA (for the interaction of genotype with change in PA, P ϭ 0.022-0.027 for the SNPs in SLC2A2, and P ϭ 0.007 for rs3758947). We conclude that moderate-to-vigorous PA may modify the risk of developing T2D associated with genes regulating insulin secretion (SLC2A2, ABCC8) in persons with IGT. sulphonylurea receptor-1; glucose transporter-2; impaired glucose tolerance; exercise; single nucleotide polymorphism GENETIC FACTORS AND LIFESTYLE interact in the development of type 2 diabetes. Physical activity, favorable dietary changes, and weight reduction were essential components of a successful lifestyle intervention in two large randomized controlled trials on the prevention of type 2 diabetes in high-risk individuals with impaired glucose tolerance (IGT), including the Finnish Diabetes Prevention Study (DPS) (44) and the Diabetes Prevention Program (DPP) (22). In the DPS, increased physical activity was associated with a decreased risk of type 2 diabetes independently of changes in diet and body weight. The individuals who increased their physical activity most (i.e., were in the upper third of the change) were 66% less likely to develop type 2 diabetes than those in the lower third (24).Two major pathogenetic factors leading to type 2 diabetes are insulin resistance and impaired insulin secretion (7). Thus the reduction in the risk of type 2 diabetes with physical activity may occur by an improvement in insulin sensitivity, ␤-cell function, or both. Numerous exercise-training studies have demonstrated that physical activity increases insulin sensitivity (18). The effect of physical activity on ␤-cell function is less clear, but some studies suggest that increased physical activity may improve early insulin secretion independently of insulin resistance (5, 11).Glucose transporter-2 (GLUT2), encoded by the SLC2A2 gene, is a facilitative glucose transporter t...

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“…Já em um ensaio clínico de menor duração, a dieta DASH foi mais efetiva na melhora do perfil de todos os componentes da SM (reduções de cintura abdominal, peso, triglicerídeos e níveis pressóricos e aumento do HDL-colesterol) quando comparada com uma dieta controle e com uma dieta hipocalórica para perda de peso (46). Além disso, a alteração na fonte de carboidratos da dieta, provavelmente independente do conteúdo de fibras, foi capaz de modificar a resposta das células β pancreáticas à glicose (47). Uma dieta com pão de centeio e massa como principal fonte de carboidratos, comparada com uma dieta rica em pão de farinha de trigo/aveia e batata, aumentou a secreção de insulina na primeira fase após glicose via oral em pacientes com SM e com sobrepeso ou obesidade.…”

Section: Hiperglicemia E Dietaunclassified

Fatores dietéticos e síndrome metabólica

Steemburgo

Dall’Alba

Gross

et al. 2007

Arq Bras Endocrinol Metab

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RESUMOO papel da dieta na síndrome metabólica (SM) tem sido estudado em relação a cada um de seus componentes: obesidade, níveis pressóricos elevados, dislipidemia e alterações no metabolismo da glicose. Entretanto, poucos estudos avaliaram os efeitos da dieta na presença da SM como uma entidade clínica independente. O objetivo deste manuscrito foi revisar a importância dos fatores dietéticos e as recomendações dietoterápicas na SM. Estudos recentes demonstraram que o consumo de grãos integrais foi associado negativamente com SM. Já alimentos com alto índice glicêmico foram associados positivamente com resistência à insulina e prevalência de SM. O seguimento de uma dieta mediterrânea foi capaz de reduzir o número de componentes da SM. Também a adoção da dieta DASH melhorou o perfil de todos os componentes da SM. Recomenda-se, para pacientes com SM, um valor energético total compatível com a obtenção e/ou manutenção do peso corporal desejável. O conteúdo de gordura, em especial o consumo de gordura saturada, e colesterol deve ser reduzido e o consumo de grãos integrais, frutas e vegetais, aumentado. Provavelmente as fibras alimentares têm um papel importante no manejo dietoterápico da SM. Novos estudos que avaliem o papel da dieta na presença e no desenvolvimento da SM são necessários. The role of diet in metabolic syndrome (MS) has been studied regarding each one of its components: obesity, high blood pressure, dyslipidemia, and abnormal glucose metabolism. However, few studies evaluated the effects of diet in the presence of MS as a unique independent disease. The aim of this manuscript was to review the role of dietary factors and dietary recommendations for MS. Recently some studies demonstrated that intake of whole-grain foods were negatively associated with MS. Foods with high glycemic index were positively associated with insulin resistance and the prevalence of MS. Following a Mediterranean-style diet caused a reduction in the number of MS components. Also, the adoption of the DASH diet improved the profile of all MS components. A total daily energy intake to obtain and/or to maintain a desirable weight is recommended for patients with MS. The fat content, especially from saturated fat, and cholesterol must be reduced and the intake of whole-grain foods, fruits, and vegetables must be increased. Probably, dietary fibers have an important role in the management of MS. New studies to evaluate the role of diet in the presence and development of MS are needed.

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Dietary carbohydrate modification enhances insulin secretion in persons with the metabolic syndrome

Abstract: Rye bread and pasta-based carbohydrate modification enhances early insulin secretion in persons with the metabolic syndrome, which may lower the risk of deteriorating glucose tolerance and development of type 2 diabetes.

Cited by 105 publications

References 49 publications

Low glycaemic index diet and disposition index in type 2 diabetes (the Canadian trial of Carbohydrates in Diabetes): a randomised controlled trial

Low glycaemic index diet and disposition index in type 2 diabetes (the Canadian trial of Carbohydrates in Diabetes): a randomised controlled trial

Physical activity modifies the effect of SNPs in theSLC2A2(GLUT2) andABCC8(SUR1) genes on the risk of developing type 2 diabetes

Fatores dietéticos e síndrome metabólica

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