This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager patientINFORMation Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gentilcore, D. Articles by Horowitz, M. Search for Related Content PubMed PubMed Citation Articles by Gentilcore, D. Articles by Horowitz, M. Related Collections Diabetes and Insulin Metabolism

Effects of Fat on Gastric Emptying of and the Glycemic, Insulin, and Incretin Responses to a Carbohydrate Meal in Type 2 Diabetes

University of Adelaide, Department of Medicine, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia

Address all correspondence and requests for reprints to: Dr. Michael Horowitz, University of Adelaide, Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia. E-mail: michael.horowitz{at}adelaide.edu.au.

Context: Gastric emptying (GE) is a major determinant of postprandial glycemia. Because the presence of fat in the small intestine inhibits GE, ingestion of fat may attenuate the glycemic response to carbohydrate.

Objective: The objective of this study was to evaluate the effect of patterns of fat consumption on GE and glucose, insulin, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) concentrations after a carbohydrate meal in type 2 diabetes.

Design: This was a randomized, cross-over study in which GE of a radioisotopically labeled potato meal was measured on 3 d.

Setting: The study was performed at the Royal Adelaide Hospital.

Patients: Six males with type 2 diabetes were studied.

Intervention: Subjects ingested 1) 30 ml water 30 min before the mashed potato (water), 2) 30 ml olive oil 30 min before the mashed potato (oil), or 3) 30 ml water 30 min before the mashed potato meal that contained 30 ml olive oil (water and oil).

Main Outcome Measures: GE, blood glucose, plasma insulin, GLP-1, and GIP concentrations were the main outcome measures.

Results: GE was much slower with oil compared with both water (P < 0.0001) and water and oil (P < 0.05) and was slower after water and oil compared with water (P < 0.01). The postprandial rise in blood glucose was markedly delayed (P = 0.03), and peak glucose occurred later (P = 0.04) with oil compared with the two other meals. The rises in insulin and GIP were attenuated (P < 0.0001), whereas the GLP-1 response was greater (P = 0.0001), after oil.

Conclusions: Ingestion of fat before a carbohydrate meal markedly slows GE and attenuates the postprandial rises in glucose, insulin, and GIP, but stimulates GLP-1, in type 2 diabetes.

Find additional patient-related information at:

The Effect of Fat in Meals

This article has been cited by other articles:

				J. Ma, J. E. Stevens, K. Cukier, A. F. Maddox, J. M. Wishart, K. L. Jones, P. M. Clifton, M. Horowitz, and C. K. Rayner Effects of a Protein Preload on Gastric Emptying, Glycemia, and Gut Hormones After a Carbohydrate Meal in Diet-Controlled Type 2 Diabetes Diabetes Care, September 1, 2009; 32(9): 1600 - 1602. [Abstract] [Full Text] [PDF]

				I. Strychar, J. S. Cohn, G. Renier, M. Rivard, N. Aris-Jilwan, H. Beauregard, S. Meltzer, A. Belanger, R. Dumas, A. Ishac, et al. Effects of a Diet Higher in Carbohydrate/Lower in Fat Versus Lower in Carbohydrate/Higher in Monounsaturated Fat on Postmeal Triglyceride Concentrations and Other Cardiovascular Risk Factors in Type 1 Diabetes Diabetes Care, September 1, 2009; 32(9): 1597 - 1599. [Abstract] [Full Text] [PDF]

				K. Vollmer, H. Gardiwal, B. A. Menge, O. Goetze, C. F. Deacon, W. E. Schmidt, J. J. Holst, and J. J. Meier Hyperglycemia Acutely Lowers the Postprandial Excursions of Glucagon-Like Peptide-1 and Gastric Inhibitory Polypeptide in Humans J. Clin. Endocrinol. Metab., April 1, 2009; 94(4): 1379 - 1385. [Abstract] [Full Text] [PDF]

				S. E. Berry, E. A Tydeman, H. B Lewis, R. Phalora, J. Rosborough, D. R Picout, and P. R Ellis Manipulation of lipid bioaccessibility of almond seeds influences postprandial lipemia in healthy human subjects Am. J. Clinical Nutrition, October 1, 2008; 88(4): 922 - 929. [Abstract] [Full Text] [PDF]

				S. K. Cervantes-Pahm and H. H. Stein Effect of dietary soybean oil and soybean protein concentration on the concentration of digestible amino acids in soybean products fed to growing pigs J Anim Sci, August 1, 2008; 86(8): 1841 - 1849. [Abstract] [Full Text] [PDF]

				A. J A H van Vught, A. G Nieuwenhuizen, R.-J. M Brummer, and M. S Westerterp-Plantenga Somatotropic responses to soy protein alone and as part of a meal. Eur. J. Endocrinol., July 1, 2008; 159(1): 15 - 18. [Abstract] [Full Text] [PDF]

				K. Vollmer, J. J. Holst, B. Baller, M. Ellrichmann, M. A. Nauck, W. E. Schmidt, and J. J. Meier Predictors of Incretin Concentrations in Subjects With Normal, Impaired, and Diabetic Glucose Tolerance Diabetes, March 1, 2008; 57(3): 678 - 687. [Abstract] [Full Text] [PDF]

				G. Riccardi, A. A Rivellese, and R. Giacco Role of glycemic index and glycemic load in the healthy state, in prediabetes, and in diabetes Am. J. Clinical Nutrition, January 1, 2008; 87(1): 269S - 274S. [Abstract] [Full Text] [PDF]

				A. N. Pilichiewicz, R. Chaikomin, I. M. Brennan, J. M. Wishart, C. K. Rayner, K. L. Jones, A. J. P. M. Smout, M. Horowitz, and C. Feinle-Bisset Load-dependent effects of duodenal glucose on glycemia, gastrointestinal hormones, antropyloroduodenal motility, and energy intake in healthy men Am J Physiol Endocrinol Metab, September 1, 2007; 293(3): E743 - E753. [Abstract] [Full Text] [PDF]