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Submitted on December 6, 2005
Accepted on March 2, 2006
University of Adelaide, Department of Medicine, Royal Adelaide Hospital, South Australia, Australia, 5000
* To whom correspondence should be addressed. E-mail: michael.horowitz{at}adelaide.edu.au.
Context: Gastric emptying (GE) is a major determinant of postprandial glycemia. As the presence of fat in the small intestine inhibits GE, ingestion of fat may attenuate the glycemic response to carbohydrate.
Objective: To evaluate the effect of patterns of fat consumption on GE, and glucose, insulin, GLP-1 and GIP concentrations, after a carbohydrate meal in type 2 diabetes.
Design: Randomized, cross-over design; GE of a radioisotopically-labeled potato meal measured on 3 days.
Setting: Department of Nuclear Medicine, PET and Bone Densitometry at the Royal Adelaide Hospital.
Patients: Six males with type 2 diabetes.
Intervention: Subjects ingested (i) 30ml water, 30 min before the mashed potato (‘water’), (ii) 30ml olive oil, 30 min before the mashed potato (‘oil’) and (iii) 30ml water, 30 min before the mashed potato meal which contained 30ml (‘water and oil’).
Main Outcome Measures: GE, blood glucose, plasma insulin, GLP-1 and GIP concentrations.
Results: GE was much slower with ‘oil’ compared with both ‘water’ (P < 0.0001) and ‘water and oil’ (P < 0.05), and slower following ‘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’ when 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.
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