TITLE:
Glycemic responses to glycemia-targeted specialized-nutrition beverages with varying carbohydrates compared to a standard nutritional beverage in adults with type 2 diabetes
AUTHORS:
Amy A. Devitt, Jennifer A. Williams, Yong S. Choe, Deborah S. Hustead, Vikkie A. Mustad
KEYWORDS:
Diabetes; Oral Nutritional Supplement; Glycemia-Targeted Specialized-Nutrition; Glucagon-Like Peptide 1; Glycemic Control; Low-Glycemic/Slowly-Digested Carbohydrates
JOURNAL NAME:
Advances in Bioscience and Biotechnology,
Vol.4 No.9A,
September
11,
2013
ABSTRACT:
Background: Postprandial plasma glucose concentration
is an important diabetes management target. Glycemia-targeted
specialized-nutrition (GTSN) beverages, containing various quantities and
types of carbohydrates (CHO), have been formulated to blunt postprandial
hyperglycemia. The objective of this research was to evaluate the effectiveness
of these products on postprandial glycemic and hormonal responses based on
comparisons of GTSN with differing carbohydrate quantities or types. Methods:
In two randomized, double-blind, crossover studies, participants (mean age 61
years) with type 2 diabetes consumed GTSN in a meal tolerance test. In the CHO
Quantity Study, a standard nutritional beverage (STD) was compared to a low
carbohydrate nutritional beverage with tapioca dextrin (GTSN-TDX) and a
balanced carbohydrate nutritional beverage containing a blend of the
slowly-digesting carbohydrates maltodextrin and sucromalt (GTSN-SDC). In the
CHO Type Study, the GTSN beverages had similar carbohydrate quantities but
varied in carbohydrate composition with GTSN-SDC compared to a formula with
tapioca starch and fructose (GTSN-TS&F), and one with isomaltulose and
resistant starch (GTSN-I&RS). Postprandial (0-240 min) concentrations of
blood glucose, insulin (CHO Quantity Study only) and glucagon-like-peptide
(GLP)-1 (CHO Quantity Study only) were measured. Results: Despite having
substantially different carbohydrate quantities, the GTSN blunted the glucose
positive area under the curve (AUC0-240 min) by 65% to 82%
compared to the STD formulation (p 0-240 min (p 0-240 min tended to be lower for GTSN-SDC
(1477 ± 460) than GTSN-TS&F (2203 ± 412; p = 0.062) and GTSN-I&RS (2190
± 412; p = 0.076). No differences were observed between GTSN-TS&F and
GTSN-I&RS. Conclusions: These results demonstrate the effectiveness of
several GTSN products and suggest that both CHO quantity and type play
important roles in postprandial glycemic response in men and women with type 2
diabetes. Furthermore, GTSN products containing slow-digesting carbohydrates
can blunt postmeal glucose and insulin concentration despite delivering greater
total grams of CHO, which provides a dietary benefit for people with diabetes.