Simple Changes in Eating Patterns Help Control Diabetes Type 2

Eating Carbs Last Could Help Patients Lower Their Blood Glucose Levels After a Meal

We’ve found two preliminary studies that suggest simple ways people with type 2 diabetes may be able to improve blood glucose control after a meal. We’ll discuss one of the studies below, the other in an upcoming post.

Background. It’s been known for quite a while that the type of carbohydrates patients with type 2 diabetes eat—not just the amount of carbohydrates—influences how high their blood glucose levels rise after a meal. Controlling that after-meal increase in blood glucose levels—known as postprandial hyperglycemia—is an important goal in diabetes. Spikes can make symptoms worse, and have been linked with an increased risk of cardiovascular disease.

A small study recently published online suggests that controlling the order in which patients eat carbs vs. other foods may help them reach their after-meal goals for blood glucose control.

The Study. 16 type 2 patients ate the same foods, but in a different order, for three days:

Investigators tested patients’ blood levels of glucose, insulin, and other factors just before the meal, then every 30 minutes, up to 180 minutes. Insulin of course helps control glucose levels, and there’s a theory—it hasn’t been proven—that eating proteins first stimulates insulin secretion.

Results. When carbohydrates were eaten last:

  • Blood glucose levels rose less than they did in the other test situations (carbohydrates eaten first, or all foods eaten together)
  • Blood glucose and insulin levels peaked at lower levels than in the other test situations, and the peaks lasted for a shorter time

Bottom line: This was a small study; larger trials are needed. But in the meantime, eating carbohydrates after proteins and vegetables seems a simple change for patients to make; and one that could perhaps improve blood glucose control after meals.

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References

Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. Food order has a significant impact on postprandial glucose and insulin levels. Diabetes Care. 2015;38:e98-e99. doi: 10.2337/dc15-0429. http://care.diabetesjournals.org/content/38/7/e98.full.pdf+html.

Shukla AP, Andono J, Touhamy SH. Carbohydrate-last meal pattern lowers postprandial glucose and insulin excursions in Type 2 Diabetes. BMJ Open Diabetes Research and Care. 2017;5:: doi: http://drc.bmj.com/content/5/1/e000440. https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-10-03-people-with-type-2-diabetes-should-save-carbs-for-last/