UBC Theses and Dissertations
A low-carbohydrate protein containing bedtime snack to control morning blood glucose in type 2 diabetes Abbie, Erica Kathleen
In people with type 2 diabetes, liver insulin resistance leading to excess hepatic glucose production results in elevated fasting glucose. A bedtime snack is frequently recommended to improve morning glucose levels, yet there is little evidence supporting this recommendation. Moreover, it is not known what the optimal composition of such bedtime snacks should be. PURPOSE: The primary purpose of this study was to determine whether a low-carbohydrate protein containing bedtime snack could reduce next morning fasting plasma glucose levels in people with type 2 diabetes when compared to a high-carbohydrate protein containing bedtime snack or a no bedtime snack condition. We also explored whether a low-carbohydrate protein containing snack consumed at bedtime would improve markers of insulin sensitivity and glucose control. METHODS: Using a randomized crossover design, fifteen patients with type 2 diabetes completed three separate conditions: i) a low-carbohydrate protein containing bedtime snack (eggs), ii) a high-carbohydrate protein matched bedtime snack (low-fat yogurt); and iii) no bedtime snack. All conditions were three days in length and were isoenergetic. RESULTS: Consuming a low-carbohydrate protein containing bedtime snack significantly reduced fasting plasma glucose (P = 0.04) and insulin (P = 0.04), improved quantitative insulin sensitivity check index (QUICKI; P = 0.003), and lowered nocturnal glucose assessed by continuous glucose monitoring (CGM; P = 0.02) when compared to a high-carbohydrate protein matched bedtime snack. There were no significant differences between the low-carbohydrate protein containing snack or high-carbohydrate protein-containing snack and the no bedtime snack condition. CONCLUSIONS: Lower fasting glucose and improved markers of insulin sensitivity suggest that a low-carbohydrate protein containing bedtime snack (eggs) may be an easy to implement nutritional strategy to improve underlying disease pathophysiology in people with type 2 diabetes.
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