Title: Differentiating the effects of whey protein and guar gum preloads on postprandial glycemia in type 2 diabetes |
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| Institution: | 1. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan;2. Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan;1. Department of Intensive Care Medicine and 3CARE, Medical Faculty, RWTH Aachen University, Aachen, Germany;2. Department of Critical Care Medicine, Queen''s University, Kingston, ON, Canada;3. Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria;4. Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany;5. Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece;6. Department of Thoracic, Cardiac and Vascular Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany;7. Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany;1. Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Republic of Korea;2. Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea;3. Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea;4. Division of Gastroenterology, Department of Internal Medicine, Bucheon St. Mary''s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea;5. Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary''s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea;6. Clinical Epidemiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea |
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| Abstract: | Background and aimsWhey protein and guar gum have both been reported to reduce postprandial glycemia in health and type 2 diabetes, associated with stimulation of glucagon-like peptide-1 (GLP-1) and/or slowing of gastric emptying. Our aim was to evaluate, in type 2 diabetes, the acute effects of low dose “preloads” of whey and guar, given alone or in combination before a meal, on postprandial glycemia, insulin, GLP-1, and gastric emptying.Methods21 patients with type 2 diabetes, managed by diet or metformin alone, were each studied on 4 days. They received a preload “shake” 15min before a mashed potato meal (368.5 kcal) labeled with 13C-octanoic-acid. The preloads comprised either (i) 17 g whey (W), (ii) 5 g guar (G), (iii) 17 g whey + 5 g guar (WG) each sweetened with 60 mg sucralose, and (iv) 60 mg sucralose alone (control; C), all dissolved in 150 mL water. Venous blood was sampled frequently for measurements of glucose, insulin, and GLP-1 concentrations. Gastric half-emptying time (T50) was calculated from breath 13CO2 excretion over 240 min.ResultsPostprandial blood glucose concentrations were lower with W and WG compared to C (each P < 0.0001, treatment × time interaction), and lower after G than C only at 30min. Insulin, GLP-1, and glucagon concentrations were higher after W than WG, G, or C (P < 0.05, treatment × time interaction), without differences between the latter three. Gastric emptying was slower with W (T50: 179.6 ± 6.1 min, P < 0.05) and WG (T50: 197.6 ± 9.7 min, P < 0.0001) when compared to C (T50: 162.9 ± 6.2 min), but did not differ between G (T50: 171.3 ± 7.0) and C (P > 0.99).ConclusionBoth whey and whey/guar preloads reduced postprandial glycemia, associated with slowing of gastric emptying. Low dose guar was less effective as a preload for glucose-lowering and did not slow gastric emptying.Clinical Trial Registry number and websiteAustralian and New Zealand Clinical Trials Registry, Trial ID ACTRN12615001272583, http://www.anzctr.org.au |
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| Keywords: | Whey protein Guar gum Gastric emptying Type 2 diabetes Incretin hormones Postprandial glycemia |
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