Effect of high and low glycemic index breakfast on postprandial metabolic parameters and satiety in subjects with type 2 diabetes mellitus under intensive insulin therapy: Controlled clinical trial

Background and aim The results of studies evaluating the metabolic effects of glycemic index (GI) in subjects with type 2 diabetes mellitus (DM2) have been contradictory. Consequently, the benefits of its application are controversial and polarized opinions of international organizations have been disclosed. The above situation leads this study to evaluate the acute effect of low and high GI breakfast on the glycemic response and satiety in subjects with DM2 under intensive insulin therapy (IIT). Methods A controlled, crossover and single-blind clinical trial was developed involving 10 obese subjects with DM2 under IIT, with a period of at least six months under IIT and with fast insulin prescription before breakfast. Subjects ingested on two different occasions a high or low GI breakfast. In both stages, glycemia was evaluated at 0 (basal), 30, 60 and 120 min, and satiety and satiation were evaluated through a visual analogue scale. Results In contrast to high GI breakfast, the low GI meal generated a significant decrease of 46% for the area under the curve of glucose (Δ 1940 mg/dL × 120 min, p = 0.022) and in mean glycemia evaluated at 30, 60 and 120 min. Moreover, in the low GI stage 8 of 10 patients achieved a 2 h postprandial glycemia lower than 180 mg/dL, without statistical significance. A nonsignificant increase of 12.7% (Δ 1.06 cm, p = 0.271) in satiety at 120 min in the low GI stage was observed. Conclusion In contrast to high GI breakfast, the low GI breakfast generated a significantly lower glycemic response. This assay allowed for the contribution of more in depth nutritional recommendations for this group of patients. Registered under ClinicalTrials.gov Identifier no. NCT02881164.