Jovanovic Ana, Gerrard Jean, Taylor Roy
Diabetes Research Group and Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
Diabetes Care. 2009 Jul;32(7):1199-201. doi: 10.2337/dc08-2196. Epub 2009 Apr 14.
In health, the rise in glucose after lunch is less if breakfast is eaten. We evaluated the second-meal effect in type 2 diabetes.
Metabolic changes after lunch in eight obese type 2 diabetic subjects were compared on 3 days: breakfast eaten, no breakfast, and no breakfast but intravenous arginine 1 h before lunch.
Despite comparable insulin levels, the rise in plasma glucose after lunch was considerably less if breakfast had been eaten (0.68 +/- 1.49 vs. 12.32 +/- 1.73 vs. 7.88 +/- 1.03 mmol x h(-1) x l(-1); P < 0.0001). Arginine administration almost halved the lunch rise in plasma glucose (12.32 +/- 1.73 vs. 7.88 +/- 1.03 mmol x h(-1) x l(-1)). The plasma free fatty acid concentration at lunchtime directly related to plasma glucose rise after lunch (r = 0.67, P = 0.0005).
The second-meal effect is preserved in type 2 diabetes. Premeal administration of a nonglucose insulin secretagogue results in halving the postprandial glucose rise and has therapeutic potential.
在健康状态下，如果吃了早餐，午餐后血糖的上升幅度会较小。我们评估了2型糖尿病患者的第二餐效应。
对8名肥胖的2型糖尿病患者在3天内午餐后的代谢变化进行了比较：吃早餐、不吃早餐以及不吃早餐但在午餐前1小时静脉注射精氨酸。
尽管胰岛素水平相当，但如果吃了早餐，午餐后血浆葡萄糖的上升幅度要小得多（分别为0.68±1.49、12.32±1.73和7.88±1.03 mmol·h⁻¹·L⁻¹；P<0.0001）。注射精氨酸使午餐后血浆葡萄糖的上升幅度几乎减半（12.32±1.73对比7.88±1.03 mmol·h⁻¹·L⁻¹）。午餐时的血浆游离脂肪酸浓度与午餐后血浆葡萄糖的上升直接相关（r = 0.67，P = 0.0005）。
2型糖尿病患者存在第二餐效应。餐前给予非葡萄糖胰岛素促分泌剂可使餐后血糖上升幅度减半，具有治疗潜力。
