The Endocrinology Clinic, Department of Medicine, Walter Reed Army Medical Center, Washington, DC, USA (Dr Fonda, Dr Vigersky)
Wellness Services, General Internal Medicine Service, Walter Reed Army Medical Center, Washington, DC, USA (Dr Jain)
Diabetes Educ. 2010 Sep-Oct;36(5):793-800. doi: 10.1177/0145721710378537.
The purpose of this study was to compare the effects of 3 meal replacement beverages on glycemic response among people with type 2 diabetes.
The study examined Glucerna Weight Loss Shake, Slim-Fast Shake, and Ensure with Fiber Shake, using a prospective, 3-way, cross-over design. Eighteen subjects with type 2 diabetes drank the beverages in random order on different weeks. The volume of each beverage was adjusted to include 50 grams of carbohydrates. Glucose was measured 0 to 180 minutes postprandial. Analyses included 2-factor analysis of variance (ANOVA) for repeated measures on both factors, calculation of area under the curve (AUC), and 1-way repeated measures ANOVA of AUC.
The postprandial glucose profiles of the shakes differed. Glucerna had the best profile as indicated by the graph of mean postprandial glucose levels and its lower incremental AUC. Despite the superiority of Glucerna, 2-hour postprandial blood glucose values exceeded the ADA's recommended upper limit for 22% of the subjects.
Meal replacement beverages are a popular and potentially effective option for people trying to lose or maintain weight; however, it is unknown to what degrees they affect postprandial blood glucose in people with type 2 diabetes. Because postprandial glycemic excursion is linked to cardiovascular disease, identifying a meal replacement beverage with the lowest glycemic response may mitigate some of the risks in patients with diabetes. Of the meal replacements observed in this study, Glucerna had the smallest effect on postprandial glucose. Glycemic response to meal replacements should be monitored given product and individual variability.
本研究旨在比较三种代餐饮料对 2 型糖尿病患者血糖反应的影响。
本研究采用前瞻性、三向交叉设计，对 Glucerna 减肥奶昔、Slim-Fast 奶昔和 Ensure 纤维奶昔进行了研究。18 例 2 型糖尿病患者在不同周随机饮用这些饮料。每种饮料的容量均调整为含有 50 克碳水化合物。餐后 0 至 180 分钟测量血糖。分析包括两因素重复测量方差分析（ANOVA），对两个因素进行分析，计算曲线下面积（AUC），以及 AUC 的单向重复测量 ANOVA。
奶昔的餐后血糖谱不同。Glucerna 的表现最佳，表现在餐后平均血糖水平及其较低的增量 AUC。尽管 Glucerna 具有优势，但 2 小时餐后血糖值超过了 ADA 推荐的 22%的上限。
代餐饮料是减肥或保持体重的人常用且潜在有效的选择；然而，尚不清楚它们在多大程度上影响 2 型糖尿病患者的餐后血糖。由于餐后血糖波动与心血管疾病有关，因此选择餐后血糖反应最低的代餐饮料可能会降低糖尿病患者的一些风险。在本研究中观察到的代餐中，Glucerna 对餐后血糖的影响最小。鉴于产品和个体的差异，应监测代餐的血糖反应。
