Crouch Michael A, Slater Robert T
From the Memorial Family Medicine Residency, Sugar Land, TX.
J Am Board Fam Med. 2016 Nov 12;29(6):759-766. doi: 10.3122/jabfm.2016.06.160128.
The extent to which glucose intolerance can be acutely improved with dietary modification is unclear. The purpose of this study was to test the effect of ingesting a low-calorie almond preload ("appetizer") 30 minutes before oral glucose tolerance testing in glucose-intolerant individuals without diabetes.
Twenty adults with prediabetes or isolated 1-hour glucose ≥160 mg/dL underwent 2 fasting oral glucose tolerance tests (GTTs)-1 standard GTT and 1 GTT 30 minutes after eating a half ounce (12) of dry-roasted almonds. Fourteen participants met 1 or more prediabetes diagnostic criteria; 6 had only elevated 1-hour glucose ≥160 mg/dL.
The mean 1-hour plasma glucose after the almond preload was 37.1 mg/dL (19.4%) lower (154.6 vs 191.7; P < .001) than in the standard GTT. The almond preload reduced the area under the glucose curve by 15.5% (P < .001). Eight individuals had a marked hypoglycemic effect (glucose reduced by 45 to 110 mg/dL); 4 had a moderate hypoglycemic effect (22-32 mg/dL).
A low-calorie almond "appetizer" showed promise as an option for decreasing postprandial hyperglycemia in individuals with prediabetes or isolated 1-hour postprandial hyperglycemia. Further study is needed to confirm and refine the role of such a premeal appetizer in the self-care of prediabetes.
通过饮食调整可使葡萄糖耐量得到急性改善的程度尚不清楚。本研究的目的是测试在无糖尿病的葡萄糖不耐受个体中，口服葡萄糖耐量试验前30分钟摄入低热量杏仁预负荷（“开胃菜”）的效果。
20名患有糖尿病前期或单纯1小时血糖≥160mg/dL的成年人接受了2次空腹口服葡萄糖耐量试验（GTT）——1次标准GTT和1次在食用半盎司（12颗）干烤杏仁30分钟后的GTT。14名参与者符合1项或多项糖尿病前期诊断标准；6名仅1小时血糖升高≥160mg/dL。
杏仁预负荷后1小时的平均血浆葡萄糖水平比标准GTT低37.1mg/dL（19.4%）（154.6对191.7；P<.001）。杏仁预负荷使葡萄糖曲线下面积减少了15.5%（P<.001）。8人有明显的低血糖效应（血糖降低45至110mg/dL）；4人有中度低血糖效应（22 - 32mg/dL）。
低热量杏仁“开胃菜”有望成为降低糖尿病前期个体或单纯餐后1小时高血糖个体餐后高血糖的一种选择。需要进一步研究来证实并完善这种餐前开胃菜在糖尿病前期自我护理中的作用。
