Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
Andriani SpA, Gravina di Puglia, Bari, Italy.
Diabetes Res Clin Pract. 2019 Mar;149:156-162. doi: 10.1016/j.diabres.2019.02.013. Epub 2019 Feb 16.
People with type 1 diabetes and celiac disease (T1D&CD) have high blood glucose variability. Processed gluten-free foods have shown to induce a worse metabolic profile whereas naturally gluten-free foods may represent healthier options. On the other hand, dietary fibre has shown to reduce postprandial glycemic excursions in individuals with diabetes. Thus, we evaluated the acute effect of fibre-enriched buckwheat (FBP) and corn pasta (CP) on postprandial blood glucose response (PP-BGR).
Ten adult patients with T1D&CD consumed two meals with the same amount of carbohydrate while differing only for pasta type (FBP or CP) preceded by the same insulin bolus. Participants utilized continuous glucose monitoring (CGM) and data over 6 h after meal were analyzed.
PP-BGR differed between the two meals, being significantly lower in the first period (0-3 h) after the CP than the FBP meal (iAUC: -38 ± 158 vs. 305 ± 209 mmol/L · 180 min, p = 0.040), whereas significantly higher in the second period (3-6 h) after the CP than the FBP meal (iAUC: 432 ± 153 vs. 308 ± 252 mmol/L · 180 min, p = 0.030). Overall, a less variable postprandial profile was observed after FBP than CP consumption.
In individuals with T1D&CD, the acute consumption of FBP induces significant differences in PP-BGR compared with CP that may be clinically relevant.
1 型糖尿病合并乳糜泻（T1D&CD）患者血糖波动较大。研究表明，加工后的无麸质食品会导致代谢状况恶化，而天然无麸质食品可能是更健康的选择。另一方面，膳食纤维已被证明可降低糖尿病患者餐后血糖波动。因此，我们评估了富含膳食纤维的荞麦（FBP）和玉米面条（CP）对餐后血糖反应（PP-BGR）的急性影响。
10 名 T1D&CD 成年患者同时食用两种含等量碳水化合物的餐食，但面条种类不同（FBP 或 CP），两种餐食前均使用相同剂量的胰岛素。参与者使用连续血糖监测（CGM），并分析餐后 6 小时内的数据。
两种餐食的 PP-BGR 存在差异，CP 餐的第一阶段（0-3 小时）餐后血糖反应明显低于 FBP 餐（iAUC：-38±158 与 305±209 mmol/L·180min，p=0.040），而 CP 餐的第二阶段（3-6 小时）餐后血糖反应明显高于 FBP 餐（iAUC：432±153 与 308±252 mmol/L·180min，p=0.030）。总的来说，与 CP 相比，FBP 可使餐后血糖波动更平缓。
在 T1D&CD 患者中，与 CP 相比，FBP 的急性摄入会引起明显不同的 PP-BGR，这可能具有临床意义。
