Department of Endocrinology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou 213003, China.
J Diabetes Res. 2022 Jul 21;2022:7083106. doi: 10.1155/2022/7083106. eCollection 2022.
Studies on nutrient sequences during meals suggest that consuming carbohydrates last lowers postprandial glucose excursions more than consuming carbohydrates first. However, this phenomenon has not been studied in gestational diabetes mellitus (GDM). Ten women with GDM consumed the same caloric foods in different sequences over five successive days: (A) dish first, followed by carbohydrate and soup last; (B) carbohydrate first, followed by dish and soup last; (C) soup first, followed by dish and carbohydrate last; (D) three meals a day ad libitum; and (E) six meals a day as ad libitum. Continuous glucose monitoring (CGM) was used to assess diurnal glycemia. Decreases in mean glucose levels and the largest glucose levels in A were similar to group C. The peak glucose of breakfast and lunch in group B was more significant than in groups A and C. The B meal pattern showed more marked glycemic excursions than groups A and C. Increasing the number of meals reduced the peak glucose level and the glycemic excursions with the same total calories. Changing meal sequences or increasing the number of meals may reduce glycemic excursions in GDM. Our trial was registered retrospectively and the trial registration number is ChiCTR2200057044.
进食时营养素顺序的研究表明，最后摄入碳水化合物比先摄入碳水化合物能更有效地降低餐后血糖波动。然而，这种现象在妊娠期糖尿病（GDM）中尚未得到研究。10 名 GDM 妇女连续 5 天以不同顺序摄入相同热量的食物：（A）先吃菜，最后吃碳水化合物和汤；（B）先吃碳水化合物，最后吃菜和汤；（C）先喝汤，最后吃菜和碳水化合物；（D）每天随意吃三餐；（E）每天随意吃六餐。连续血糖监测（CGM）用于评估日间血糖。A 组的平均血糖水平和最大血糖水平下降与 C 组相似。B 组早餐和午餐的餐后血糖峰值比 A 组和 C 组更为显著。B 餐模式的血糖波动比 A 组和 C 组更为明显。增加进餐次数可降低相同总热量摄入时的餐后血糖峰值和血糖波动。改变进餐顺序或增加进餐次数可能会降低 GDM 的血糖波动。我们的试验是回顾性注册的，试验注册号为 ChiCTR2200057044。
