Effects on blood glucose, insulin, lipid and proatherosclerotic parameters in stable type 2 diabetic subjects during an oral fat challenge.

BACKGROUND: Restriction of fat intake has been effective in improving insulin sensitivity in obese and type 2 diabetic subjects, but what effects the recommended diet (less than 30% of total calories from fat) have not been elucidated in subjects with type 2 diabetes. The purpose of this study was to test the effects of oral fat challenge, composing 30% calories of a meal, on blood glucose, insulin, lipid, leptin, plasminogen activator inhibitor-1 (PAI-1) and tumor necrosis factor-alpha (TNF-alpha). DESIGN AND METHODS: Blood glucose, insulin, lipid, leptin, TNF-alpha and PAI-1 were compared in 14 type 2 diabetic patients and 10 normal subjects after an oral fat challenge upto 2 hours (fasting, 15 min, 30 min, 45 min, 60 min, 90 min and 120 min). RESULTS: Postprandial glucose, total cholesterol, leptin, PAI-1 levels did not differ significantly from levels at fasting. Serum triglyceride increased significantly from baseline only in diabetic patients (P = 0.042). Serum insulin increased postprandially in both groups (P = 0.028 in diabetic group and P = 0.055 in normal group), with displaying a prolonged insulin response in diabetic subjects. TNF-alpha decreased postprandially in both groups without significant difference, although diabetic patients have higher baseline levels (P = 0.024 compared to normal subjects). CONCLUSIONS: Oral fat load does not have an acute effect on blood glucose, total cholesterol, leptin and PAI-1 levels in both type 2 diabetic and normal subjects. TNF-alpha value showed decreased trend in both diabetic and normal subjects. The tendency of a delayed postprandial insulin response and elevated serum triglyceride level in diabetic subjects might be related to insulin resistance at the level of adipose tissue. Additional research is needed to assess the impact of the use of fat contents on the macronutrient composition of the diet, and potentially healthy and nutritional benefits for patients with diabetes.