Late-night-dinner deteriorates postprandial glucose and insulin whereas consuming dinner dividedly ameliorates them in patients with type 2 diabetes: A randomized crossover clinical trial.

ABSTRACT

BACKGROUND AND OBJECTIVES: The aims of this study is to explore the acute effect of consuming dinner at different timing on postprandial glucose and hormone in patients with type 2 diabetes. METHODS AND STUDY DESIGN: Eight patients (age 70.8±1.9 years, HbA1c 7.6±0.6 %, BMI 23.3±3.2, mean±SD) were randomly assigned in this crossover study. Patients consumed the test meals of dinner at 1800 on the first day, and dinner at 2100 or divided dinner (vegetable and rice at 1800 and vegetable and the main dish at 2100) on the second or third day. Postprandial glucose, insulin, glucagon, free fatty acid (FFA), active glucagon-like peptide-1 (GLP-1), and active glucose- dependent insulinotropic polypeptide (GIP) concentration after dinner were evaluated. RESULTS: Both incremental area under the curve (IAUC) 2h for glucose and insulin were higher in dinner at 2100 than those in dinner at 1800 (IAUC glucose 449±83 vs 216±43 mmol/L×min, p<0.01, IAUC insulin772±104 vs 527±107 µU/mL×min, p<0.01, mean±SEM). However, in divided dinner both IAUC 4h for glucose and insulin tended to be lower than those of dinner at 2100 (IAUC glucose 269±76 mmol/L×min, p=0.070, IAUC insulin 552±114 µU/mL×min, p=0.070). IAUC of active GLP-1 and active GIP demonstrated no difference among different dinner regimen. CONCLUSIONS: Consuming late-night-dinner (2100) deteriorates postprandial glucose and insulin compared with those of early-evening-dinner (1800) whereas consuming dinner dividedly ameliorates them.