Postprandial glucose, insulin and incretin responses to different carbohydrate tolerance tests

Nov 15, 2014Journal of diabetes

Blood sugar, insulin, and digestion hormone responses after different carbohydrate tests

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Abstract

Oral glucose consumption resulted in higher plasma glucose and insulin levels at 30 and 60 minutes compared to standard noodles.

Plasma glucose and insulin levels after oral glucose were significantly higher at 30 and 60 minutes, but lower at 180 minutes, compared to standard noodles.
Glucagon levels at 180 minutes were higher following oral glucose consumption.
The response of active glucagon-like peptide-1 (AGLP-1) was elevated at 30, 60, and 120 minutes after oral glucose, but decreased at 180 minutes.
In individuals with normal glucose tolerance, oral glucose resulted in a greater insulin response relative to AGLP-1 compared to standard noodles.
In type 2 diabetes mellitus patients, the insulin response associated with standard noodles was greater than that with oral glucose.

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BACKGROUND: Few studies have focused on postprandial incretin responses to different carbohydrate meals. Therefore, we designed a study to compare the different effects of two carbohydrates (75 g oral glucose, a monosaccharide and 100 g standard noodle, a polysaccharide, with 75 g carbohydrates equivalently) on postprandial glucose, insulin and incretin responses in different glucose tolerance groups.

METHODS: This study was an open-label, randomized, two-way crossover clinical trial. 240 participants were assigned to take two carbohydrates in a randomized order separated by a washout period of 5-7 days. The plasma glucose, insulin, c-peptide, glucagon and active glucagon-like peptide-1 (AGLP-1) were measured. The incremental area under curve above baseline from 0 to 120 min of insulin (iAUC(0 -120 min)- INS) and AGLP-1(iAUC(0 -120 min)- AGLP-1) was calculated.

RESULTS: Compared with standard noodles, the plasma glucose and insulin after consumption of oral glucose were higher at 30 min (both P < 0.001) and 60 min (both P < 0.001), while lower at 180 min (both P < 0.001), but no differences were found at 120 min. The glucagon at 180 min was higher after consumption of oral glucose (P = 0.010). The AGLP-1 response to oral glucose was higher at 30 min (P < 0.001), 60 min (P < 0.001) and 120 min (P = 0.022), but lower at 180 min (P = 0.027). In normal glucose tolerance (NGT), oral glucose elicited a higher insulin response to the corresponding AGLP-1 (P < 0.001), which was represented by iAUC(0 -120 min) -INS /iAUC(0 -120 min)- AGLP-1, while in type 2 diabetes mellitus (T2DM), standard noodles did (P = 0.001).

CONCLUSIONS: Monosaccharide potentiated more rapid and higher glycemic and insulin responses. Oral glucose of liquid state would elicit a more potent release of AGLP-1. The incretin effect was amplified after consumption of standard noodles in T2DM.

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Postprandial glucose, insulin and incretin responses to different carbohydrate tolerance tests

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