Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017
A whey/guar “preload” reduces postprandial glycaemia and HbA1c in type 2 diabetes: a 12-week, single-blind, randomised and placebo-controlled trial (#185)
Background/Aims:
We have shown that whey “preloads”, taken before meals for up to 4 weeks, slow gastric emptying (GE) and reduce postprandial glucose (PPG) in type 2 diabetes (T2DM). Guar also slows carbohydrate absorption. We aimed to evaluate the effects of 12 weeks treatment with a whey/guar preload on GE, PPG, and HbA1c, in T2DM.
Methods:
79 patients with T2DM [44 male; age 64±0.7years; BMI 29.8±0.6 kg/m2; HbA1c 6.6±0.1%; 40 managed by diet alone and 39 by diet and metformin] were randomised, in a single-blind fashion, to receive 150ml flavoured shakes containing either 20g whey protein and 5g guar (WG), or flavoured placebo (P), 15 min before two meals each day for 12 weeks. No other specific dietary advice was given.
Patients attended the laboratory at baseline, week 1 and week 12, and consumed WG or P shakes (except at baseline) 15 min before a mashed potato meal labelled with 13C-octanoic acid. Venous blood was sampled for PPG, and the gastric 50% emptying time was calculated by measuring breath 13CO2 over 240min. HbA1c, body weight and body composition (DEXA) were also measured. Data are shown as means ± SEM.
Results:
GE at baseline did not differ between the groups. GE was slower with the WG preload (P<0.01, Tx*Time interaction). PPG at baseline was similar in both groups, and was lower after the WG than P treatments at both week1 and week 12 (Figure 1). At the end of treatment, the difference in HbA1c between WG and P group was 0.1% (P 6.7±0.05% vs WG 6.6±0.05% P<0.05). No change in body weight, lean mass or fat mass were observed in either group.
Conclusion:
In patients with well controlled T2DM, 12 weeks treatment with a low dose whey/guar preload has sustained effects to slow GE, reduce PPG, and modestly reduce HbA1c.
