Non-insulin dependent diabetes mellitus (NIDDM) is a common
disorder of carbohydrate metabolism. The main characteristic of NIDDM is
high blood glucose levels. People with NIDDM are at increased risk of
microvascular (retinopathy, nephropathy and neuropathy) and
macrovascular (coronary heart disease) complications. It has been found in
insulin-dependent diabetic subjects that maintaining low blood glucose
levels can reduce the risk of microvascular complications. Risk factors that
have been identified in NIDDM subjects for heart disease have included
high triglyceride levels, high levels of very-low density lipoprotein (VLDL)
cholesterol and low levels of high-density lipoprotein (HDL) cholesterol.
The current dietary recommendation for people with NIDDM is to consume
a diet high in complex carbohydrate and fiber and low in fat. This
recommendation has recently been challenged by some investigators who
have suggested that high monounsaturated fat diets may be better.
Sixteen people with NIDDM who were in moderate metabolic control
and had low to moderate blood lipid levels were randomized to receive
either Ensure with Fiber® (high carbohydrate) or Glucerna® (high
monounsaturated fat). The diets were followed for 28 days, with an average
of about 90% of energy corning from the formula. Subjects performed finger
prick blood glucose monitoring at home before and 2 hours after each meal
for two days each week. Fasting blood samples were taken from the
subjects on days 0, 7 and 28, and were used to measure selected indices of
carbohydrate and lipid metabolism. It was found that the consumption of
Glucerna® resulted in lower postprandial rises in blood glucose when
compared to Ensure with Fiber® (p=0.000). Statistical analysis using
repeated measures ANOVA revealed significant time effects, in which a
decrease in serum glucose (p=0.000), and plasma glucagon (p=0.002) were
found. A different pattern of change between the groups was noted for
plasma insulin levels (p=0.028) in which the Ensure with Fiber® group
displayed a decrease in insulin over time. No significant effects were found
for plasma triglycerides, total cholesterol or apo B cholesterol. There was a
different pattern of change for HDL cholesterol between the two groups
(p=0.004), explained by a significant decrease in the Glucerna® group. This
result may be confounded by the significantly different baseline levels of
HDL cholesterol between the two groups.
Overall, this study found that the only advantage of the high
monounsaturated fat, Glucerna® diet over the high carbohydrate, Ensure
with Fiber® diet, was the lower rise in postprandial blood glucose levels.
This study found no benefit of Glucerna® on other indices of carbohydrate
metabolism or on indices of lipid metabolism. More research is needed to
understand the metabolic effects of high carbohydrate and high
monounsaturated fat diets in NIDDM subjects. / Land and Food Systems, Faculty of / Graduate
| Identifer | oai:union.ndltd.org:UBC/oai:circle.library.ubc.ca:2429/5769 |
| Date | 05 1900 |
| Creators | Bowron, Elaine |
| Source Sets | University of British Columbia |
| Language | English |
| Detected Language | English |
| Type | Text, Thesis/Dissertation |
| Format | 8546909 bytes, application/pdf |
| Rights | For non-commercial purposes only, such as research, private study and education. Additional conditions apply, see Terms of Use https://open.library.ubc.ca/terms_of_use. |
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