title: Effect of a new starch-free bread on metabolic control in NIDDM patients.
abstract: OBJECTIVE
  The aim of the study was to evaluate the effect on blood glucose levels in non-insulin-dependent diabetics (NIDDM) of reduction of the carbohydrate content through the use of a new, almost starch-free type of bread (SF-bread). We only substituted the bread in the breakfast meal.
  
  
  RESULTS
  The study consisted of two parts: 1) a two-day randomized study of the effect of SF-bread on the morning blood glucose levels of NIDDM patients and 2) an open, crossover trial of three months duration where each patient was given SF- or ordinary bread. Ten patients participated in the first part and eight in the second part of the study. All patients had well established non insulin-dependent diabetes mellitus. In the first part of the study, the area under the curve describing time-dependent changes in blood glucose level after a standard breakfast was significantly lower in patients on SF-bread (182 +/- 154 Units; mean value +/- SD) than in the controls (630 +/- 258 Units; p < 0.00001). Peak blood glucose concentration was 14.8 +/- 2.3 mM on the control day and 11.6 +/- 1.7 mM on the SF-bread day (p < 0.001). In the second part of the study, the diet including SF-bread reduced fasting blood glucose from 13.3 +/- 3.5 mM to 10.2 +/- 2.0 mM (p < 0.006) and the fraction of HbA1c from 0.090 +/- 0.014 to 0.081 +/- 0.015 (p < 0.02). Similar changes were not seen on the ordinary diet. Serum cholesterol levels were significantly reduced by the SF-bread as compared to the ordinary diet (5.8 +/- 0.6 to 5.5 +/- 0.5 mM versus 5.7 +/- 0.8 to 5.8 +/- 0.7 mM; p < 0.05).
  
  
  CONCLUSIONS
  Substitution of ordinary bread with starch-free bread at breakfast causes significant improvements in blood glucose levels in NIDDM patients on both a short and long term basis. Possibly secondary to this, a favorable influence on lipid levels was noted.
authors.affiliation: Nutritional Unit, Frederiksberg Hospital, Denmark.
authors.forename: B
authors.initials: B
authors.lastname: Stilling
authors.forename: J
authors.initials: J
authors.lastname: Mehlsen
authors.forename: O
authors.initials: O
authors.lastname: Hamberg
authors.forename: J J
authors.initials: JJ
authors.lastname: Larsen
authors.forename: N C
authors.initials: NC
authors.lastname: Gram
authors.forename: S
authors.initials: S
authors.lastname: Madsbad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D001939:Bread; D002784:Cholesterol / Q000097:blood; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy*; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006441:Hemoglobin A / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D013213:Starch / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D013213:Starch; D006441:Hemoglobin A; D002784:Cholesterol