title: Effects of different proportion of carbohydrate in breakfast on postprandial glucose excursion in normal glucose tolerance and impaired glucose regulation subjects.
abstract: BACKGROUND
  The variability of postprandial plasma glucose is an independent risk factor for diabetes. The type and amount of carbohydrate may be important determinants of glycemic control. The aim of the study was to compare the effects of different proportions of carbohydrate in breakfast on postprandial blood glucose fluctuations in impaired glucose regulation (IGR) and normal glucose tolerance (NGT) subjects.
  
  
  METHODS
  This is a cross-sectional study of two groups including 55 subjects with IGR and 78 individuals with NGT. Their recorded breakfast was sorted into low-carbohydrate (LC) (carbohydrate <45%), medium-carbohydrate (MC) (carbohydrate 45-65%), and high-carbohydrate (HC) (carbohydrate >65%) meals according to the proportion of carbohydrate. Glucose concentrations were continuously measured with a continuous glucose monitoring system, and parameters such as the incremental area under the curve (iAUC) of glucose and postprandial glucose excursion (PPGE) were calculated to evaluate postprandial glucose fluctuations.
  
  
  RESULTS
  The postprandial fluctuations of glucose increased gradually with increased proportions of carbohydrate in breakfast in both IGR and NGT subjects. For the MC and HC meals, iAUC, PPGE, postprandial glucose spike (PGS), and mean blood glucose were significantly greater than those in the NGT group (P<0.05), respectively. The median time to PGS and the time period in which glucose concentrations decreased to baseline after the MC and HC meals in the IGR group were significantly longer than those in the NGT group (P<0.01), respectively. Compared with the NGT subjects for the HC meal, the IGR subjects consuming the MC meal had greater PGS, range of glucose concentrations, SD, and PPGE (P<0.05).
  
  
  CONCLUSIONS
  The proportion of carbohydrate in breakfast contributes to glucose excursions in the NGT and IGR subjects. In the IGR subjects, a HC meal should be avoided and a LC meal should be recommended to prevent development of diabetes.
authors.affiliation: Department of Endocrinology and Metabolism, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Kang
authors.forename: Chun
authors.initials: C
authors.lastname: Wang
authors.forename: Lv
authors.initials: L
authors.lastname: Lifang
authors.forename: Dawei
authors.initials: D
authors.lastname: Chen
authors.forename: Yanzhi
authors.initials: Y
authors.lastname: Yang
authors.forename: Guanjian
authors.initials: G
authors.lastname: Liu
authors.forename: Hu
authors.initials: H
authors.lastname: Wen
authors.forename: Lihong
authors.initials: L
authors.lastname: Chen
authors.forename: Liping
authors.initials: L
authors.lastname: He
authors.forename: Xiujun
authors.initials: X
authors.lastname: Li
authors.forename: Haoming
authors.initials: H
authors.lastname: Tian
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
authors.forename: Xingwu
authors.initials: X
authors.lastname: Ran
mesh_terms: D000328:Adult; D000368:Aged; D062408:Breakfast / Q000208:ethnology; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000517:prevention & control; D050528:Diet, Carbohydrate-Restricted / Q000208:ethnology; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects*; D045604:Extracellular Fluid / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism*; D018149:Glucose Intolerance / Q000208:ethnology / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D019518:Postprandial Period; D011236:Prediabetic State / Q000208:ethnology / Q000378:metabolism* / Q000503:physiopathology; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D005947:Glucose