title: Effect of eating vegetables before carbohydrates on glucose excursions in patients with type 2 diabetes.
abstract: The aim of this review was to evaluate whether eating vegetables before carbohydrates could reduce the postprandial glucose, insulin, and improve long-term glycemic control in Japanese patients with type 2 diabetes. We studied the effect of eating vegetables before carbohydrates on postprandial plasma glucose, insulin, and glycemic control for 2.5 y in patients with type 2 diabetes. The postprandial glucose and insulin levels decreased significantly when the patients ate vegetables before carbohydrates compared to the reverse regimen, and the improvement of glycemic control was observed for 2.5 y. We also compared the postprandial glucose and glucose fluctuations assessed by continuous glucose monitoring system for 72-h in patients with type 2 diabetes and subjects with normal glucose tolerance when subjects ate vegetables before carbohydrates and carbohydrates before vegetables in a randomized crossover design. The glycemic excursions and incremental glucose peak were significantly lower when the subjects ate vegetables before carbohydrates compared to the reverse regimen. This evidence supports the effectiveness of eating vegetables before carbohydrates on glucose excursions in the short-term and glycemic control in the long-term in patients with type 2 diabetes.
authors.affiliation: School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30 Habikino, Habikino-shi, Osaka 583-8555, Japan.
authors.forename: Saeko
authors.initials: S
authors.lastname: Imai
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Fukui
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan ; Kajiyama Clinic, 25-1-136 Oiwake-cho, Saiin, Ukyo-ku, Kyoto 615-0035, Japan.
authors.forename: Shizuo
authors.initials: S
authors.lastname: Kajiyama
keywords: diet; eating order; glucose excursion; postprandial glucose; type 2 diabetes