title: Effect of a low dose whey/guar preload on glycemic control in people with type 2 diabetes--a randomised controlled trial.
abstract: OBJECTIVE
  Large preloads of protein and fat have been shown to lower glucose after a carbohydrate-rich meal in people with type 2 diabetes but add a considerable energy burden. Low calorie preloads [<5% of daily energy intake] have been tested in this study in people with prediabetes and with type 2 diabetes.
  
  
  METHODS
  This was an unblinded randomised crossover study with two placebo days and two active treatment days. Glucose was measured for 3 hours with fingerprick samples as well as continuous glucose monitoring [CGMS]. Twenty-four subjects with pre-diabetes or moderately controlled type 2 diabetes [fasting glucose < 10 and HbA1c < 8.5%] were recruited. The preload contained 17 g whey protein plus 3 g lactose and 5 g guar, and 1 g flavour material [including sucralose] dissolved in 150 ml cold water or 150 ml cold water with no additives. The breakfast test meal consisted of 2 slices of bread, margarine and jam [3 slices for men] with the test drink 15 minutes beforehand.
  
  
  RESULTS
  Peak fingerprick glucose was reduced by 2.1 mmol/L at 45 min [p < 0.0001]. Average fingerprick glucose over 3 hours was reduced by 0.8 mmol/L [p = 0.0003]. There was no difference between those with diabetes or prediabetes or those on medication or not on medication.
  
  
  CONCLUSIONS
  An 80 kcal whey protein/fibre preload can lower average glucose over 3 hours by 0.8 mmol/L. If used long term before at least two carbohydrate-rich meals/day this preload could lower HbA1c by up to 1%.
  
  
  BACKGROUND
  The trial was registered with the Australian New Zealand Clinical Trials Registry number ACTRN12612001251819.
authors.affiliation: University of South Australia, North Terrace, GPO Box 2471, Adelaide, SA 5001, Australia. peter.clifton@unisa.edu.au.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Clifton
authors.forename: Claire
authors.initials: C
authors.lastname: Galbraith
authors.forename: Leah
authors.initials: L
authors.lastname: Coles
mesh_terms: D001628:Beverages / Q000032:analysis*; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D062408:Breakfast; D018592:Cross-Over Studies; D031293:Cyamopsis / Q000737:chemistry*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D038321:Glycemic Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D008894:Milk Proteins / Q000008:administration & dosage*; D009520:New Zealand; D011236:Prediabetic State / Q000378:metabolism; D000067816:Whey Proteins
chemical_list: D001786:Blood Glucose; D004043:Dietary Fiber; D004044:Dietary Proteins; D006442:Glycated Hemoglobin; D008894:Milk Proteins; D000067816:Whey Proteins