Postprandial glycemic response to isocaloric carbohydrate load in men with different types of obesity

BACKGROUND: Carbohydrates exert major impact on postprandial blood glucose levels. Diet therapy for obesity and diabetes mellitus usually implies dietary restrictions on the amount, type and daily distribution of carbohydrates, wherein the timing of meals and its composition play a significant role. However currently there is insufficient evidence-based data to guide how carbohydrates consumption should be distributed during a day in obese men.
AIM: To investigate postprandial glucose levels in response to an isocaloric carbohydrate load at main meals (breakfast, lunch, dinner) in individuals with different types of obesity.
MATERIALS AND METHODS: The study enrolled men aged 25 to 65 years. The total number of study participants was 43 men. Group 1 (n=17) consisted of obese men with subcutaneous type of fat distribution (SFD) while group 2 (n=16) was represented by obese men with abdominal type of fat distribution (AFD). Group 3 (comparators) consisted of 10 men with normal body weight (NBW). The duration of continuous glucose monitoring was 5–6 days. Observation period included 3 days of usual physical and work activity regimens. Glycemic response on carbohydrate isocaloric load was assessed on different days and mealtime. During first and fifth days men were instructed to eat as usual without any restrictions. Standard carbohydrate breakfast was introduced during the second day while standard carbohydrate lunch and dinner were performed at the third and fourth days respectively.
RESULTS: Results of isocaloric carbohydrate load representing different standard meals (breakfast, lunch, dinner) showed that in NBW men the most intense utilization of glucose occurs in the morning during breakfast. Glucose tolerance was significantly lower at all meals in AFD men group comparing to men with NBW and SFD. In men with SFD glucose tolerance was relatively lower than in NBW men only during standard breakfast. At lunch and dinner time disposition of the glycemic curve in men with SFD and NBW didn’t significantly differ.
CONCLUSION: Dividing men according to obesity phenotypes allows to identify features of regulation of carbohydrate metabolism and as a result to reveal different risk levels of type 2 diabetes and its’ complications. The combination of continuous glucose monitoring with dietary control can significantly increase the effectiveness of therapeutic interventions for obesity and offers a pathogenetic approach to personalized diet therapy

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