Diurnal glycemic pattern on inclusion of sucrose in daily meals in type 2 diabetes: Reflection of antecedent glycemic control

Background: Inclusion of sucrose in diabetic diets is not recommended in subjects with diabetes since effects of such diets on glycemic indices are not established. Some studies have documented lapse in metabolic control on consumption of these diets type 2 diabetes. However, most studies examined plasma glucose only for a few hours after ingestion of a single meal containing sucrose after an overnight fast whereas others recommended increasing insulin dose prior to the meal. None of these studies examined influence of inclusion of sucrose in daily meals in subjects with new onset diabetes at diagnosis and again after achieving desirable glycemic control.

 

Objective : Study was conducted to assess glycemic responses to ingestion of all meals containing sucrose constituting 50% of carbohydrate calories. 

 

Methods: 12 subjects with new onset type 2 diabetes participated. They were administered the following isocaloric diets for 4 days each prior to and after achieving desirable glycemic control; Diet 1- Diabetic diet recommended by American Diabetes Association (ADA), diet 2- test diet containing sucrose, diet 3- ADA diet. Glycemic control was assessed by diurnal glycemia (average of pre-prandial, postprandial and bedtime blood glucose), fasting plasma glucose, HbA1c and fructosamine on 4th day of each dietary period.

 

Results: All glycemic indices deteriorated after consumption of sucrose containing meals prior to initiation of treatment and remained worsened on return to ingestion of ADA diet. Glycemic responses after all meals improved markedly on achieving desirable glycemic control. Moreover, glycemic indices remained unaltered on consumption of sucrose containing meals after attaining and maintaining desirable glycemic control.

 

Conclusion: Diurnal glycemic responses deteriorate on ingestion of daily meals containing sucrose in subjects with new onset uncontrolled type 2 diabetes. In contrast, diurnal glycemic pattern is unaltered following consumption of daily meals containing sucrose after attaining and maintaining desirable glycemic control.