Insulin response and glycemic effects of meals in non-insulin-dependent diabetes

Glycemic and hormonal responses to two breakfast mixed meals were studied in six obese subjects with NIDDM. The study evaluated a high-glycemic-effect (HGE) and a low-glycemic-effect (LGE) meal, each with ∼600 kcal and 12% protein, 15% fat, and 73% carbohydrate. Plasma insulin and counterregulatory hormones were measured at baseline and at 30-min intervals for 5 h after meals. Mean fasting plasma glucose and insulin concentrations were similar before both studies: for the LGE meal, 11.9 ± 1.8 mmol/L and 261.9 ± 50.1 pmol/L; for the HGE meal, 11.9 ± 2.0 mmol/L and 262.6 ± 43.1 pmol/L. Peak plasma glucose concentrations were ∼25% lower with the LGE meal and the area under the glucose curve was 63% of that obtained for the HGE meal (p < 0.05). Although the integrated insulin responses of the two meals did not differ, the peak occurred 60 min earlier in the LGE meal (p < 0.05). The LGE meal may produce a lower glycemic response, in part because of earlier insulin secretion.