Effect of diabetes-specific nutrition formulas on satiety and hunger hormones in patients with type 2 diabetes

Adham Mottalib, Martin J Abrahamson, David M Pober, Rani Polak, Ahmed H Eldib, Shaheen Tomah, Sahar Ashrafzadeh, Osama Hamdy, Adham Mottalib, Martin J Abrahamson, David M Pober, Rani Polak, Ahmed H Eldib, Shaheen Tomah, Sahar Ashrafzadeh, Osama Hamdy

Abstract

Objectives: Diabetes-specific nutritional formulas (DSNFs) are frequently used by patients with type 2 diabetes (T2D) as part of nutrition therapy to improve glycemic control and reduce body weight. However, their effects on hunger and satiety hormones when compared to an isocaloric standardized breakfast are not fully understood. This study aims to evaluate the postprandial effects of two DSNFs-Glucerna (GL) and Ultra Glucose Control (UGC)-versus oatmeal on selected satiety and hunger hormones.

Method: After an overnight fast, 22 patients with T2D (mean age 62.3 ± 6.8 years, A1C 6.8 ± 0.7%, body weight 97.4 ± 21.3 kg, and BMI 33.2 ± 5.9 kg/m²) were given 200 kcal of each meal on three separate days. Blood samples for amylin, cholecystokinin (CCK), ghrelin, glucagon, leptin, and peptide-YY (PYY) were collected at baseline and 30, 60, 90, 120, 180, and 240 min after the start of each meal. Incremental area under the curve (iAUC0-240) for each hormone was calculated.

Results: iAUC0-240 for glucagon and PYY were significantly higher after GL and UGC than after oatmeal (p < 0.001 for both). No difference was observed between the three meals on postprandial amylin, CCK, ghrelin, and leptin hormones.

Conclusions: Intake of DSNFs significantly increases secretion of PYY and glucagon, two important satiety hormones. While subjective satiety was not directly evaluated, the increased effect on satiety hormones may partially explain the mechanism of body weight loss associated with DSNF use.

Conflict of interest statement

O.H. is on the advisory board of AstraZeneca and Sanofi-Aventis U.S. LLC and is a consultant to Merck & Co., Inc. and Abbott Nutrition. He is a shareholder of Healthimation, Inc. and receives research grants from the National Dairy Council and Novo Nordisk. M.J.A. is on the advisory boards of Novo Nordisk and WebMD Health Services and owns stock in Health IQ. A.M., D.M.P., R.P., A.H.E., S.T. and S.A. declare no conflict of interest.

Figures

Fig. 1. Adjusted serum concentrations of glucagon…
Fig. 1. Adjusted serum concentrations of glucagon and peptide YY (PYY) in 22 subjects with type 2 diabetes after intake of 200kcal of oatmeal, Glucerna, and Ultra Glucose Control (UGC).
Values are mean ± SEM. *p < 0.0001
Fig. 2. Adjusted serum concentrations of active…
Fig. 2. Adjusted serum concentrations of active amylin, cholecystokinin, ghrelin, and leptin in 22 subjects with type 2 diabetes after intake of 200kcal of oatmeal, Glucerna, and Ultra Glucose Control (UGC).
Values are mean ± SEM. CCK cholecystokinin. Incremental area under the curve was not different between meals for all four variables

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Source: PubMed

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