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Clin Nutr. 2018 Dec 4. pii: S0261-5614(18)32548-2. doi: 10.1016/j.clnu.2018.11.015. [Epub ahead of print]

Gastrointestinal effects of extra-virgin olive oil associated with lower postprandial glycemia in type 1 diabetes.

Author information

1
Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
2
Institute for Research on Population and Social Policies (IRPPS), National Research Council, Fisciano, SA, Italy.
3
Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. Electronic address: annuzzi@unina.it.

Abstract

OBJECTIVE:

To explore the possible mechanisms behind the lower glycemic response observed when extra-virgin olive oil (EVOO) is added to a high-glycemic index meal in patients with type 1 diabetes (T1D).

RESEARCH DESIGN AND METHODS:

According to a randomized cross-over design, eleven T1D patients (6 women, 5 men) on insulin pump consumed in the metabolic ward, one week apart, three high-glycemic index meals differing only for amount and quality of fat: high-monounsaturated fat (EVOO), high-saturated fat (Butter), and low-fat (LF). Before and after the meals, blood glucose (continuous glucose monitoring), gastric emptying rate (ultrasound technique), and plasma concentrations of glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide GIP (ELISA), glucagon (RIA), and lipids (colorimetric assays) were evaluated.

RESULTS:

Blood glucose iAUC (mmol/lx360 min) was lower after the EVOO (690 ± 431) than after the Butter (1320 ± 600) and LF meals (1007 ± 990) (M ± SD, p = 0.041 by repeated measures ANOVA). Gastric antrum volume was significantly larger in the early (60-90 min) postprandial phase (106 ± 21 vs. 90 ± 16 ml, p = 0.048) and significantly smaller in the late phase (330-360 min) (46 ± 10 vs. 57 ± 22 ml, p = 0.045) after the EVOO than after Butter meal. EVOO significantly increased postprandial GLP-1 iAUC (261 ± 311) compared to Butter (189 ± 349) (pmol/Lx180 min, p = 0.009). Postprandial GIP and glucagon responses were not significantly different between EVOO and Butter. Postprandial triglyceride iAUC was significantly higher after EVOO (100 ± 53) than after Butter (65 ± 60) (mmol/l × 360 min, p = 0.048).

CONCLUSIONS:

Changes in gastric emptying and GLP-1 secretion and reduced glucose absorption through glucose-lipid competition may contribute to lower glycemia after a high-glycemic index meal with EVOO in T1D patients.

CLINICAL TRIALS NUMBER:

NCT02330939.

KEYWORDS:

Dietary fat; Extra-virgin olive oil; Gastric emptying; Incretins; Postprandial glycemia; Type 1 diabetes

PMID:
30567626
DOI:
10.1016/j.clnu.2018.11.015

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