Diabetes Self-Management Blog

As the saying goes, breakfast is the most important meal of the day, and according to new research presented at the annual meeting of the European Association for the Study of Diabetes (EASD), this may indeed be the case — at least as far as people with Type 2 diabetes are concerned.

In past research, eating breakfast has been associated with lower body-mass index (a measurement of weight relative to height) and fasting blood fats and improved insulin sensitivity. To determine the effect of the size and nutrient composition of breakfast on blood glucose control, researchers in Israel recruited 59 adults with Type 2 diabetes to eat either a big breakfast or a small breakfast.

The 29 participants assigned to the big-breakfast group consumed 33% of their daily calories in their morning meal, which was composed of up to 30% protein and up to 37% fat, with the remainder of calories coming from carbohydrate. The 30 participants assigned to the small-breakfast group ate 12.5% of their daily calories at breakfast, with up to 70% of the meal coming from carbohydrate.

At the end of the three-month study period, 23 people in each group had completed the program. The researchers found that those in the big-breakfast group experienced an average A1C reduction of 0.460% and an average fasting blood glucose decrease of 14.51 mg/dl, compared to reductions of 0.146% and 4.91 mg/dl, respectively, in the small-breakfast group.

Additionally, those in the big-breakfast group had lost an average of 2.43 kg (approximately 5.35 pounds) and seen a reduction in systolic blood pressure (the top number) of 9.58 mmHg, compared to reductions of 1.86 kg (roughly 4.10 pounds) and 2.43 mmHg in the small-breakfast group. Members of the big breakfast group also reported that they were less hungry later in the day — likely the result of reduced levels of the hunger hormone ghrelin — while those in the small breakfast group experienced increased feelings of hunger.

Moreover, about one-third of the big-breakfast eaters were able to reduce the amount of diabetes medicine they took daily, while roughly 17% of the small-breakfast eaters had to increase their use of diabetes medicines.

“In this study the Type 2 diabetics on the big breakfast had low carbohydrates and high fat and high protein, and they appeared to have better glycemic control,” noted presentation moderator Andreas Pfeiffer, MD. “There are a number of studies which are going in the same direction and which appear to reinforce and support that view, so having a good breakfast in the morning and then a second meal in the afternoon and a little [meal] in the evening appears to be a good scheme.”

He added, however, that for people with diabetes and kidney problems, the diet may not be ideal due to its high protein content.

Because the study has not yet been published in a peer-reviewed journal, the findings should be considered preliminary. Limitations of the trial include its small size and short duration.

For more information, read the article “Hearty Breakfast Good in Type 2 Diabetes” or review the presentation abstract on the Web site of the EASD. And to learn more about managing your blood glucose levels, click here.

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