Preventing after-meal blood sugar spikes is one of the most important — and often, one of the most vexing — challenges for people who are living with diabetes. But according to a small new study out of American Friends of Tel Aviv University, skipping breakfast triggers significant spikes throughout the rest of the day for people who have Type 2 diabetes. An estimated 28 million people in the United States are currently living with Type 2 diabetes, while another 86 million have prediabetes.
Many Americans are in the habit of skipping breakfast, a practice that has been linked to obesity and cardiovascular problems in previous research. To determine the effect of fasting until noon in people with diabetes, researchers looked at 22 people with Type 2 diabetes with an average age of 56.9 years and an average body-mass index of 28.2 (considered overweight).
Over two days, the participants ate the same number of calories and the same meal — consisting of milk, tuna, bread, and a chocolate breakfast bar — for lunch and dinner. On the first day, however, the subjects ate breakfast, while on the second day they fasted until lunch.
The researchers found that the participants’ blood sugar levels spiked up to an average of 268 mg/dl after lunch and 298 mg/dl after dinner on the day they did not eat breakfast, compared to 192 mg/dl and 215 mg/dl, respectively, on the day they ate breakfast. The scientists theorize that the insulin-producing beta cells lose their “memory” during the extended period of fasting, causing a delayed insulin response that results in elevated blood sugar levels. Additionally, they note that fasting releases fatty acids into the blood, which temporarily reduces insulin sensitivity in the body.
“We theorized that the omission of breakfast would not be healthy, but it was surprising to see such a high degree of deterioration of glucose metabolism only because the participants did not eat breakfast,” noted study author Daniela Jakubowicz, MD. “This means that reducing the amount of starch and sugars in lunch and dinner will have no effect on reducing elevated glucose levels if diabetic individuals also skip breakfast.”
“In light of our study, we highly recommend that Type 2 diabetics not skip breakfast, because it causes major damage to the beta-cell function and leads to high sugar levels, even if they don’t overeat at lunch and dinner,” she added.
Previous research has indicated that increasing protein at breakfast is best for preventing after-meal blood sugar spikes.
The research team plans to conduct a similar study in people who have have Type 1 diabetes.
For more information, read the article “Diabetics who skip breakfat provoke hazardous blood sugar spikes” or see the study’s abstract in the journal Diabetes Care. And for more information about preventing after-meal blood sugar spikes, see the article “Strike the Spike II: Dealing With High Blood Glucose After Meals,” by 2014 Diabetes Educator of the Year Gary Scheiner.
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Diane Fennell: Diane Fennell has been an editor at Diabetes Self-Management magazine since 2003. She is currently the Editorial Director. (Diane Fennell is not a medical professional.)
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