Glycemic Index and the Impact of Ready-to-Use Blenderized Diet on Glucose and Insulin Levels in People with Type 2 Diabetes Mellitus

Authors

  • Pimnapanut Sridonpai Institute of Nutrition, Mahidol University, Salaya, Phuthamonthon, Nakhon Pathom, Thailand
  • Karaked Tongdonpo Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
  • Aree Prachansuwan Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
  • Sasiumphai purttiponthanee Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
  • Thunnalin Winuprasith Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
  • Numphung Rungraung Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
  • Niramol muangpracha Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
  • Wantanee Kriengsinyos Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand

Keywords:

Ready-to-Use Blenderized Diet (RTU-BD), Glycemic Index (GI), Type 2 Diabetes Mellitus (T2DM)

Abstract

Controlling postprandial blood glucose levels within the normal range reduces the risk of diabetes mellitus and helps prevent complications in people with diabetes mellitus. Blenderized diet (BD) is gaining increasing attention due to its versatility for oral and tube feeding. The preparation of BD involves multiple steps, with food safety being a crucial consideration. A convenient and nutritionally complete ready-to-use blenderized diet (RTU-BD) has been formulated in response to these challenges. This research aims to investigate the glycemic index (GI) according to ISO 26642:2010 in 15 healthy individuals aged 23-34 years, each studied on five occasions for 120 minutes, as well as to examine postprandial blood glucose and insulin levels in 14 individuals with Type 2 Diabetes Mellitus (T2DM), aged 37-58 years, each studied twice for 240 minutes after consuming RTU-BD. The study adopts a randomized double-blind crossover trial. Both formulations of RTU-BD exhibited a low GI (GI ≤ 55). The RTU-BD low glycemic index formula (BDT) demonstrated GI values of 29 when compared to the standard formula (STD), which was 49 (p<0.05). Consistent with the responses observed in blood glucose and insulin levels among T2DM patients, the mean area under the blood glucose curve for the BDT formula was 4,776 ± 2,496 mg.min/dL compared to the STD formula's 6,434 ± 4,308 mg.min/dL (p<0.05). RTU-BD formulas also better insulin responsiveness (p<0.05). Notably, the BDT demonstrated a more pronounced effect, leading to preferable blood glucose levels compared to the STD. In conclusion, the developed RTU-BD presents an alternative for consumers seeking to manage post-meal blood glucose levels while ensuring appropriate nutrition.

References

สมาคมโรคเบาหวานแห่งประเทศไทย. แนวทางเวชปฏิบัติสำหรับโรคเบาหวาน พ.ศ.2566. พิมพ์ครั้งที่ 1. นนทบุรี: บริษัท ศรีเมืองการพิมพ์ จำกัด; 2566.

Ojo O, Ojo OO, Adebowale F, Wang XH. The effect of dietary glycaemic index on glycaemia in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Nutrients 2018;19;10(3):1-15.

วันทนีย์ เกรียงสินยศ. การศึกษาค่าดัชนีน้ำตาล การเปลี่ยนแปลงระดับน้ำตาลและการเผาผลาญ สารอาหารเพื่อนำไปใช้เป็นพลังงานภายหลังการรับประทานน้ำตาลไอโซมอลทูโลส. มหาวิทยาลัยมหิดล, สถาบันโภชนาการ; 2553.

Lina BA, Jonker D, Kozianowski G. Isomaltulose (Palatinose): a review of biological and toxicological studies. Food Chem Toxicol 2002;40(10):1375-81.

Maresch CC, Petry SF, Theis S, Bosy-Westphal A, Linn T. Low glycemic index prototype isomaltulose-update of clinical trials. Nutrients 2017;13;9(4):1-12.

Liu S, Willett WC, Stampfer MJ, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 2000;71(6):1455-61.

Augustin LSA, Kendall CWC, Jenkins DJA, et al. Glycemic index, glycemic load and glycemic response: an International scientific consensus summit from the international carbohydrate quality consortium (ICQC). Nutr Metab Cardiovasc Dis 2015;25(9):795-815.

Sieri S, Agnoli C, Grioni S, Weiderpass E, et al. Glycemic index, glycemic load, and risk of coronary heart disease: a pan-European cohort study. Am J Clin Nutr 2020;1;112(3):631-43.

Bennett K, Hjelmgren B, Piazza J. Blenderized tube feeding: health outcomes and review of homemade and commercially prepared products. Nutr Clin Pract 2020;35(3):417-31.

Jalali M, Sabzghabaee AM, Badri SS, Soltani HA, Maracy MR. Bacterial contamination of hospital-prepared enteral tube feeding formulas in Isfahan, Iran. J Res Med Sci 2009;14(3):149-56.

Borghi R, Dutra Araujo T, Airoldi Vieira RI, Theodoro de Souza T, Waitzberg DL. ILSI task force on enteral nutrition; estimated composition and costs of blenderized diets. Nutr Hosp 2013;1;28(6):2033-8.

Mokhalalati JK, Druyan ME, Shott SB, Comer GM. Microbial, nutritional and physical quality of commercial and hospital prepared tube feedings in Saudi Arabia. Saudi Med J 2004;25(3):331-41.

Johnson TW, Milton DL, Johnson K, et al.Comparison of microbial growth between commercial formula and blenderized food for tube feeding. Nutr Clin Pract 2019;34(2):257-63.

Jayanama K, Maitreejorn P, Tangsermwong T, et al. The amelioration of nutritional status and phase angle, safety, and satisfaction in tube-fed patients with ready-to-use blenderized diet with chicken and pumpkin. Rama Med J 2019;42(4):12-21.

International Standards Organization. ISO 26642: Food products - Determination of the glycaemic index (GI) and recommendation for food classification. Geneva (Switzerland): ISO; 2010.

Augustin LSA, Kendall CWC, Jenkins DJA, et al. Glycemic index, glycemic load and glycemic response: an international scientific consensus summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis 2015;25(9):795-815.

Voss AC, Maki KC, Garvey WT, et al. Effect of two carbohydrate-modified tube-feeding formulas on metabolic responses in patients with type 2 diabetes. Nutrition 2008;24(10):990-7.

Ohkura T, Inoue K, Fujioka Y, et al. The proinsulin/insulin (PI/I) ratio is reduced by postprandial targeting therapy in type 2 diabetes mellitus: a small-scale clinical study. BMC Res Notes 2013;11;6:1-8.

Wolever TM. Carbohydrate and the regulation of blood glucose and metabolism. Nutr Rev 2003;61(5):S40-8.

Atkinson FS, Brand-Miller JC, Foster-Powell K, Buyken AE, Goletzke J. International tables of glycemic index and glycemic load values 2021: a systematic review. Am J Clin Nutr 2021;8;114(5):1625-32.

Kordowski A, Kunstner A, Schweitzer L, et al. PalatinoseTM (Isomaltulose) and prebiotic inulin-type fructans have beneficial effects on glycemic response and gut microbiota composition in healthy volunteers-a real-life, retrospective study of a cohort that participated in a digital nutrition program. Front Nutr 2022;7;9:1-13.

Wan X, Guo H, Liang Y, et al. The physiological functions and pharmaceutical applications of inulin: A review. Carbohydr Polym 2020;15;246:1-15.

Birkeland E, Gharagozlian S, Gulseth HL, et al. Effects of prebiotics on postprandial GLP-1, GLP-2 and glucose regulation in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled crossover trial. Diabet Med 2021;38(10):1-10.

Feinle C, O'Donovan D, Doran S, et al. Effects of fat digestion on appetite, APD motility, and gut hormones in response to duodenal fat infusion in humans. Am J Physiol Gastrointest Liver Physiol 2003;284(5):G798-807.

Hofman Z, De Van Drunen J, Kuipers H. The glycemic index of standard and diabetes-specific enteral formulas. Asia Pac J Clin Nutr 2006;15(3):412-7.

Patel K, Kudrigikar V, Bachani D, Mehta S. Glycemic index of a diabetes-specific nutritional powder: an open-label study in healthy Indian adults. Food Nutr Sci 2023;3;14(3):200-24.

Buranapin S, Siangruangsang S, Chantapanich V, Hengjeerajarus N. The comparative study of diabetic specific formula and standard formula on postprandial plasma glucose control in type 2 DM patients. J Med Assoc Thai 2014;97(6):582-8.

Hofman Z, Lansink M, Rouws C, DE van Drunen J, Kuipers H, Diabetes specific tube feed results in improved glycaemic and triglyceridaemic control during 6 h continuous feeding in diabetes patients. E Spen Eur E J Clin Nutr Metab 2007;2(2):44-50.

Ceriello A, Lansink M, Rouws CH, van Laere KM, Frost GS. Administration of a new diabetes-specific enteral formula results in an improved 24h glucose profile in type 2 diabetic patients. Diabetes Res Clin Pract 2009;84(3):259-66.

Gonzalez-Ortiz M, Martinez-Abundis E, Hernandez-Salazar E, Kam-Ramos AM, Robles-Cervantes JA. Effect of a nutritional liquid supplement designed for the patient with diabetes mellitus (Glucerna SR) on the postprandial glucose state, insulin secretion and insulin sensitivity in healthy subjects. Diabetes Obes Metab 2006;8(3):331-5.

Lansink M, Hofman Z, Genovese S, Rouws CHFC, Ceriello A. Improved glucose profile in patients with type 2 diabetes with a new, high-protein, diabetes-specific tube feed during 4 hours of continuous feeding. JPEN J Parenter Enteral Nutr 2017;41(6):968-75.

Alish CJ, Garvey WT, Maki KC, et al. A diabetes-specific enteral formula improves glycemic variability in patients with type 2 diabetes. Diabetes Technol Ther 2010;12(6):419-25.

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Published

2024-04-27

How to Cite

Sridonpai, P., Tongdonpo, K., Prachansuwan, A., Purttiponthanee, S., Winuprasith, T., Rungraung, N., Muangpracha, N., & Kriengsinyos, W. (2024). Glycemic Index and the Impact of Ready-to-Use Blenderized Diet on Glucose and Insulin Levels in People with Type 2 Diabetes Mellitus. Journal of Nutrition Association of Thailand (Online), 59(1), 47–59. Retrieved from https://he01.tci-thaijo.org/index.php/JNAT/article/view/269266

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Research article