SEARCHRCTendocrinology, nutrition

RCT·endocrinology, nutrition, clinical nutrition, internal medicine, clinical trial·PMC10169634

Beneficial effects of premeal almond load on glucose profile on oral glucose tolerance and continuous glucose monitoring: randomized crossover trials in Asian Indians with prediabetes

European Journal of Clinical Nutrition · 7 authors, 5 centres

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TL;DR

This study used two randomized crossover trials to test whether eating 20g of almonds before meals improved blood sugar control in 60 Asian Indian adults with prediabetes. The almond preload significantly reduced post-meal blood sugar spikes and improved overall glucose metrics.

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This two-phase crossover randomized controlled trial (NCT04769726) evaluated the effect of a 20g premeal almond load on glycemia in 60 Asian Indian adults with prediabetes. In the OGTT-based phase, participants consumed almonds 30 minutes before a 75g glucose load, while in the CGMS phase, they consumed almonds before three major meals for 3 days during free-living conditions, each compared to a control period without almonds. The primary result was a significant reduction in postprandial hyperglycemia; in the OGTT phase, the almond load lowered the overall AUC for blood glucose, insulin, C-peptide, and glucagon (p<0.001), with a 18.05% reduction in glucose AUC. Limitations include the short-term, single-center design and the open-label nature of the CGMS phase. The findings suggest that premeal almond consumption is a feasible dietary strategy to acutely improve postprandial glycemic control in individuals with prediabetes.

STUDY TYPE

RCT

SPECIALTY

endocrinology

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100% · A

ORIGINAL PAPER

PMC10169634

Beneficial effects of premeal almond load on glucose profile on oral glucose tolerance and continuous glucose monitoring: randomized crossover trials in Asian Indians with prediabetes

European Journal of Clinical Nutrition

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ABSTRACT

Abstract Background Rapid conversion from prediabetes to diabetes and frequent postprandial hyperglycemia (PPHG) is seen in Asian Indians. These should be the target of dietary strategies. Objectives We hypothesized that dietary intervention of preloading major meals with almonds in participants with prediabetes will decrease overall glycemia and PPHG. Design The study included two phases: (1) an oral glucose tolerance test (OGTT)-based crossover randomized control study, the effect of a single premeal almond load (20 g) given before OGTT was evaluated ( n = 60, 30 each period). (2) The continuous glucose monitoring system (CGMS)-based study for 3 days including premeal almond load before three major meals was a free-living, open-labeled, crossover randomized control trial, where control and premeal almond load diets were compared for glycaemic control ( n = 60, 30 in each period). The study was registered at clinicaltrials.gov (registration no. NCT04769726). Results In the OGTT-based study phase, the overall AUC for blood glucose, serum insulin, C-peptide, and plasma glucagon post-75 g oral glucose load was significantly lower for treatment vs. control diet ( p < 0.001). Specifically, with the former diet, PPHG was significantly lower (18.05% in AUC on OGTT, 24.8% at 1-h, 28.9% at 2-h post OGTT, and 10.07% during CGMS). The CGMS data showed that premeal almond load significantly improved 24-glucose variability; SD of mean glucose concentration and mean of daily differences. Daily glycaemic control improved significantly as per the following: mean 24-h blood glucose concentration (M), time spent above 7.8 mmol/L of blood glucose, together with the corresponding AUC values. Premeal almond load significantly decreased following: overall hyperglycemia (glucose AUC), PPHG, peak 24-h glycaemia, and minimum glucose level during night. Conclusion Incorporation of 20 g of almonds, 30 min before each major meal led to a significant decrease in PPHG (as revealed in OGTT-based study phase) and also improved insulin, C-peptide, glucagon levels, and improved glucose variability and glycemic parameters on CGMS in participants with prediabetes. Clinical trial registry The study was registered at clinicaltrials.gov (registration no. NCT04769726). Subject terms: Lifestyle modification, Diabetes

CITATION EXPORT

Seema Gulati, Anoop Misra, Rajneesh Tiwari et al.. Beneficial effects of premeal almond load on glucose profile on oral glucose tolerance and continuous glucose monitoring: randomized crossover trials in Asian Indians with prediabetes. European Journal of Clinical Nutrition. (2023). https://doi.org/10.1038/s41430-023-01263-1

AUTHORS

7 · 5 CENTRES

Seema Gulati, Anoop Misra, Rajneesh Tiwari, Meenu Sharma, Ravindra M Pandey, Ashish Datt Upadhyay, Hem Chandra Sati

1Diabetes Foundation (India), New Delhi, India
2National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India
3Center of Nutrition & Metabolic Research (C-NET), New Delhi, India
4Fortis C-DOC Centre for Excellence for Diabetes, Metabolic Disease, and Endocrinology, New Delhi, India
5All India Institute of Medical Sciences, New Delhi, India