Glycemic and insulinemic response of subjects with type 2 diabetes after consumption of three energy bars. (Research and Professional Briefs).(Statistical Data Included)

Adequate control of postprandial blood glucose levels is an important component of overall blood glucose management (1,2). Diabetes snack bars designed to slow the rate of carbohydrate digestion and absorption may be useful in lowering postprandial blood glucose levels and potentially improving glycemic control. This study evaluated the acute effects of ingestion of equivalent quantities of resistant starch and fully digestible starch, as part of a snack bar, on postprandial blood glucose and insulin levels in subjects with type 2 diabetes.

METHODS

Subjects

Seven men and 3 women with type 2 diabetes controlled by medical nutrition therapy alone participated in the study. Age range was 43 to 74 years of age and duration of diabetes ranged from 5 months to 5 years. Hemoglobin A1c was less than 9.0%, and fasting plasma glucose < 11.2 mmol/L (1) Mean body weight was 87 kg (range 63-100 kg).

Intervention

In a double-blind, randomized, 3-way crossover design study (approved by the Park Nicollet Institute Institutional Review Board), subjects reported to the center after an overnight fast (10 to 12 hours) on 3 separate occasions (3 to 10 days apart). Subjects consumed approximately 50 grams of carbohydrate from one of three snack bars: the Choice din[R] Nutrition Bar (Mead Johnson & Go, Evansville, Ind) which contains resistant starch (resistant starch bar), the Benefit Bar[R] (Health Management Resources, Boston, Mass) an energy bar with similar macronutrient composition that does not contain resistant starch (traditional energy bar) and the Snickers Bar[R] (Mars Inc, Hackettstown, NJ) a popular candy bar (candy bar). Bars were presented in a randomized order and all subjects consumed all three bars. Blood glucose and insulin levels were drawn -30, 0, 30, 60, 90, 120, 150, 180, 240, and 300 minutes after initiating the feeding.

Nutrient Composition of Experimental Food

The nutrient composition of the bars is detailed in the Table. The Choice dm[R] nutrition bar contains CrystaLean[R] (7.25g) as a source of resistant starch.

CrystaLean is a highly retrograded maltodextrin composed primarily of a(1-4)-linked D-glucose units, produced by Opta Food Ingredients Inc, (Bedford, Mass). It provides approximately 2.7 kilocalories (2) per gram of carbohydrate. (Personal communication, Opta Food Ingredients, Inc, October 2000). The nutrient composition of test portions of the 3 food bars was similar in energy and total carbohydrate content but varied in fat and protein.

Blood Glucose and Insulin Analysis

Plasma glucose was analyzed using the hexokinase method on a Dade Behring Paramax (Deerfield, Ill). Plasma insulin levels were determined using an immunochemiluminetric method and apolyclonal in house antibody …