Dietary Fatty Acids Differentially Associate with Fasting Versus 2 Hour Glucose Homeostasis: Implications for The Management of Subtypes of Prediabetes
Over nutrition has fuelled the global epidemic of type 2 diabetes, but the role of individual macronutrients to the diabetogenic process is not well delineated. We aimed to examine the impact of dietary fatty acid intake on fasting and 2 hour plasma glucose concentrations, as well as tissue specific insulin action governing each. Normoglycemic controls (n 15) athletes (n 14) and obese (n 23) as well as people with prediabetes (n 10) and type 2 diabetes (n 11) were queried about their habitual diet using a Food Frequency Questionnaire. All subjects were screened by an oral glucose tolerance test (OGTT) and studied using the hyperinsulinemic/euglycemic clamp with infusion of 6,62H2 glucose. Multiple regression was performed to examine relationships between dietary fat intake and 1) fasting plasma glucose, 2) suppression of endogenous glucose production, 3) 2 hour post OGTT plasma glucose, and 4) skeletal muscle insulin sensitivity (glucose rate of disappearance (Rd) and non oxidative glucose disposal (NOGD) The %kcal from saturated fat (SFA) was positively associated with fasting (b 0.303, P 0.018) and 2 hour plasma glucose (b 0.415, P<0.001) and negatively related to suppression of hepatic glucose production (b 0.245, P 0.049) clamp Rd (b 0.256, P 0.001) and NOGD (b 0.257, P 0.001) The %kcal from trans fat was also negatively related to clamp Rd (b 0.209, P 0.008) and NOGD (b 0.210, P 0.008) In contrast, the %kcal from polyunsaturated fat (PUFA) was negatively associated with 2 hour glucose levels (b 0.383, P 0.001) and positively related to Rd (b 0.253, P 0.007) and NOGD (b 0.246, P 0.008) Dietary advice to prevent diabetes should consider the underlying pathophysiology of the prediabetic state.
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