Seema Gulati, Anoop Misra, Rajneesh Tiwari, Meenu Sharma, Ravindra M Pandey, Ashish Datt Upadhyay, Hem Chandra Sati
Journal: European journal of clinical nutrition 2023;77(5):586-595
PMID: 36732571
Prediabetes is a condition where blood sugar levels are higher than normal, increasing the risk of developing type 2 diabetes. Managing blood sugar levels, especially after meals, is important in preventing disease progression. Certain foods, such as almonds, may help control blood sugar by slowing digestion and reducing glucose spikes. This study was conducted to examine whether eating almonds before meals could improve blood sugar control in people with prediabetes.
The results showed that consuming almonds before meals led to lower post-meal blood sugar spikes and improved overall blood sugar control compared to the control condition. Measures indicated better blood sugar stability when almonds were included before meals.
In conclusion, eating almonds before meals may be a simple and effective strategy to improve blood sugar control in individuals with prediabetes. Healthcare professionals may use this approach as part of dietary advice to help reduce post-meal blood sugar spikes and support diabetes prevention.
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).
© 2023. The Author(s).
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