METABOLIC AND DIETARY VARIABLES ASSOCIATED WITH GLYCEMIC CONTROL IN PATIENTS WITH RECENTLY DIAGNOSED TYPE-II DIABETES-MELLITUS

We studied 86 obese patients with recently diagnosed Type 2 diabetes w ho received the same basic education during the first three months and after that either a 12-month intensified diet and exercise or convent ional diet education. The principal aim of the study was to examine th e effects of these treatment modes on glucose tolerance and insulin se cretion and to elucidate the variables associated with improved glycae mic control. The intensified education resulted in a better glycaemic control than the conventional one (fasting blood glucose 6.2+/-0.3 vs 1.5+/-0.3 mmol/l, p<0.01; glycated haemoglobin Ale 6.6+/-0.2 vs 7.5+/- 0.3%, p<0.05). Fasting plasma insulin and C-peptide concentrations dec reased significantly in both groups (fasting plasma insulin (mean+/-SE M) 23.6+/-1.6 vs 17.9+/-1.7 mU/l in the intervention group 0 vs 15 mon ths, and 25.1+/-3.2 vs 20.6+/-2.1 mU/l in the conventional treatment g roup, respectively). Increments of plasma insulin and C-peptide respon ses to the oral glucose load increased in subjects who had the greates t decrease in fasting blood glucose level. After combining the treatme nt groups, the variables associated with improved fasting blood glucos e by multiple regression analysis were a high initial level of fasting blood glucose (p<0.001), weight reduction (p<0.001), a high initial l evel of fasting plasma insulin (p<0.001), an increased response of pla sma insulin to the oral glucose load (p<0.001), a low intake of satura ted fatty acids (p<0.05) and a decreased proportion of the palmitic ac id in serum triglycerides (p<0.01). This model explained 73% of the de crease in fasting blood glucose level. In conclusion, besides weight l oss a moderate intake of saturated fatty acids was associated with the improved glycaemic control of patients with Type 2 diabetes possibly through improved insulin sensitivity.