EFFECTS OF A LARGE SUPPER ON GLUCOSE-LEVELS THE FOLLOWING MORNING IN PATIENTS WITH TYPE-2 DIABETES

Seventeen patients were studied to test the hypothesis that a large ev ening meal influences the fasting glucose level and glucose tolerance the following morning in patients with type 2 diabetes. Oral hypoglyce mic agents were discontinued for 2 weeks. The baseline fasting plasma glucose levels were 12.3 +/- 0.9 mmol/L. Fasting and postprandial (pos t-Sustacal) glucose, insulin, and C-peptide measurements were performe d the morning after the patients received three separate meal protocol s spaced 1 week apart. The caloric distribution of the meal protocols was (1) 7 kcal/kg of ideal body weight breakfast and lunch and 14 kcal /kg supper (small supper); (2) 7 kcal/kg breakfast and lunch and 28 kc al/kg for supper (large supper); and (3) 14 kcal/kg breakfast and lunc h (no supper). Fasting glucose levels were higher the morning after th e large supper compared to no supper (13.6 +/- 0.7 versus 12.3 +/- 0.5 mmol/L, p < 0.05) and also to the small supper (13.6 +/- 0.7 versus 1 2.5 +/- 0.6 mmol/L, p = 0.05). No difference was observed in the fasti ng glucose levels between the small supper and no supper (p > 0.2). Th e fasting insulin and C-peptide levels, and the post-Sustacal areas un der the curve of glucose, insulin, and C-peptide did not differ among the meals. In patients with type 2 diabetes, a large evening meal is a ssociated with a modest elevation in fasting glucose the following mor ning. (C) 1998 Elsevier Science Inc.