Postprandial hypertriglyceridaemia in treated type 2 diabetic subjects - the role of dietary components

Postprandial hyperlipidaemia is a risk factor for cardiovascular diseases ( CVD). This study was done (a) to evaluate whether postprandial hypertriglyc eridaemia was common in Indian type 2 diabetic patients on treatment and (b ) to see whether the high carbohydrate content of the diet was a cause of t he lipid abnormality. Two hundred type 2 diabetic subjects (M:F, 137:63; me an age 51.6 +/- 10.2 years, mean BMI 25.5 +/- 3.1 kg/m(2)) with diabetes du ration of 7.6 +/- 5.6 years were studied. Fasting and 2 h post prandial res ponses of plasma glucose and triglycerides (TG) were measured using a break fast meal, usually consumed by the patient with the intake of usual hypogly caemic drugs. Patients with a post prandial TG value greater than 15% of th e corresponding fasting TG value were designated as group 2 and the remaini ng subjects as group 1. Dietary composition of the breakfast were calculate d. Among the 200 subjects, 52 (26%) had post prandial TG higher than the fa sting values. This was seen in patients who were consuming lower percentage of carbohydrates and higher percentage of fats than prescribed. Therefore the postprandial rise in TG was probably due to the high fat content of the diet and due to a lower insulin sensitivity. This study highlights the fac ts that postprandial hypertriglyceridaemia is seen only in a small proporti on of the treated patients and the high carbohydrate diet does not produce hypertriglyceridaemia, either in the fasting or post prandial state. The mi nority who show an increased TG value at 2 h have been taking lower carbohy drate with higher fat content in the meal. This could have produced a lower insulin sensitivity in these patients. (C) 2000 Elsevier Science Ireland L td. All rights reserved.