Six and 12 weeks of caloric restriction increases β cell function and lowers fasting and postprandial glucose concentrations in people with type 2 diabetes

Matheni Sathananthan, Meera Shah, Kim L. Edens, Karen Grothe, Francesca Piccinini, Luca P. Farrugia, Francesco Micheletto, Chiara Dalla Man, Claudio Cobelli, Robert A. Rizza, Michael Camilleri, Adrian Vella

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Background: Caloric restriction alone has been shown to improve insulin action and fasting glucose metabolism; however, the mechanism by which this occurs remains uncertain. Objective: We sought to quantify the effect of caloric restriction on β cell function and glucose metabolism in people with type 2 diabetes. Methods: Nine subjects (2 men, 7 women) with type 2 diabetes [BMI (in kg/m<sup>2</sup>): 40.6 ± 1.4; age: 58 ± 3 y; glycated hemoglobin: 6.9% ± 0.2%] were studied using a triple-tracer mixed meal after withdrawal of oral diabetes therapy. The oral minimal model was used to measure β cell function. Caloric restriction limited subjects to a pureed diet (<900 kcal/d) for the 12 wk of study. The studies were repeated after 6 and 12 wk of caloric restriction. Results: Fasting glucose concentrations decreased significantly from baseline after 6 wk of caloric restriction with no further reduction after a further 6 wk of caloric restriction (9.8 ± 1.3, 5.9 ± 0.2, and 6.2 ± 0.3 mmol/L at baseline and after 6 and 12 wk of caloric restriction, respectively; P = 0.01) because of decreased fasting endogenous glucose production (EGP: 20.4 ± 1.1, 16.2 ± 0.8, and 17.4 ± 1.1 μmol · kg<sup>-1</sup> · min<sup>-1</sup> at baseline and after 6 and 12 wk of caloric restriction, respectively; P = 0.03). These changes were accompanied by an improvement in β cell function measured by the disposition index (189 ± 51, 436 ± 68, and 449 ± 67 10<sup>-14</sup> dL · kg<sup>-1</sup> · min-2 · pmol<sup>-1</sup> at baseline and after 6 and 12 wk of caloric restriction, respectively; P = 0.01). Conclusions: Six weeks of caloric restriction lowers fasting glucose and EGP with accompanying improvements in β cell function in people with type 2 diabetes. An additional 6 wk of caloric restriction maintained the improvement in glucose metabolism.

Original languageEnglish (US)
Pages (from-to)2046-2051
Number of pages6
JournalJournal of Nutrition
Volume145
Issue number9
DOIs
StatePublished - 2015

Keywords

  • Bariatric surgery
  • Caloric restriction
  • Disposition index
  • Endogenous glucose production
  • Gastric emptying
  • Insulin action
  • Insulin secretion

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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