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Lipid, glycemic, and insulin responses to meals rich in saturated, cis-monounsaturated, and polyunsaturated (n-3 and n-6) fatty acids in subjects with type 2 diabetes mellitus

¹From the Division of Nutrition and Metabolic Diseases, Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas, TX, and the Department of Kinesiology, Texas Christian University, Fort Worth, TX
²Department of Clinical Sciences, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, TX
³Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, TX
⁴Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas, TX
⁵From the Division of Nutrition and Metabolic Diseases, Department of Internal Medicine, and Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas, TX

abhimanyu.garg{at}utsouthwestern.edu

ABSTRACT

Objective: The recommendations for dietary fats in patients with type 2 diabetes (T2DM) are largely based on the impact of fatty acids on fasting serum lipid and glucose concentrations. How fatty acids affect postprandial insulin, glucose, and triglyceride concentrations remains unclear, however. The objective of this study is to study the effect of fatty acids on postprandial insulin, glucose, and triglyceride responses.

Research Design and Methods: Test meals rich in palmitic acid, linoleic acid, oleic acid, and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and containing 1,000 kcal each were administered in a randomized cross-over design to 11 T2DM subjects. Serum insulin, glucose, and triglycerides concentrations were measured for 360 minutes. All subjects received an isoenergetic diet of constant composition throughout the study.

Results: According to repeated measures ANOVA, insulin (p=0.0002) but not glucose (p=0.10) response was significantly different between meals. Insulin response was lower to meals rich in oleic acid or EPA and DHA than to meals rich in palmitic acid or linoleic acid (p<0.01). The triglyceride response did not reach statistical significance (p=0.06) but tended to be lower with EPA and DHA than with the other fatty acids. Similar trends were seen for area under the curve (AUC) and incremental AUC for serum insulin and triglycerides but the differences were not significant.

Conclusions: In comparison to palmitic acid and linoleic acid, oleic acid or EPA and DHA may modestly lower insulin response in patients with T2DM without deteriorating glucose response. EPA and DHA may also reduce triglyceride response.

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