The Effect Of Different Meal Sequence On Blood Glucose Spectrum In New Town Residents With Type 2 Diabetes

Objective:To evaluate the effects of different meal sequence on blood glucose spectrum,hypoglycemic events and meal enjoyment in new town residents with type 2diabetes.Methods:This is a randomized crossover study with a washout period of at least 48hours.A total of 64 new town residents with type 2 diabetes who were admitted to a tertiary hospital in Nanjing from December,2019 to January,2021 were selected by convenient sampling method,then they were randomly divided into groups A and B,with 32 in each group.On the basis of general diabetes diet education,participants in the two groups received intervention of different meal sequence on two separate days:all participants ate and exercised according to their daily habits on the night before the trial,and fasted after 22:00;On the first study day,participants in group A consumed all food together（mixed meal）,participants in group B eat vegetables first,protein and fat second before Carbohydrates（sequential meal）,don’t have the time interval between two kinds of food,but suggest that eating slowly,Do not restrict drinking water between two meals but do not allow to eat,drink coffee,strong tea or milk tea.On the second study day,groups A and B exchanged the order of meals,and the others were the same as on the first study day.To evaluate the effects of different meal sequences on blood glucose spectrum,hypoglycemic events and meal enjoyment of new town residents with type 2 diabetes.Results:1.A total of 62 participants in this study completed all data collection.2.Blood glucose spectrum:The intra-group comparison showed that blood glucose continued to rise for 90 minutes after breakfast,and there were significantly differences in blood glucose at each time point（P<0.05）.PBG_{（breakfast120min）}were significantly increased than FBG、PBG_{（breakfast30min）、}PBG_{（breakfas60min）}in mixed meal（P<0.05）,and PBG_{（breakfast120min）}were significantly increased than FBG、PBG_{（breakfast30min）}in sequential meal（P<0.05）.The blood glucose continued to rise for120 minutes after lunch,and there were significantly differences in blood glucose at each time point（P<0.05）.The blood glucose continued to rise for 90 minutes after dinner,and there were significantly differences in blood glucose at each time point（P<0.05）,PBG_{（dinner120min）}were significantly increased than blood glucose before dinner、PBG_{（dinner30min）、}PBG_{（breakfas60min）}.The comparison between the two groups showed There was no significant difference in blood glucose between the two groups before and after breakfast and lunch（P>0.05）,and the blood glucose before and after dinner in sequential meal was significantly lower than that in mixed meal（P<0.05）.The FBG on the day after the trial in sequential meal was significantly lower than that in mixed meal.Compared with mixed meals,The MBG,PPGE,AUC,SDBG,TAR in sequential meals were significantly decreased（P<0.05）,while the TIR was significantly increased（P<0.05）.3.Frequency of hypoglycemic events:The frequency of hypoglycemic events in sequential meal was lower than that in mixed meal,but the difference did not reach statistical significance（P=0.058）.4.Meal enjoyment:The meal enjoyment of sequential meal was significantly higher than that in the mixed meal（P<0.05）.Conclusions:1.Sequential meal was more beneficial to improve the blood glucose spectrum of new town residents with type 2 diabetes than mixed meal.2.The incidence of hypoglycemic events in sequential meals was improved than that in mixed meals,but it did not reach statistical significance,so further study and analysis are needed.3.Sequential meal was more beneficial to improve the Meal enjoyment of new town residents with type 2 diabetes than mixed meal.