High-Energy Breakfast Diet Reduces Daily Insulin Dose for Type 2 Diabetes

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A high-energy breakfast diet may be an effective strategy to improve diabetes control, according to a new study.

In patients with type 2 diabetes mellitus (T2DM) and obesity, a high-energy breakfast promotes weight loss, improves diabetes outcomes and decreases the need for insulin.

“This study shows that in obese, insulin-treated type 2 diabetes patients a diet with three meals per day, consisting of a big breakfast, average lunch and small dinner, had many rapid and positive effects compared to the traditional diet with six small meals evenly distributed throughout the day: better weight loss, less hunger and better diabetes control while using less insulin,” said lead author Daniela Jakubowicz, MD, professor of medicine at Tel Aviv University. 

“The hour of the day-when you eat and how frequently you eat-is more important than what you eat and how many calories you eat. Our body metabolism changes throughout the day. A slice of bread consumed at breakfast leads to a lower glucose response and is less fattening than an identical slice of bread consumed in the evening.”

The researchers presented their results at ENDO 2018, the annual meeting of the Endocrine Society in Chicago, Ill.

Jakubowicz and colleagues studied 29 patients, average aged 69 years, with obesity and T2DM being treated with insulin. The patients were randomly assigned to consume one of two different weight-loss diets, which contained an equal number of daily calories. One group (Bdiet) ate three meals, including a large breakfast, a medium-sized lunch and a small dinner. The second group (6Mdiet) ate six small meals evenly spaced throughout the day, including three snacks.

Overall glycemia was assessed for 14 days at baseline, during the first two weeks on diet, and at the end of the study by continuous glucose monitoring. Glucose levels were tested every two weeks and insulin dosage was adjusted as needed.

After three months, the Bdiet group lost 5 kilograms (11 pounds), but the 6Mdiet group gained 1.4 kg (3 lb). Fasting glucose levels decreased more in the Bdiet group (54 mg/dL) than in the 6Mdiet group (23 mg/dL).

Overall mean glucose levels dropped in the first 14 days by 29 mg/dL and 38 mg/dL after three months in the Bdiet group; the 6Mdiet group levels dropped only 9 mg/dL and only 17 mg/dL, respectively. Mean glucose levels during sleep dropped only in the Bdiet group, by 24 mg/dL, but not in the 6Mdiet group.

What’s more, the Bdiet group needed significantly less insulin (-20.5 units/day), while the 6Mdiet group needed more insulin (+2.2 units/day).

Overall hunger and carbohydrate craving decreased significantly in Bdiet group, but increased in the 6Mdiet group.

Importantly, the researchers found a significant reduction of overall glycemia after as little as 14 days on Bdiet, when the patient had almost the same weight as baseline. This suggests that even before weight loss, the change in the meal timing itself has a quick beneficial effect on glucose balance.

“A diet with adequate meal timing and frequency has a pivotal role in glucose control and weight loss,” said Jakubowicz.

For more information, check out the full article: Jakubowicz D, Froy O, Tsameret S, et al. High Energy Breakfast Diet is an Effective Strategy for Weight Loss and Reduction of the Total Daily Insulin Dose in Type 2 Diabetes. Paper presented at: ENDO 2018; March 2018; Chicago, IL.