Optimizing glycemic variability in type 2 diabetes using simple dietary and culinary recommendations to modulate...

Area of Science:

• Nutrition Science
• Metabolic Health
• Diabetes Management

Background:

• Postprandial glycemic excursions in type 2 diabetes (T2D) increase glycemic variability (GV) and cardiovascular risk.
• Controlling starch digestibility offers a nutritional strategy to reduce GV and improve glycemic control by promoting gradual glucose release.

Purpose of the Study:

• To assess the feasibility and efficacy of a 3-month dietary intervention using slowly digestible starch (SDS) in T2D patients with suboptimal glycemic control.
• To evaluate the impact of SDS-rich products and counseling on GV, glycemic control, and cardiometabolic parameters.

Main Methods:

• A 12-week randomized, controlled trial involving 51 T2D patients assigned to either a high-SDS (H-SDS) or low-SDS (L-SDS) diet.
• Participants received commercial starchy products and tailored dietary/culinary counseling.
• Continuous glucose monitoring system (CGMS) assessed GV parameters (MAGE, SD, CV, CONGA, MODD); glycemic and cardiometabolic markers were also measured.

Main Results:

• The H-SDS diet significantly reduced Mean Amplitude of Glycemic Excursions (MAGE) and other GV parameters compared to the L-SDS diet (P=0.0025).
• Glycated hemoglobin (HbA1c) showed a trend towards greater reduction in the H-SDS group, with levels falling below the 7% target.
• Dietary compliance was high (96%), and cardiometabolic markers remained similar between groups.

Conclusions:

• Modulating starch digestibility via an H-SDS diet is an effective and accessible strategy for improving GV and glycemic management in T2D.
• This intervention enables patients with suboptimal glycemic control to achieve recommended glycemic targets.