J Korean Diabetes > Volume 19(4); 2018 > Article
The Journal of Korean Diabetes 2018;19(4):193-199.
DOI: https://doi.org/10.4093/jkd.2018.19.4.193    Published online January 8, 2019.
식사 중 탄수화물은 언제 먹어야 하나
배재현, 조영민
Effect of Nutrient Preload and Food Order on Glucose, Insulin, and Gut Hormones.
Jae Hyun Bae, Young Min Cho
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea.
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. ymchomd@snu.ac.kr
Postprandial hyperglycemia is associated with the risk of diabetes mellitus, cardiovascular disease, and mortality. Nutrition therapy is an important component of the management of postprandial hyperglycemia. Postprandial glucose levels are determined by several factors, such as the quantity and composition of nutrients, gastric emptying rates, secretion of incretin hormones, insulin secretion, glucose uptake by peripheral tissues, and endogenous glucose production. Nutrient preload and food order (or meal sequence) are dietary approaches targeting these factors. Nutrient preload reduces postprandial glucose excursion by enhancing insulin secretion, augmenting the secretion of glucagonlike peptide-1, and delaying gastric emptying. Carbohydrates-last food order improves glycemic control, increases the secretion of glucagon-like peptide-1, and decreases insulin requirements. Therefore, both nutrient preload and manipulation of food order can be an effective, safe, and feasible strategy for treating hyperglycemia in individuals with diabetes mellitus.
Key Words: Carbohydrates, Diabetes mellitus, Food, Gastrointestinal hormones, Glucagon-like peptide-1, Incretins, Insulin
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