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Alpana Shukla Part 3, On What Type of Diabetes Does Food Order Work Best




In part 3 of this Exclusive Interview, Alpana Shukla talks with Diabetes in Control Medical Editor Joy Pape about the relevance of the food order study for people with any type of diabetes or no diabetes.

Alpana Shukla, MD, MRCP (UK) is Assistant Professor of Research in the Division of Endocrinology, Diabetes & Metabolism at Weill Cornell Medical College in New York.

Transcript of this video segment:

Pape: So, is this relevant to patients with type 1 diabetes and patients with type 2 diabetes on insulin?

Shukla: So, I think it is — I think — we believe it is relevant. We haven’t actually studied this in that population, but our results show that when you eat in this manner you require less insulin. So, we think that it’s likely that patients will have better control and they may require less insulin for the same amount of carbohydrate consumed. It’s definitely an area that we wish to pursue further and we are actively looking to do a study in this field.

Pape: Right. So, I know the study hasn’t been done yet, but I can speak to my experience with having taught patients this and I’ve seen it also. But again, it hasn’t been studied yet. Now, have you studied this intervention in patients who don’t have diabetes?

Shukla: So, we just finished the study in patients who had prediabetes. And in fact, I have just submitted the results for publication at this point. It’s under review. But I’m very happy to share some of the data which we actually showed at the Obesity Week Conference last year. And in fact, the results in the prediabetic population were also similar to what we found in patients with type 2 diabetes. And that having the carbohydrate last was significantly lower to post meal glucose response. In this study we actually did a third intervention which is interesting because one of the things that people have raised after the first two studies were done was, “We can’t always eat the protein and vegetables first because it’s just not natural to the way we eat and we prefer to have the protein and carbohydrate together.” And that is actually natural to a way that a lot of people — a lot of cultural meal patterns worldwide. And so, keeping that in mind what we did in this experiment was to introduce the third intervention which was having a big vegetable portion first which had a salad dressing, so some amount of fat. And then we had them consume the protein and carbohydrate together. And this is a much simpler thing to do for a lot of people. And in fact, what we found was even with this intervention the glucose levels were much lower. In fact, the glucose peaks were similarly reduced by eating either the salad first or the protein and vegetables first.  

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