Discussion
T2D, prediabetes, hyperglycemia, T2D [, hypoglycemic, diabetes
PREDIABETES, HYPERGLYCEMIA, ADVERSE EFFECTS, INSULIN RESISTANCE, HYPERINSULINEMIA, COMPLICATIONS, DIABETES
This is the first study to investigate the effects of a premeal almond load on parameters of glycemia in Asian Indians with prediabetes. As mentioned previously, there is only one study by Crouch et al. [It is important to note that the prevalence of prediabetes is rising in India [Almonds and other nutrients have been given at various times in relation to major meals to reduce blood glucose levels. Several investigators have shown that almonds given with meals lower PPBG. In studies that evaluated meals with almonds matched for carbohydrate content, PPBG concentrations were reduced by 9–20% in healthy individuals, and 7–30% in individuals with prediabetes and T2D [In our study change in glucose AUC is greater than the insulin AUC for premeal almond load. OGTT graph (Fig. Studies in which other nutrients (e.g., fructose and soya yogurt) were used as premeal almond load also showed encouraging results. Heacock et al. [Besides HbA1C, the role of glycaemic variability in relation to the development of complications of diabetes is increasingly being researched. Glycaemic variability is denoted by intraday glycaemic excursions, including episodes of hyperglycemia and hypoglycemic. These short-term changes, frequent glucose fluctuations, may independently contribute to diabetes-related complications [It is difficult to comment on the exact mechanism of action of preloading almonds. The following have been researched and discussed. (a) Premeal almond load stimulates the release of stored insulin 30 min sooner than insulin release stimulated by the 75-g oral glucose load. This hypothesis is described as priming the “pancreatic pump” [Individuals with prediabetes and T2D demonstrate lower GLP-1 response to an oral glucose load in comparison to healthy individuals [It is known that serum C-peptide levels parallel the insulin secretory capacity of pancreatic beta cells. The levels would increase in those having insulin resistance and hyperinsulinemia. Jenkins et al. [Effects of almond consumption on plasma glucagon and plasma DPP-4 levels have not been evaluated previously. Importantly, high circulating DPP-4 levels are linked to several adverse effects including those on the liver, and such high levels are prevalent in Asian Indian participants with T2D [