Order in which different kinds of food are eaten has a significant impact on post-meal glucose and insulin levels in in obese patients with type 2 diabetes, a new study from Weill Cornell Medical College has found.

The authors say their findings may have implications for the diets of diabetic and other high-risk patients. Senior author Dr. Louis Aronne said:

“Carbohydrates raise blood sugar, but if you tell someone not to eat them — or to drastically cut back — it’s hard for them to comply. This study points to an easier way that patients might lower their blood sugar and insulin levels."

It was a small study, involving 11 people consuming a meal of carbohydrates (ciabatta bread and orange juice), protein, vegetables and fat (chicken breast, lettuce and tomato salad with low-fat dressing and steamed broccoli with butter) twice, on separate days a week apart.

Type 2 diabetics usually use the finger prick test for checking glucose levels during the day.

Keeping normal levels, especially after meals, is very important. If a diabetics’ blood sugar level is consistently high or frequently spikes, they risk complications of their disease, including hardening of the arteries and eventually death from heart disease.

“We’re always looking for ways to help people with diabetes lower their blood sugar,” said Dr. Aronne. “We rely on medicine, but diet is an important part of this process, too. Unfortunately, we’ve found that it’s difficult to get people to change their eating habits.

The study found that glucose levels were much lower 30, 60 and 120 minute after eating, by around 29 percent, 37 percent and 17 percent, respectively, when vegetables and protein were eaten before the carbohydrates.

Insulin was also significantly lower when protein and vegetables were eaten first. This finding confirms that the order in which we eat food matters, and suggests a new way to effectively control post-meal glucose levels in diabetic patients.

“Based on this finding, instead of saying ‘don’t eat that’ to their patients, clinicians might instead say, ‘eat this before that,’” Dr. Aronne said. “While we need to do some follow-up work, based on this finding, patients with type 2 might be able to make a simple change to lower their blood sugar throughout the day, decrease how much insulin they need to take, and potentially have a long-lasting, positive impact on their health."

Alpana P. Shukla, Radu G. Iliescu, Catherine E. Thomas and Louis J. Aronne Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels Diabetes Care July 2015 vol. 38 no. 7 e98-e99 doi: 10.2337/dc15-0429

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