Macronutrient Sequence May Improve Postprandial Glycemia in Type 2 Diabetes Patients

Strategic Insights -

Fresh data from a new report by researchers at Universidad CES suggests that altering the sequence of macronutrients consumed during a meal may have a positive impact on postprandial glycemia, or blood sugar levels, in individuals with type 2 diabetes. According to the study, a carbohydrate-last (CL) strategy, where protein and fat are consumed before carbohydrates, may lead to significantly lower postprandial glucose levels compared to consuming carbohydrates first or in an unordered manner. However, the study's authors caution that further research is needed to confirm the long-term benefits of this approach.

Key Takeaways:

  • A carbohydrate-last (CL) strategy may improve postprandial glycemia in type 2 diabetes patients by reducing postprandial glucose levels at 60 minutes.
  • The CL strategy involves consuming protein and fat before carbohydrates, whereas carbohydrate-first (CF) or unordered (U) intake may have a negative impact on metabolic parameters in adults with type 2 diabetes.
  • The meta-analysis included 17 studies involving 389 participants, with 114 (29%) in a parallel design and 192 (49%) in a crossover design receiving the CL strategy.
  • Compared to CF or U intake, the CL group had significantly lower postprandial glucose levels at 60 minutes (MD: -42.73 mg/dL; 95% CI: -55.51, -29.96; p
  • Further research is needed to confirm the applicability of the CL strategy in advanced disease stages and to establish long-term metabolic benefits.
  • The study's authors emphasize the need for further investigation to establish the optimal macronutrient sequence for type 2 diabetes management.

Statistics:

  • 17 studies involving 389 participants were included in the meta-analysis.
  • The CL strategy was associated with significantly lower postprandial glucose levels at 60 minutes compared to CF or U intake (MD: -42.73 mg/dL; 95% CI: -55.51, -29.96; p
  • The meta-analysis included studies with a parallel design (29% of participants) and crossover design (49% of participants).
  • The study's authors concluded that further research is needed to confirm the long-term benefits of the CL strategy.

Sources:

  • Acta Diabetologica, Universidad CES, Medellin, Colombia. - "Nutrient intake order on metabolic outcomes in type 2 diabetes: a systematic review and meta-analysis." Acta Diabetologica, 2025.
  • Luisa M. Saldarriaga-Callejas, Universidad CES, Medellin, Colombia. - (Publisher contact information for the journal Acta Diabetologica is: Springer-verlag Italia Srl, Via Decembrio, 28, Milan, 20137, Italy.)