American Diabetes Association
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An isoenergetic multifactorial diet reduces pancreatic fat and increases postprandial insulin response in patients with type 2 diabetes: a randomized controlled trial

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posted on 2022-07-21, 15:14 authored by Giuseppe Della Pepa, Valentina Brancato, Giuseppina Costabile, Dominic Salamone, Alessandra Corrado, Marilena Vitale, Carlo Cavaliere, Marcello Mancini, Marco Salvatore, Delia Luongo, Gabriele Riccardi, Angela A. Rivellese, Giovanni Annuzzi, Lutgarda Bozzetto


Objective: To compare the effect of an isocaloric multifactorial diet with a diet rich in monounsaturated fatty acids (MUFA) and similar macronutrient composition on pancreatic fat (PF) and postprandial insulin response in Type 2 Diabetes (T2D).

Research Design and Methods: According to a randomized controlled parallel group design, 39 individuals with T2D, 35–75 years-old, in satisfactory blood glucose control, were assigned to an 8-week isocaloric intervention with a multifactorial diet rich in MUFA, polyunsaturated fatty acids, fibre, polyphenols, and vitamins (n=18) or a MUFA rich diet (n=21). Before/after the intervention, PF content was measured by the proton-density fat fraction using a 3D mDixon MRI sequence, plasma insulin and glucose concentrations were measured over a 4h test-meal with a similar composition as the assigned diet. 

Results: After 8 weeks, PF significantly decreased after the multifactorial diet (from 15.7±6.5% to 14.1±6.3%, p=0.024) while it did not change after the MUFA diet (from 17.1±10.1% to 18.6±10.6%, p=0.139) with a significant difference between diets (p=0.014). Postprandial glucose response was similar in the two groups. Early postprandial insulin response (iAUC0-120) significantly increased with the multifactorial diet (from 36340±34954 to 44138±31878 pmol/L·min, p=0.037), while it did not change significantly in the MUFA diet (from 31754±18446 to 26976±12265 pmol/L·min, p=0.178), with a significant difference between diets (p=0.023). Changes in PF inversely correlated with changes in early postprandial insulin response (r=-0.383, p=0.023). 

Conclusions: In T2D patients, an isocaloric multifactorial diet including several beneficial dietary components markedly reduced PF. This reduction was associated with an improved postprandial insulin response.


This study was supported by the Department of Clinical Medicine and Surgery of the Federico II University Hospital.


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