PD137 - METABOLIC IMPACT OF LIBERALIZED CARBOHYDRATE INTAKE ON INSULIN RESISTANCE AND FREE FATTY ACIDS IN TYPE 2 DIABETES PATIENTS

PD137

METABOLIC IMPACT OF LIBERALIZED CARBOHYDRATE INTAKE ON INSULIN RESISTANCE AND FREE FATTY ACIDS IN TYPE 2 DIABETES PATIENTS

P. Skořepa^1,2,*, O. Sobotka^1,2, M. Tichá^2,3, L. Sobotka²

¹Department of Military Internal Medicine and Military Hygiene, University of Defence, ²3rd Department of Internal Medicine – Metabolic Care and Gerontology, University Hospital in Hradec Kralove, Hradec Kralove, ³Internal Medicine, Pardubice Hospital, Pardubice, Czech Republic

Rationale: Carbohydrate (CHO) restriction is standard in Type 2 Diabetes (T2D) management to prevent exacerbating insulin resistance. However, CHO is the primary source of reducing equivalents (NADPH) and building blocks for anabolism. We tested whether increased CHO intake alters insulin resistance or free fatty acids in T2D patients.

Methods: In a sequential clinical study, 15 patients with T2D were monitored over two weeks. First week they received a standard diabetic diet (250 g CHO/day), followed by a week with supplementation with 150 g of maltodextrin (total 400 g CHO/day). Continuous glucose monitoring (CGM) tracked glucose profiles. After each week period subjects received 100 g carbohydrate meal and glucose, insulin and C-peptide levels were measured (ELISA method). Serum free fatty acids were measured using a plate-based spectrophotometric assay. Statistical analysis utilized Area Under the Curve (AUC), as median and interquartile range.

Results: High-CHO intake did not significantly alter glucose tolerance or insulin resistance markers. Following the 100g challenge, glucose AUC showed no significant difference: standard diet 3101 (2787–3845) min·mmol/L vs. high-CHO 3706 (2786–4170) min·mmol/L. Insulin and C-peptide AUCs remained stable (Insulin: 115.3 vs. 115.0 min·U/L; C-peptide: 12.3 vs. 11.8 min·µmol/L). Analysis indicated preserved postprandial FFA suppression under both diets, with no significant differences between regimens (regimen effect p=0.807; interaction p=0.476).

Conclusion: Increasing CHO intake to 400 g/day for one week does not impair insulin resistance, compromise glycemic control or significantly alter postprandial FFA suppression in T2D patients. Findings suggest CHO intake can be more liberalized than guidelines suggest, potentially supporting anabolic processes and metabolic flexibility without exacerbating diabetic pathology.

Disclosure of Interest: None declared