755-P: A Plant-Based Meal Stimulates Incretin and Insulin Secretion More than an Energy- and Macronutrient-Matched Standard Meal in Type 2 Diabetes: A Randomized Crossover Study

Objective: We tested the effects of two energy- and macronutrient-matched meals: a standard meat (M-meal) and a vegan (V-meal) on postprandial incretin and insulin secretion in participants with type 2 diabetes (T2D).

Research Design and Methods: A randomized crossover design was used in 20 participants with T2D. Plasma concentrations of glucose, insulin, C-peptide, glucagon-like peptide -1 (GLP-1), amylin, and gastric inhibitory peptide (GIP) were determined at 0, 30, 60, 120 and 180 minutes. Beta-cell function was assessed with a mathematical model, using C-peptide deconvolution. Repeated-measures ANOVA was used for statistical analysis.

Results: Postprandial plasma glucose responses were similar after both test meals (p=0.64). An increase in the stimulated secretion of insulin (by 30.5%; 95% CI 21.2 to 40.7%; p<0.001), C-peptide (by 7.1%; 95% CI 4.1 to 9.9%; p<0.001), and amylin (by 15.7%; 95% CI 11.8 to 19.7%; p<0.001) was observed following consumption of the V-meal. An increase in stimulated secretion of GLP-1 (by 19.2%; 95% CI 12.4 to 26.7%; p<0.001) and a decrease in GIP (by -9.4%; 95% CI -17.3 to -0.7%; p=0.02) were observed after the V-meal. Several parameters of beta-cell function increased after the V-meal, particularly insulin secretion at a fixed glucose value 5 mmol/L, rate sensitivity, and the potentiation factor.

Conclusions: Our results indicate an increase in postprandial incretin and insulin secretion, following consumption of a single vegan meal, suggesting a therapeutic potential of plant-based meals for improving beta-cell function in T2D.