226-OR: The Mediterranean Diet Increases GLP-1 and Oxyntomodulin Compared with Vegetarian Diet in Type 2 Diabetes Subjects

Aim: To compare a Mediterranean dietetic pattern with a vegetarian pattern in terms of hunger-satiety perception through post-prandial assessment of appetite-related hormones glucagon-like peptide 1 (GLP-1) and Oxyntomodulin (OXM), as well as self-rated Visual Analogue Scale (VAS) quantification, in overweight/obese type-2 diabetes (T2D) subjects.

Methods: Twelve T2D subjects (M:F = 7:5), mean age 63 ± 8.5 years, were enrolled in our randomized, controlled, crossover study. Participants were given a vegetarian meal high in complex carbohydrate and dietary fiber (HFV, 35g fiber/1000 Kcal) as well as a Mediterranean (MED) meal in two different days over a one-week washout period. The two meals were isocaloric. Appetite ratings, glucose/insulin and gastrointestinal hormone concentrations were measured at fasting and every 30’ until 4 hours following meal consumption.

Results: GLP-1 and OXM levels were significantly higher following MED meal consumption compared with HFV meal (240’ AUC, P <.022 and P <.023, respectively). Both MED and HFV meal resulted in a biphasic secretion pattern of GLP-1 and OXM, although MED meal was related to a delayed, significantly higher second GLP-1 peak at 150’ compared with that of HFV meal (P <.05). MED meal was related to lower glucose trend compared with HFV meal (P <.039), whereas we did not observe significant changes in terms of self-reported VAS scores and insulin trend.

Conclusions: In T2D overweight/obese subjects, a MED-like meal is more effective than a vegetarian meal in terms of post-prandial plasma glucose homeostasis and GLP-1 and OXM release. These changes were not confirmed by VAS appetite self-assessment over a 4 hours period.