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Are there interindividual differences in the reactive hypoglycaemia response to breakfast? A replicate crossover trial

Lookup NU author(s): Professor Emma StevensonORCiD

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Abstract

© The Author(s) 2024. Background: Following consumption of a meal, circulating glucose concentrations can rise and then fall briefly below the basal/fasting concentrations. This phenomenon is known as reactive hypoglycaemia but to date no researcher has explored potential inter-individual differences in response to meal consumption. Objective: We conducted a secondary analysis of existing data to examine inter-individual variability of reactive hypoglycaemia in response to breakfast consumption. Methods: Using a replicate crossover design, 12 healthy, physically active men (age: 18–30 y, body mass index: 22.1 to 28.0 kg⋅m− 2) completed two identical control (continued overnight fasting) and two breakfast (444 kcal; 60% carbohydrate, 17% protein, 23% fat) conditions in randomised sequences. Blood glucose and lactate concentrations, serum insulin and non-esterified fatty acid concentrations, whole-body energy expenditure, carbohydrate and fat oxidation rates, and appetite ratings were determined before and 2 h after the interventions. Inter-individual differences were explored using Pearson’s product-moment correlations between the first and second replicates of the fasting-adjusted breakfast response. Within-participant covariate-adjusted linear mixed models and a random-effects meta-analytical approach were used to quantify participant-by-condition interactions. Results: Breakfast consumption lowered 2-h blood glucose by 0.44 mmol/L (95%CI: 0.76 to 0.12 mmol/L) and serum NEFA concentrations, whilst increasing blood lactate and serum insulin concentrations (all p < 0.01). Large, positive correlations were observed between the first and second replicates of the fasting-adjusted insulin, lactate, hunger, and satisfaction responses to breakfast consumption (all r > 0.5, 90%CI ranged from 0.03 to 0.91). The participant-by-condition interaction response variability (SD) for serum insulin concentration was 11 pmol/L (95%CI: 5 to 16 pmol/L), which was consistent with the τ-statistic from the random-effects meta-analysis (11.7 pmol/L, 95%CI 7.0 to 22.2 pmol/L) whereas effects were unclear for other outcome variables (e.g., τ-statistic value for glucose: 0 mmol/L, 95%CI 0.0 to 0.5 mmol/L). Conclusions: Despite observing reactive hypoglycaemia at the group level, we were unable to detect any meaningful inter-individual variability of the reactive hypoglycaemia response to breakfast. There was, however, evidence that 2-h insulin responses to breakfast display meaningful inter-individual variability, which may be explained by relative carbohydrate dose ingested and variation in insulin sensitivity of participants.

Publication metadata

Author(s): Gonzalez JT, Lolli L, Veasey RC, Rumbold PLS, Betts JA, Atkinson G, Stevenson EJ

Publication type: Article

Publication status: Published

Journal: European Journal of Nutrition

Year: 2024

Volume: 63

Pages: 2897-2909

Print publication date: 01/12/2024

Online publication date: 04/09/2024

Acceptance date: 01/07/2024

Date deposited: 16/09/2024

ISSN (print): 1436-6207

ISSN (electronic): 1436-6215

Publisher: Springer Science and Business Media Deutschland GmbH

URL: https://doi.org/10.1007/s00394-024-03467-y

DOI: 10.1007/s00394-024-03467-y

Data Access Statement: Electronic supplementary material is available alongside the publication on the publisher's page: https://link.springer.com/article/10.1007/s00394-024-03467-y#Sec14

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