Non-insulin dependent diabetes mellitus (
NIDDM) is associated with chronic
hyperglycemia, which increases the risk of developing microvascular and macrovascular complications. Elevated
triglyceride (TG) and
VLDL cholesterol levels and low levels of
HDL cholesterol have also been frequently reported in
NIDDM patients. A diet high in complex
carbohydrate and low in fat is typically recommended for management of
NIDDM, however, this has recently been challenged by scientific reports of the benefits of dietary intakes high in monounsaturated fat. Thirty-two individuals with
NIDDM were randomized to receive either Ensure with Fibre (30% fat) or a high
monounsaturated fatty acid product,
Glucerna (50% fat). These products were consumed for 28 days at > 80% of daily energy intake. Post-treatment, dietary compliance was verified by a higher plasma TG 18:1 n-9 (p < 0.001) in the
Glucerna group and a higher plasma TG 18:2 n-6 (p < 0.001) in the Ensure with Fibre group. The postprandial rise in
blood glucose levels, determined by fingerprick samples, was significantly lower (p < 0.01) in the
Glucerna group. Trends of clinical interest were greater mean decreases in the
Glucerna group compared to the Ensure with Fibre group in:
fructosamine, 9.13 umol/L vs 0.14 umol/
L; glucose, 1.61 mmol/L vs 0.63 mmol/L; and
insulin, 46.0 pmol/L vs 12.6 pmol/L; respectively. However, overall, fasting plasma
glucose,
fructosamine, TG and
cholesterol levels were not significantly different between groups. Thus, in these patients, the high monounsaturated fat diet and the standard diet were similar with regard to usual indicators of
carbohydrate and lipid metabolism. A high monounsaturated fat diet appears to pose no risk to
lipoprotein metabolism in
NIDDM patients.