Carbohydrates-Last Food Order Improves Time in Range and Reduces Glycemic Variability

Advancements in continuous glucose monitoring technology allow nuanced assessment of glycemic control.Glycemic variability (GV) and time spent with glucose in target range time-in-range (TIR) are now recognized risk predictors for diabetes-related complications and are associated with cardiovascular risk, even for patients with well-controlled HbA 1c (1,2).Prior research by our group and others demonstrates that besides carbohydrate amount and type, the timing of carbohydrate consumption during a meal significantly impacts regulation of postprandial glucose levels (3-5).In acute crossover studies, consuming fibrous vegetables and protein 10 min before carbohydrate (i.e., carbohydrates-last [CL] food order) reduced incremental postprandial glucose peaks and glycemic variability for up to 3 h in comparison with the reverse sequence (carbohydrates-first [CF] food order) in patients with type 2 diabetes (T2D) (4).Here, in this study (clinical trial reg.no.NCT04738799, clinicaltrials.gov)we examine the glycemic effects of nutrient sequencing without a rest interval between consumption of meal components-under