Effect of Food Order on Ghrelin Suppression

Data suggest that the temporal sequence of carbohydrate ingestion during a meal has a significant impact on postprandial glucose (1–3), insulin, and glucagon-like peptide 1 (GLP-1) excursions (4) in type 2 diabetes, while the effects on ghrelin suppression and satiety have not been reported. The study design and methods have previously been described in detail (4). Briefly, using a crossover design, 16 subjects with overweight/obesity and metformin-treated type 2 diabetes were assigned to consume the same meal on 3 days in random order: Blood was sampled for glucose, insulin, active GLP-1, and total ghrelin measurements at baseline (just before meal ingestion) and at 30-min intervals up to 180 min. Participants rated their hunger and fullness levels using a visual analog …