Glycemic Impact of Hospital Food (Breakfast) among Patients with Type-2 Diabetes Mellitus (#198)
Background: Hospital is ideally a place where patients recuperate. The nutritional values of food provided naturally play an important role. Sparse data are available on how hospital food affects diabetic patients' glucose control. In a prospective study, we aimed to examine the nutritional contents and glycemic impact of hospital breakfast among patients with Type-2 Diabetes Mellitus (T2DM).
Methods: Patients with T2DM on diet-control alone or oral hypoglycemic agents were recruited at Maroondah Hospital at least 24 hours post-admission. Patients with T1DM, insulin-requiring, on modified diet, and fasting were excluded. Capillary blood glucose levels (BGL) were measured no more than 30 minutes before and 2 hours after breakfast using calibrated Roche Accu-Chek Performa Nano meters with strict protocols. Food/drinks were weighed before and after eating. Patients were interviewed to ensure no foods/drinks from sources other than the meal tray had been consumed.
Results: Data were available from 25 patients for analysis. Sixty-eight percent and 84% of the patients had pre- or post-prandial BGL ≥6.1mmol/L or ≥7.8mmol/L, respectively. There was significant difference between fasting and post-prandial BGL (p<0.001) with a mean difference of 4mmol/L. Of the foods available at breakfast, the most common foods consumed by the patients were wholemeal bread, margarine and low-fat milk. None of the foods available independently resulted in significant BGL excursions. The macronutrients most and least consumed were carbohydrates and fibres, respectively (50.2±6.1g (mean±SEM) vs 4.6±0.6g). No macronutrient components were independently associated with significant BGL excursions.
Conclusions: Breakfast foods available at Maroondah Hospital for diabetic patients were limited to a range of food high in carbohydrates and low in fibres. Most patients had undesirable pre- and post-prandial BGL, likely indicating the generally sicker population. The availability of a wider range of food choices, including lower carbohydrate options, is desirable, with further studies required to investigate glycemic benefits of introducing such food.
- Clark CA, Gardiner J, McBurney MI, et al. Effects of breakfast meal composition on second meal metabolic responses in adults with Type 2 diabetes mellitus. Eur J Clin Nutr 2006;60:1122-9.