Glycemic Impact of Hospital Food (Breakfast) among Patients with Type-2 Diabetes Mellitus — ASN Events

Glycemic Impact of Hospital Food (Breakfast) among Patients with Type-2 Diabetes Mellitus (#198)

Wei-Ling Chiu 1 , Chris Gilfillan 2 , Anita Wilton 3
  1. MBChB, BSci; Department of Medicine, Eastern Health, Melbourne
  2. MBBS, PhD, FRACP; Department of Medicine, Eastern Health, Melbourne
  3. APD, Department of Dietetics, Eastern Health , Melbourne

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.    

  1. 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.