Postprandial glycemic effects of lactose-hydrolyzed milk supplemented with mulberry leaf and corn silk extracts in adults with type 2 diabetes: A randomized crossover trial

IF 2.6 Q3 NUTRITION & DIETETICS Clinical nutrition ESPEN Pub Date : 2025-04-03 DOI:10.1016/j.clnesp.2025.03.174

You Sun , Yong Zhang , Xiaokang Niu , Yan Liu , Lingling Xu , Yifan Wang , Qi Zhang , Jingjing He , Yinghua Liu , Kaishuai Zhang , Ran Wang , Jian He , Jie Guo

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Abstract

Background & aims

Lactose-hydrolyzed milk is widely used to address lactose intolerance. However, its monosaccharide content may rapidly increase postprandial blood glucose levels and heighten glycemic variability. We aimed to explore the effects of mulberry leaf and corn silk extracts (medicinal and edible homologous materials) and their supplementation in lactose-hydrolyzed milk on postprandial glycemic control in adults with type 2 diabetes.

Methods

Eligible participants in this crossover trial were randomized to four interventions, separated by a 7 d washout. Intervention foods were whole-grain bread (50 g carbohydrates) together with water, mulberry leaf and corn silk extracts (MCE), lactose-hydrolyzed milk (LHM), or lactose-hydrolyzed milk supplemented with mulberry leaf and corn silk extracts (LHM-MCE). Continuous glucose monitoring systems were used to collect fasting and postprandial interstitial glucose over 2 h after interventions and to calculate the incremental area under the curve (iAUC). Paired Wilcoxon signed-rank test was used to compare the difference in iAUC, 1-h postprandial glycemic (1h PG), 2h PG, maximum glycemic, and maximum glucose excursion from baseline across interventions.

Results

Twenty-eight adults with type 2 diabetes (55 ± 10 years old, fasting blood glucose: 6.93 ± 1.22 mmol/L) completed the trial. MCE was associated with lower levels of maximum glycemic (median of difference [interquartile range]: (−0.9 [−1.9, 0.4], P = 0.025) and maximum glucose excursion from baseline (−0.9 [−1.5, −0.03], P = 0.005) compared to water. LHM-MCE was associated with lower levels of 1h PG (−0.7 [−1.9, 0.4], P = 0.04), maximum glycemic (−0.9 [−2.2, 0.4], P = 0.014), and maximum glucose excursion from baseline (−1.0 [−2.3, −0.4], P = 0.003) compared to LHM.

Conclusions

Mulberry leaf and corn silk extracts may benefit postprandial glycemic control and their incorporation into lactose-hydrolyzed milk could be a promising dietary intervention for patients with type 2 diabetes.

Registration number of clinical trial

ChiCTR2400086442.

Website

https://www.chictr.org.cn/showproj.html?proj=235132.

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添加桑叶和玉米丝提取物的乳糖水解乳对成人2型糖尿病患者餐后血糖的影响：一项随机交叉试验

背景与目的：乳糖水解乳被广泛用于治疗乳糖不耐症。然而，其单糖含量可能会迅速增加餐后血糖水平和增加血糖变异性。本研究旨在探讨桑叶和玉米丝提取物（药用和食用同源物质）及其在乳糖水解乳中的添加对成人2型糖尿病餐后血糖控制的影响。方法：本交叉试验中符合条件的受试者被随机分为4个干预组，间隔为7天的洗脱期。干预食物为全麦面包（50 g碳水化合物）加水、桑叶和玉米丝提取物（MCE）、乳糖水解乳（LHM）或乳糖水解乳中添加桑叶和玉米丝提取物（LHM-MCE）。使用连续血糖监测系统收集干预后2小时内空腹和餐后间质血糖，并计算曲线下增量面积（iAUC）。采用配对Wilcoxon符号秩检验比较iAUC、餐后1小时血糖（1h PG）、2h PG、最大血糖和最大葡萄糖偏离基线的差异。结果：28例成人2型糖尿病患者（55±10岁，空腹血糖：6.93±1.22 mmol/L）完成试验。与水相比，MCE与较低的最大血糖水平（差异中位数[四分位数范围]:-0.9 [-1.9,0.4]，P=0.025）和最大葡萄糖偏离基线（-0.9 [-1.5,-0.03]，P=0.005）相关。与LHM相比，LHM- mce与较低的1h PG水平（-0.7 [-1.9,0.4]，P=0.04）、最大血糖水平（-0.9 [-2.2,0.4]，P=0.014）和最大葡萄糖偏离基线水平（-1.0 [-2.3,-0.4]，P=0.003）相关。结论：桑叶和玉米丝提取物可能有助于餐后血糖控制，将其加入乳糖水解乳中可能是一种有希望的2型糖尿病患者饮食干预措施。临床试验注册号：ChiCTR2400086442。网站:https://www.chictr.org.cn/showproj.html?proj=235132。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.