Premeal Load of Macronutrients as an Effective Nutritional Strategy to Control Postprandial Glycemia

Objective: Effective glycemic management is of paramount importance for individuals with prediabetes and type 2 diabetes (T2D). Specifically, controlling postprandial hyperglycemia (PPHG) appears to be a significant factor in regulating blood glucose levels, especially in the early stages of T2D. Consequently, controlling PPHG becomes a crucial goal in managing diabetes to mitigate the development of diabetic macrovascular disease. In this review, we aim to examine the existing body of evidence regarding premeal load and its impact on glucose disturbances in humans. Materials and methods: We scrutinize the role of proteins, fats, dietary fiber, fructose, and edible nuts such as almonds, in their capacity to influence postprandial glucose excursions. To identify articles investigating the effects of premeal load on glycemia, we conducted a comprehensive literature search using the PubMed medical search database (National Library of Medicine, Bethesda, MD, USA) from 1966 to August 2023. Results: The incorporation of these nutrients as premeal load components in conventional dietary regimens stands as an effective strategy to decrease postmeal blood glucose levels and, in some cases, restore glycemic homeostasis to a normative state. These favorable outcomes can be attributed to alterations in gastric emptying kinetics, modulation of incretin hormones, and dynamic interactions with the gut microbiota. Conclusions: The customization of dietary patterns to encompass these components as premeal load holds the promise for glycemic regulation, particularly among high-riskpopulations, such as individuals of Asian Indian descent, who are disproportionately susceptible to prediabetes and T2D.