By Max Bingham, PhD Skipping breakfast likely leads to alterations in the way circadian clock genes are expressed with the result being altered glucose regulation, particularly after lunch. According to Jakubowicz et al. ( p. 1573 ), this occurs in both healthy individuals and those with type 2 diabetes, but importantly it points to breakfast consumption as being a potential strategy for glycemic control in type 2 diabetes. Using a crossover study design, the authors randomly assigned healthy individuals ( n = 18) and individuals with established type 2 diabetes ( n = 18) to a test day with breakfast and lunch and a day with only lunch. Clock-related gene expression was then assessed in blood samples before and after the meals, along with plasma glucose, insulin, glucagon-like peptide 1 (GLP-1), and dipeptidyl peptidase IV activity. Skipping breakfast did alter gene expression, but in both healthy individuals and individuals with type 2 diabetes. Skipping breakfast also resulted in a notable drop in insulin response after lunch in individuals with type 2 diabetes while the glucose spike following lunch was much greater. In both groups, GLP-1 response was ∼35% lower when breakfast was skipped. While the authors cover a number of genes involved in circadian rhythms, they highlight specifically that Ampk expression levels fell when breakfast was skipped but were upregulated when it was consumed. The significance? AMPK activation is known to stimulate glucose uptake, so the upregulation probably indicates improved glycemic control. According to author Oren Froy: “As breakfast skipping adversely affects clock and clock-controlled gene expression and is correlated with increased postprandial glycemic response, consumption of breakfast should be an important strategy when targeting glycemic control in type 2 diabetes. In addition, as the circadian clock controls …

中文翻译：

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在本期糖尿病护理中

麦克斯·宾汉姆（Max Bingham）博士跳过早餐很可能会导致昼夜节律基因表达方式的改变，结果是葡萄糖调节的改变，尤其是午餐后。根据Jakubowicz等人的说法。（p。1573），健康人群和2型糖尿病患者均会发生这种情况，但重要的是，这表明早餐是2型糖尿病控制血糖的一种潜在策略。使用交叉研究设计，作者将健康个体（n = 18）和患有2型糖尿病的个体（n = 18）随机分配到测试日（含早餐和午餐）和仅午餐（含午餐）的一天。然后在饭前和饭后在血液样本中评估与时钟相关的基因表达，以及血浆葡萄糖，胰岛素，胰高血糖素样肽1（GLP-1）和二肽基肽酶IV的活性。跳过早餐确实改变了基因表达，但在健康个体和2型糖尿病个体中均如此。不吃早餐还会导致2型糖尿病患者午餐后胰岛素反应显着下降，而午餐后的血糖峰值则要大得多。在两组中，不吃早餐时，GLP-1应答降低约35％。尽管作者涵盖了许多与昼夜节律有关的基因，但他们特别指出，跳过早餐时Ampk的表达水平下降，但食用时却被上调。意义？已知AMPK激活可刺激葡萄糖摄取，因此上调可能表明血糖控制得到改善。根据作者Oren Froy的说法：“由于不吃早餐会影响时钟和时钟控制的基因表达，并且与餐后血糖反应增加有关，因此，在控制2型糖尿病的血糖控制时，早餐的摄入应该是一项重要策略。此外，作为生物钟控制...