Useful meal tolerance test (MTT) for carbohydrate amount and post-prandial blood glucose

Background: Low carbohydrate diet (LCD) has been effective for type 2 diabetes mellitus (T2DM), because of less post-prandial increase of blood glucose.
Case presentation: The case is 62-year-old male with T2DM, who had experience of LCD a few years ago. He developed diabetic exacerbation as HbA1c 10.7% in autumn 2021.
Results: He began super-LCD with 12% of carbohydrate in calorie ratio, and recorded the pictures of detail food intake every day and 45-minunte post-prandial blood glucose for long. His HbA1c decreased to 7.1% for 9 weeks. For breakfast, carbohydrate amount varies from 19.7 g to 51.1g, and 45-min post-prandial blood glucose distribute 121mg/dL to 226mg/dL. The relationship between carbohydrate amount in breakfast and 45-min post-prandial blood glucose was investigated. As a result, significant correlation was observed between them (R2=0.46, p<0.05). Regression curve revealed y=2.5897x+73.226, in which the slope of the straight line is 2.6.
Discussion and Conclusion: Obtained data may suggest that carbohydrate 1g can increase post-prandial glucose 2.6mg/dL. As to the standard fact of carbohydrate metabolism in the textbook, 3.0mg/dL glucose increase per carbohydrate 1g has been observed. Restricted carbohydrate intake would be beneficial for improving glucose variability in T2DM.

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