Non-Insulin-Treated Diabetics Should Eat Breakfast

Background:  DM patients on insulin shouldn’t skip meals; but what about non-insulin treated diabetics?
n = 22, mean age 57, mean A1c = 7.7% on diet only or metformin
All studied on a three-meal day, and then again on a day when they skipped breakfast
Meals were standardized (research meals), so only difference was breakfast or not.
No breakfast days:  mean peak glucose after lunch and dinner significantly higher (by 40 and 25%, respectively), and post-meal insulin levels lower.
Higher levels of FFAs and lower levels of GLP-1 on no-breakfast days (these both have downstream effects of raising glucose levels).
Conclusion:  Skipping breakfast hurts your glucose homeostasis later in the day.  May be the “second-meal phenomenon” where the first meal of the day enhances beta-cell responsiveness (and thereby better glucose homeostasis) later in the day.
Diabetes Care 2015 Oct; 38:1820

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