Continuous Glucose Monitoring to assess glycaemic excursions following mid-meal consumption of standard care hospital biscuits or Lupin-enriched biscuits: A pilot study in surgical patients with type 2 diabetes.

The aim of the study was to examine the effect of lupin mid-meal biscuit snacks, compared to wholemeal spelt or standard hospital biscuits, on interstitial glucose levels in post-operative patients with Type 2 Diabetes Mellitus (T2DM). In a cross-over study design, twenty hospital patients with T2DM (mean age 74 years and mean BMI 31 kg/m2) were asked to consume, in order, lupin biscuits (20% lupin, equivalent to a total of 1 tablespoon lupin flour), wholemeal spelt and standard plain sweet biscuits as mid-meal snacks (4 biscuits per day; 2 each for morning and afternoon tea) on three consecutive treatment days. Participants utilised continuous glucose monitoring (CGM) and appetite perceptions and bowel motions were evaluated by questionnaires. Interstitial glucose levels were not significantly different in the first 90 minutes after consumption of the mid-meal biscuits at morning and afternoon tea, irrespective of type. However, after consumption of the lupin biscuits on day 1, interstitial glucose levels dropped significantly 90 minutes postprandially after dinner, which was not observed after the other two treatments. Additionally, patients reported feeling less hungry and fuller after consuming the lupin biscuits on day 1, compared to days 2 and 3 of the study. These findings suggest that due to the potential beneficial physiological role of small amounts of lupin flour on glycaemic control, hospital menu standards could be revised to include low glycaemic index, high fibre and high protein lupin-based mid meal snacks as a means to improve in patient glycaemic control and reduced hospital length of stay.