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Serum Glucose and Insulin Response to Mango and Papaya in Type 2 Diabetic Subjects

Kaniz Fatema, MSc
Biomedical Research Group, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka—1000, Bangladesh

Liaquat Ali, PhD*
Biomedical Research Group, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka—1000, Bangladesh

Mohammad H Rahman, MSc,
Biomedical Research Group, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka—1000, Bangladesh

Shahana Parvin, MBBS, MPhil
Biomedical Research Group, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka—1000, Bangladesh

Zahid Hassan, MBBS
Biomedical Research Group, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka—1000, Bangladesh

Abstract/ Executive Summary:

To rank Bangladeshi Mango and Papaya in terms of their Glycemic Index (GI) and Insulinemic Index (II), which are useful measures of glucose and insulin responses to a dietary component, thirteen type 2 diabetic subjects consumed, under a cross-over design, equi-carbohydrate amounts of mango (250 g), papaya (602 g) and white bread (the reference food, 63 g). Blood sample was drawn 5 times between 0h and 3h. Serum C-peptide was measured to evaluate Insulinemic status. Mango and Papaya showed higher serum glucose responses compared to that of bread. The similar glycemic responses of Papaya and Mango were reflected in their GI values. Papaya showed higher insulin response compared to both Mango and Bread (p 0.001). Papaya also showed significantly higher C-peptide–glucose ratio in comparison to that of Mango and Bread. The data suggest that equi-carbohydrate amount of Papaya and Mango produce higher glycemic response as compared to bread, but the two fruits are comparable regarding this property. The higher insulin response of papaya needs to be considered in case of therapeutic management of diabetic patients and in assessing the risk of atherogenesis due to hyperinsulinemia.

Keywords: Diabetes Mellitus; Glycemic Index; Insulinemic Index; Mango; Papaya; Dietary management

Location:

Start Date:

End Date:

Program Area: Resource Development and Management

Commodity: Mango, Papaya

Objectives:

The present work is the first one to investigate the fruits in this country under the series. Langra Mango (Mangifira Indica L) and Papaya (Carica Papaya L), being two of the most popular and available fruits in the country, have been chosen for this study.

Methodology:

2.1. Subjects Thirteen (13) Type 2 diabetic subjects (male 7 and female 6) were included in this study. The participants were selected from the BIRDEM Outpatient Department. Diabetes was diagnosed and classified by the WHO criteria. Patients with acute or chronic complications of diabetes mellitus and those using insulin, oral contraceptives or steroid were excluded. Pregnancy was also an exclusion criteria. All participants gave their written consent after being fully informed about the nature of the study. 2.2. Study design Detailed family history was taken, and clinical and biochemical findings were recorded in a predesigned case record form. The body weight, in kilogram, was measured by using appropriate scales (Detect-Medic, Detect Scales INC, USA). Body Mass Index and waist-hip ratio of the subjects were calculated by appropriate formula. The subjects were requested to fast overnight (8-10 hr) and suggested not to take medicine. An intravenous cannula was inserted into a superficial vein in the forearm, fasting blood samples were collected and meal was served. The meal was consumed within 15 min along with 200 ml water. Blood samples were then collected at 30, 60, 120 and 180 minutes. Separated serum was preserved at 40°C for future biochemical analysis. 2.3. Test meals Langra Mango (Mangifira Indica L) (250 g) and Papaya (Carica Papaya L) (602 g), having 50 g available carbohydrate in each fruit (calculated from a food table), were given to the subjects. White bread (63 g calculated by chemical analysis) was given as a reference meal. 2.4. Laboratory method Serum glucose was measured by glucose-oxidase method (Sera Pak, Bayer, USA), C-peptide was measured by an ELISA technique (DRG International Inc, Germany) and Fructosamine was measured by colorimetric method (Boaheringer-Mannheim, Germany). 2.5. Statistical analysis All analyses were done using the SPSS Windows Package. Experimental values were expressed as mean SD (standard deviation) or median (range) as appropriate. To compare results between two groups students t-test were performed where appropriate. ANOVA (Duncan) was performed to test the difference between means and Nonparametric (MannWhitney) test was done to calculate the difference of different test meals and Bonferroni ‘t’ test for ratio of different parameters. Integrated serum glucose values over the 3 hour time period was calculated by area under the curve using a mathematical model.

Source of Information: Nutrition Research 23 (2003) 9–14

Article Link (Online Journal):

Funding Source:

1.

Budget:

Total Budget (Tk.) :

Achievement/Findings:

Insulin is the central hormone in maintaining blood glucose homeostasis. In type 2 diabetes mellitus the absolute level of insulin may be low, normal or higher in the blood although there is always a relative insulin deficiency. In spite of the life-saving role of the hormone the level of higher insulin in blood (hyperinsulinaemia) has been shown to be associated with increased atherosclerosis leading to cardiovascular disorders. Due to this atherogenic role of insulin it is desirable to control the blood glucose of patients keeping the insulin levels as low as possible. In this context, serum C-peptide (a marker of insulin) measurement in the present study has an important implications. The results show that although GI is same for Papaya and Mango, the insulin response is substantially higher [reaching significant levels in case of absolute values and C-peptide Index in case of papaya. This insulin secretogogue property may have some advantages in cases of patients with low insulin levels, but in patients with normal or higher insulin levels this may not be desirable. In the absence of detailed biochemical investigations for insulin secretory capacity (or at least for insulin/C-peptide level measurements) it is difficult to assess the Insulinemic status of a subject. In these circumstances it seems that a cautious approach is necessary regarding the quantity of papaya advised. The physicians should also be aware of this property of papaya when an oral drug or insulin is prescribed. If a free choice is given, mango should be the preferred food for a diabetic patient whose insulin secretory status is unknown.

Knowledge Management: Journal