SOURCE: Jakubowicz K, et al. Fasting until noon triggers increased postprandial hyperglycemia and impaired insulin response after lunch and dinner in individuals with type 2 diabetes: A randomized clinical trial. Diabetes Care 2015;38:1820-1826.

Primary education (grades K-6) teachers have parroted the mantra “breakfast is the most important meal of the day” to children and parents alike for at least 60 years. Although I’m not quite sure whether our grandparents’ teachers also had the same party line, it wouldn’t surprise me in the least. Before continuing further I must confess to my own breakfast pathology: Since my teens, I have happily consumed a 12-ounce Mountain Dew and a Chunky candy bar for breakfast every morning, eschewing coffee or anything that required more preparation than tearing open the single-layer silvery Chunky wrapper. After ingesting this carbohydrate/caffeine concert, I am happy to abstain from further calories until noon or later, after which I employ what you would call “normal” food.

It’s a good thing I don’t have type 2 diabetes (T2DM), because apparently the omission of breakfast wreaks havoc on carbohydrate metabolism later in the day in diabetics. To elucidate the phenomenon further, Jakubowicz et al compared glucose, fatty acid, and glucagon metrics in a population of T2DM patients, half of whom consumed breakfast and the other half did not. All meals were provided to subjects and standardized for caloric content. Subjects were randomly assigned to a crossover-design methodology.

Omission of breakfast was associated with less secretion of insulin and glucagon-like peptide and higher levels of free fatty acids, glucose, and glucagon. In an era where the expanding tools for management of T2DM are accompanied by a comparably expanded price, it’s nice to know that some simple lifestyle measures may enhance the opportunity for glucose control.