Reduction of Dipeptidyl Peptidase 4 Activity in Patients with Type 2 Diabetes Mellitus who Consumed fruits before Meals
Dwipajati(1), Dono Indarto (2), Paramasari Dirgahayu(3)
Nutrition Department, Health Polytechnic of Malang(1); Department of Physiology, Medical Faculty of Universitas Sebelas Maret(2); Faculty of Medicine, Universitas Sebelas Maret(3)
Abstract
Some patients with type 2 diabetes mellitus (T2DM) have high expression of dipeptidyl peptidase 4 (DPP4) enzyme that breaks down glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP1) hormones. During eating carbohydrate, K and L cells in the human small intestine produce GIP and GLP1 respectively that stimulate pancreatic β cells to release insulin. Recent evidence has revealed that fruit consumption before meals reduces fasting blood glucose level in patients with T2DM. Therefore, the aim of this study was to investigate the effect of fruit consumption before meals on DPP4 activity among patients with T2DM. A randomized control trial study with pre-posttest control group design was performed in 19 T2DM patients. They were randomly divided into 2 groups: 10 in the control (C) group eating a standardized diet and the other in the treatment (T) group eating fruit before consumption of standard diet. Fasting and post prandial serum DPP4 activities were measured using a H-Gly-Pro-pNA substrate in the 1st and 7th day-s intervention. Kruskal Wallis and paired t tests were used to analyze mean DPP4 activity in both groups with p value < 0.05. In 1st day intervention, mean fasting DPP4 activity in the C group (189.42+116.27 nmol/ min/ mg protein) was higher than mean fasting DPP4 activity in the T group (121.75±74.86 nmol/ min/ mg protein). Reduced post prandial DPP4 activity was found in the C group (111.84±71.05) and increased in the T group (143.99+72.41). After 7 days intervention, reduction of fasting and post prandial DPP4 activities was observed in the C and T groups respectively. Meanwhile, mean fasting DPP4 activity in the T group remained unchanged and increased post prandial DPP4 activity was in the C group. Fruit consumption before meals reduces fasting and increases post prandial DPP4 activities in patients with T2DM.
Keywords: Type 2 diabetes mellitus, Fruit consumption, DPP4 activity
Topic: Nutrition and Functional Food