Evidence mapPaperPMID 41683291Full record

Trial reportNutrients2026

The Impact of a Fat-Dominant Preload Before a Carbohydrate-Rich Meal on Glucose Homeostasis in Patients Without Diabetes After Sleeve Gastrectomy: A Proof-of-Concept, Randomised, Open-Label, Crossover Study.

Gráinne Whelehan, Louisa Y Herring, Aikaterina Tziannou, Joseph Henson, Alice E Thackray, David Bowrey, Jenny Abraham, Vinod Menon, Iskandar Idris, Helen Waller and 5 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Gráinne WhelehanDiabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK.ORCID 0000-0003-1391-4349
Louisa Y HerringDiabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK.ORCID 0000-0002-9592-6759
Aikaterina TziannouDiabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK.ORCID 0009-0009-3445-440X
Joseph HensonDiabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK.
Alice E ThackrayNIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester LE5 4PW, UK.ORCID 0000-0002-7800-3207
David BowreyDepartment of Surgery, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK.
Jenny AbrahamDepartment of General Surgery, University Hospitals Coventry & Warwickshire NHS Trust Coventry, Coventry CV2 2DX, UK.
Vinod MenonDepartment of General Surgery, University Hospitals Coventry & Warwickshire NHS Trust Coventry, Coventry CV2 2DX, UK.
Iskandar IdrisWarwick Medical School, University of Warwick, Coventry CV4 7AL, UK.ORCID 0000-0002-7548-8288
Helen WallerDiabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK.
David J StenselNIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester LE5 4PW, UK.ORCID 0000-0001-9119-8590
David R WebbDiabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK.
Thomas YatesDiabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK.
Melanie J DaviesDiabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK.ORCID 0000-0002-9987-9371
Dimitris PapamargaritisDiabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK.

Funding

Health Education East Midlands (HEEM) Starter Grant Award for Clinical Lecturers 123456National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC) 123456
6 · The paper itself

Abstract

BACKGROUND/

objectivesSleeve gastrectomy (SG) improves glycaemic control; however, it also markedly accelerates gastric emptying, which can lead to exaggerated postprandial glucose and insulin excursions and, in some cases, postprandial hyperinsulinaemic hypoglycaemia. In non-surgical populations, fat preloads can reduce postprandial glycaemia by slowing gastric emptying, but their effects after SG are unclear.

methodsTen adults >1-year post-SG completed a randomised, open-label, crossover study involving two mixed-meal tolerance tests (MMTTs), preceded (-30 min) by either a moderate, fat-dominant preload (28 g Brazil nuts) or 100 mL water (control). Blood samples were collected over three hours to assess plasma glucose, insulin, c-peptide, and total glucagon-like peptide-1 (GLP-1). Hypoglycaemia and dumping symptoms were assessed using validated questionnaires. Nadir plasma glucose concentration was the primary outcome.

resultsNadir plasma glucose was identical between conditions (both 3.8 mmol/L; 95% CI: -0.4, 0.3, DISCUSSION: A moderate, fat-dominant preload consumed before a mixed meal did not alter nadir or overall postprandial glucose in adults without diabetes after SG. However, the preload was associated with higher peak insulin secretion, a finding that should be interpreted with caution, as the study was not powered for secondary outcomes. Given the unique gastrointestinal physiology after SG, further research is needed to determine how different nutrient compositions or timing approaches influence postprandial glucose homeostasis in this population.

Indexed as

Blood GlucoseDietary CarbohydratesDietary FatsGastrectomyAdultC-PeptideCross-Over StudiesFemaleGastric EmptyingGlucagon-Like Peptide 1HomeostasisHumansInsulinMaleMealsMiddle AgedBlood GlucoseC-PeptideDietary CarbohydratesDietary FatsGlucagon-Like Peptide 1Insulinbariatric surgeryc-peptidefat-dominantglucagon-like peptide-1glucoseglucose homeostasisinsulinpreloadsleeve gastrectomy

Identifiers

PMID41683291
PMCPMC12899494

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.