Are Lipid Panels Altered by a Large Lunch Meal in Type 2 Diabetes?

Introduction: Recently, analyses of large heterogeneous databases have suggested that there are no differences whether “lipid panels” are drawn in the fed or fasted state, even in diabetic individuals. Whether this is true for individual diabetic patients is unknown. Methods: We studied eight type 2 diabetic individuals and measured serial lipid panels to determine the effect of a large lunch meal. A “Big Mac” equivalent meal was fed to each volunteer and blood for lipid assays was obtained at baseline and hourly for five hours following the meal. Results: The meal induced a significant elevation of glucose, insulin, and c-peptide in each volunteer. In addition, the following lipid parameters significantly changed from baseline concentration during the meal: total cholesterol, non-HDL cholesterol, LDL-cholesterol and triglycerides. Furthermore, the timing of the blood draw post meal also was a determinant of the lipid concentration. No significant concentration change occurred in HDL-cholesterol. Conclusions: In type 2 diabetic patients, lipid panels should be drawn in the fasting state unless the only lipid parameter of interest is HDL-cholesterol.