Postprandial Plasma Glucose and Insulin Responses with Different Sources of Soluble Fiber in Type 2 Diabetes Patients: A Randomized Crossover Clinical Trial

Presentation Number: SUN 637
Date of Presentation: April 2nd, 2017

Mirela J Azevedo*1, Claudia Mesquita de Carvalho2, Tatiana Pedroso de Paula2, Vitoria Muller Testa Machado2, Jussara Carnevale Almeida3 and Luciana Vercoza Viana4
1Hospital de Clinicas de Porto Alegre, Brazil, 2Hospital de Clinicas de Porto Alegre, 3Hospital de Clinicas de Porto Alegre, Porto Alegre - RS, Brazil, 4HCPA - Hospital de Clinicas de Porto Alegre, PORTO ALEGRE

Abstract

Background: Postprandial hyperglycemia, a risk factor for cardiovascular disease and mortality in patients with type 2 diabetes (1), can contribute up to 70 % on HbA1c levels (2). The fiber content of foods is an important determinant of postprandial glucose response. Moreover, a meta-analyses of randomized controlled trials showed that an increase of fiber intake, from foods or supplements decreased HbA1c (3); however, it is unclear if soluble fibers from foods have the same beneficial effects than supplements. The aim of this study was to compare the acute effect of soluble fiber intake from foods or supplement on postprandial plasma glucose and insulin in patients with type 2 diabetes.

Methods: A randomized, open label, crossover clinical trial was conducted in patients with type 2 diabetes. Patients consumed three isocaloric breakfasts (meal tests 369.8±9.4kcal), with one-week washout period between them: 1) high content of soluble fiber from food sources (HFD; 9.7g), 2) high content of soluble fiber from supplement (HFS; 9.1g), and 3) usual fiber content (UF; 2.5g). The primary outcomes were postprandial responses of plasma glucose and insulin (0-180 min). Data were analyzed by repeated measures ANOVA and post hoc tests.

Results: A total of 19 patients [65.8±7.3 years, 10 (5-9) years of diabetes duration, HbA1c 7.0±0.8%, BMI 28.2±2.9 kg/m²] completed 57 meal tests. The areas under the curves (AUCs) for plasma glucose [mg/dL.min; mean(95%CI)] did not differ between HFD [7860.8 (6256.8-9464.8)] and HFS [7847.4 (5604.6-10090.1)] meals (p=1.00) and were both lower than UF meal [9526.6(7548.8-11504.4)] (p=0.014 and p=0.037, respectively). Insulin AUCs [uUi/mL.min; mean(95%CI)] did not differ (p=0.877) between breakfasts: HFD [3781.1(2512.7-5049.6)], HFS [4006.3(2711.1-5301.5), and UF [4314.9(3027.2-5602.7].

Conclusions: In patients with type 2 diabetes the intake of soluble fiber from foods or supplement in a usual meal results in the same glycemic response.

 

Nothing to Disclose: MJA, CMD, TPD, VMTM, JCA, LVV