Plasma glucose and insulin responses after consumption of breakfasts with different sources of soluble fiber in type 2 diabetes patients: a randomized crossover clinical trial
Plasma glucose and insulin responses after consumption of breakfasts with different sources of soluble fiber in type 2 diabetes patients: a randomized crossover clinical trial
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DOI：
10.3945/ajcn.117.157263
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发表时间：
2017-11-01
影响因子：
7.1
通讯作者：
Azevedo, Mirela J.
中科院分区：
文献类型：
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作者：
de Carvalho, Claudia M.;de Paula, Tatiana P.;Azevedo, Mirela J.
背景：碳水化合物的数量和质量是影响餐后血糖的重要因素。至于纤维含量，目前尚不清楚从食物或补充剂中摄入可溶性纤维是否对降低餐后血糖有同样有益的作用。目的：本研究的目的是比较普通膳食后从食物或补充剂中摄入可溶性纤维对2型糖尿病(T2D)患者餐后血糖和血浆胰岛素的急性影响。设计：对T2D患者进行随机交叉临床试验。患者食用等卡路里早餐(平均+/-SD：369.8+/-9.4千卡)，从饮食来源获得的高纤维(总纤维：9.7g；可溶性纤维：5.4g)，从瓜尔豆胶补充剂中获得的高含量的可溶性纤维(总纤维：9.1g；可溶纤维：5.4g)，以及正常数量的纤维(总纤维：2.4g；可溶纤维：0.8g)。主要结果是餐后血糖和胰岛素(0-180min)。结果：19例患者[年龄65.8±-7.3岁；中位数(IQR)，T2D病程10(5-9)年；糖化血红蛋白7.0%+/-0.8%；体重指数(kg/m(2))28.2+/-2.9]共完成57项膳食试验。早餐后血糖曲线下增量面积[mg/dL.min；平均值(95%CI)]在饮食高纤维组[7861(6257,9465)]和补充剂高纤维组[7847(5605，10,090)]之间差异无统计学意义(P=1.00)，两者均低于普通纤维组[9527(7549，11,504)](P=0.014和P=0.037)。IAUC[MU IU/mL.min；Mean(95%CI)]差异无统计学意义(P=0.877)：HFS3781(2513,5050)，HFS[4006(2711,5302)，UF[4315(3027,5603)]。结论：T2D患者早餐时纤维摄入量较高与餐后血糖较低有关，从食物和补充剂中摄取可溶性纤维具有相似的作用。
Background: The amount and quality of carbohydrates are important determinants of plasma glucose after meals. Regarding fiber content, it is unclear whether the intake of soluble fibers from foods or supplements has an equally beneficial effect on lowering postprandial glucose.Objective: The aim of our study was to compare the acute effect of soluble fiber intake from foods or supplements after a common meal on postprandial plasma glucose and plasma insulin in patients with type 2 diabetes (T2D).Design: A randomized crossover clinical trial was conducted in patients with T2D. Patients consumed isocaloric breakfasts (mean +/- SD: 369.8 +/- 9.4 kcal) with high amounts of fiber from diet food sources (total fiber: 9.7 g; soluble fiber: 5.4 g), high amounts of soluble fiber from guar gum supplement (total fiber: 9.1 g; soluble fiber: 5.4 g), and normal amounts of fiber (total fiber: 2.4 g; soluble fiber: 0.8 g). Primary outcomes were postprandial plasma glucose and insulin (0-180 min). Data were analyzed by repeated measures ANOVA and post hoc Bonferroni test.Results: A total of 19 patients [aged 65.8 +/- 7.3 y; median (IQR), 10 (5-9) y of T2D duration; glycated hemoglobin 7.0% +/- 0.8%; body mass index (in kg/m(2)) 28.2 +/- 2.9] completed 57 meal tests. After breakfast, the incremental area under the curve (iAUC) for plasma glucose [mg/dL.min; mean (95% CI)] did not differ between high fiber from diet (HFD) [7861 (6257, 9465)] and high fiber from supplement (HFS) [7847 (5605, 10,090)] (P = 1.00) and both were lower than usual fiber (UF) [9527 (7549, 11,504)] (P = 0.014 and P = 0.037, respectively). iAUCs [mu IU/mL.min; mean (95% CI)] did not differ (P = 0.877): HFD [3781 (2513, 5050)], HFS [4006 (2711, 5302), and UF [4315 (3027, 5603)].Conclusions: Higher fiber intake was associated with lower postprandial glucose at breakfast, and the intake of soluble fiber from food and supplement had a similar effect in patients with T2D.