Chronic Consumption of Short-Chain Fructooligosaccharides Does Not Affect Basal Hepatic Glucose Production or Insulin Resistance in Type 2 Diabetics

Abstract

Short-chain fructooligosaccharides (FOS) are prebiotics, which escape digestion in the small intestine and are fermented by the colonic microflora into short-chain fatty acids. Recently, we found that the daily consumption of 20 g FOS decreased basal hepatic glucose production in healthy subjects without any effect on insulin-stimulated glucose metabolism. In this study, we evaluated the effects of the chronic ingestion of FOS on plasma lipid and glucose concentrations, hepatic glucose production and insulin resistance in type 2 diabetics. Type 2 diabetic volunteers (n = 10; 6 men, 4 women) received either 20 g/d FOS or sucrose for 4 wk in a double-blind crossover design. FOS did not modify fasting plasma glucose and insulin concentrations or basal hepatic glucose production. The plasma glucose response to a fixed exogenous insulin bolus did not differ at the end of the two periods. Erythrocyte insulin binding also did not differ. Serum triacylglycerol, total and HDL cholesterol, free fatty acid, apolipoproteins A1 and B and lipoprotein (a) concentrations were not modified by the chronic ingestion of FOS. We conclude that 4 wk of 20 g/d of FOS had no effect on glucose and lipid metabolism in type 2 diabetics.

Do SCFA have a role in appetite regulation?

“…One study reported daily supplementation with 14 g Jerusalem Artichoke concentrate (containing OF) for 12 weeks significantly reduced BMI and % body fat levels (59) , while another reported daily supplementation with 21 g OF significantly reduced BW, fat mass and central fat mass (60) . However, none of the other studies found a significant influence of inulin-type fructan supplementation on BW post-intervention (59,65,66,(68)(69)(70)(71)(72) or on food intake during the intervention (65)(66)(67)(68) .…”

“…Less compelling is anthropometric and food intake data from chronic intervention studies, although these were not the main outcomes of interest for all studies (65)(66)(67)(68)(69)(70)(71)(72) except for two (59,60) . One study reported daily supplementation with 14 g Jerusalem Artichoke concentrate (containing OF) for 12 weeks significantly reduced BMI and % body fat levels (59) , while another reported daily supplementation with 21 g OF significantly reduced BW, fat mass and central fat mass (60) .…”

Impact of Diet Composition on Blood Glucose Regulation

“…Luo et al (1996) were the first to show that 20 g of short chain fructans given for four weeks in healthy subjects decreased basal hepatic glucose production, but had no detectable effect on insulin-stimulated glucose metabolism. In T2DM subjects, no significant modification of glucose homeostasis (plasma glucose level or hepatic glucose production) occurred in prebiotic-treated patients (Luo et al, 2000). In a similar study conducted in hypercholesterolemic patients, fructan-prebiotics reduced the PPI response, but the clinical relevance of this effect remains unclear (Giacco et al, 2004).…”

Gut Microbiota and the Pathogenesis of Insulin Resistance

“…In type 2 diabetic patients, no significant modification of glucose homeostasis (plasma glucose level, hepatic glucose production) occurred in prebiotics-treated patients [57]. In a similar study conducted in hypercholesterolemic patients, prebiotics (inulin-type fructans) treatment reduced the postprandial insulin response, but the clinical relevance of this effect remained unclear [58].…”