Metabolic effects of high-carbohydrate, high-fiber diets for insulin-dependent diabetic individuals

Abstract

The metabolic effects of high-carbohydrate (70%), high-fiber (70 g) (HCHF) and low-carbohydrate (39%), low-fiber (10 g) (LCLF) diets were examined for 10 subjects with insulin-dependent diabetes mellitus (IDDM). After a 1-wk control period subjects on a metabolic ward were randomly allocated to HCHF or LCLF diets for 4 wk. After a 6-wk washout period subjects re-entered the metabolic ward for 4 wk on the alternate diet. Artificial-pancreas studies were performed on each diet for measurement of insulin requirements. Compared with the LCLF diet, the HCHF diet reduced basal insulin requirements (P less than 0.025), increased carbohydrate disposed of per unit insulin (P less than 0.0008), and lowered total (P less than 0.0004) and high-density-lipoprotein cholesterol (P less than 0.0013). Glycemic control and other lipid fractions did not differ significantly. These results suggest that in IDDM patients, HCHF diets enhance peripheral glucose disposal, decrease basal insulin requirements, and lower total cholesterol without altering glycemic control or triglycerides.

Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes

“…Of these reports, 226 were excluded based on other criteria, leaving 41 trials (39 reports) that satisfied the inclusion criteria but did not meet the exclusion criteria, of which 11 trials (ten reports) investigated pulses alone, 19 trials (19 reports) investigated pulses in a low-GI dietary intervention, and 11 trials (ten reports) investigated pulses in a high-fibre dietary intervention. Tables 1, 2, and 3 show the characteristics of the 41 randomised controlled experimental trials included in each of the three meta-analyses: pulses alone [45][46][47][48][49][50][51][52][53][54], pulses in low-GI diets [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] and pulses in highfibre diets [55][56][57][58][59][60][61][62][63][64]. The 11 trials (ten reports) investigating pulses alone (Table 1) were predominantly crossover in design (seven trials, five of which had a washout period), studied a total of 253 participants (type 2 diabetes, n=21; normoglycaemia and/or hypercholesterolaemia, n=232) and had a mean sample size of 23.…”

Diabetes mellitus and the stomach

“…An open crossover study in 10 patients with Type I diabetes showed that the consumption of a high-fibre and low-carbohydrate diet for 4 weeks enhanced the peripheral glucose disposal and decreased the basal insulin requirements but did not alter glycaemic control [133]. In 15 patients with Type II diabetes, the addition of 15 g guar gum to the daily diet for 48 weeks resulted in an improvement of long-term glycaemic control, postprandial glucose tolerance and lipid concentrations [134].…”

Dietary fiber and cardiovascular disease: Experimental and epidemiologic advances

“…Dietary fiber-rich interventions have been shown to lower serum insulin and glucose concentrations as well as improve insulin sensitivity [16,17]. More recent trials have studied the long-term glycemic effects of purified fibers.…”