Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non-insulin-dependent diabetes

Pastors, Joyce Green; Blaisdell, Peter W.; Balm, Timothy K.; Asplin, C. M.; Pohl, Stephen L.

doi:10.1093/ajcn/53.6.1431

Cited by 107 publications

(63 citation statements)

References 18 publications

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“…This result is similar to that obtained by Jarjis et al (1984) in healthy and in type 2 diabetic volunteers. Pastors et al (1991) found significant decreases for insulin after the administration of psyllium in type 2 diabetic patients, with a reduction (12%) higher than the reported in this study (5%). We have also found in a previous study (Sierra et al, 2001) carried out in healthy volunteers, a significant and higher reduction of insulin concentrations (36.1%) after the administration of ispaghula husk.…”

Section: Discussioncontrasting

confidence: 86%

“…In contrast, no significant differences were found after a 50 g glucose load Therapeutic effects of psyllium M Sierra et al administered with 3.5 or 7 g fibre to healthy subjects (Jarjis et al, 1984). The mean decrease of C max obtained in this study after the administration of psyllium (10%) was similar to that reported by Sartor et al (1981) after a standardized breakfast (9%), and lower than the indicated by Pastors et al (1991) at breakfast (14%) and at dinner (20%), and by Sierra et al (2001) in healthy subjects after a glucose load (15.5%).…”

Section: Discussionsupporting

confidence: 50%

“…Earlier studies reported that psyllium reduced fasting serum glucose concentrations in individuals with type 2 diabetes (Fagerberg, 1982) and in type 2 diabetic patients with chronic portalsystemic encephalopathy (Uribe et al, 1985). Other studies demonstrated that different preparations of ispaghula husk lowered postprandial serum glucose concentrations in type 1 (Florholmen et al, 1982), in type 2 diabetic patients (Sartor et al, 1981;Pastors et al, 1991;Anderson et al, 1999), in healthy volunteers (Sierra et al, 2001) and in both healthy and type 2 diabetic subjects (Jarjis et al, 1984). Fibre doses used were different, ranging from 3.6 g administered with breakfast (Florholmen et al, 1982) to 35 g per day administered as a dietary supplement (Uribe et al, 1985).…”

Section: Discussionmentioning

confidence: 98%

“…Ispaghula husk is a gel-forming (water-soluble) fibre which has been used in treatment for constipation for many years. During the last two decades, several studies have been carried out to investigate whether ispaghula interferes with normal intestinal absorption of carbohydrate in healthy volunteers (Jarjis et al, 1984;Sierra et al, 2001) and in type 1 (Florholmen et al, 1982;Uribe et al, 1985) and type 2 diabetic patients (Sartor et al, 1981;Jarjis et al, 1984;Pastors et al, 1991). The effect of psyllium on fasting plasma cholesterol in hypercholesterolaemic patients has also been evaluated (Bell et al, 1989) and in obese and diabetic patients (Frati-Munari et al, 1983).…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic effects of psyllium in type 2 diabetic patients

et al. 2002

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Objective: The aim of this study was to evaluate the effects of psyllium in type 2 diabetic patients. Design: The study included three phases: phase 1 (1 week), phase 2 (treatment, 14 g fibre=day, 6 weeks) and phase 3 (4 weeks). At the end of each phase a clinical evaluation was performed after the ingestion of a test breakfast of 1824.2 kJ (436 kcal). Measurements included concentrations of blood glucose, insulin, fructosamine, GHbA 1c , C-peptide and 24 h urinary glucose excretion. In addition, uric acid, cholesterol and several mineral and vitamin concentrations were also evaluated. Setting: The study was performed at the Department of Pharmacology, Toxicology and Nursing at the University of Leó n (Spain). Subjects: Twenty type 2 diabetic patients (12 men and 8 women) participated in the study with a mean age of 67.4 y for men and 66 y for women. The mean body mass index of men was 28.2 kg=m 2 and that of women 25.9 kg=m 2 . Results: Glucose absorption decreased significantly in the presence of psyllium (12.2%); this reduction is not associated with an important change in insulin levels (5%). GHbA 1c , C-peptide and 24 h urinary glucose excretion decreased (3.8, 14.9 and 22.5%, respectively) during the treatment with fibre (no significant differences) as well as fructosamine (10.9%, significant differences). Psyllium also reduced total and LDL cholesterol (7.7 and 9.2%, respectively, significant differences), and uric acid (10%, significant difference). Minerals and vitamins did not show important changes, except sodium that increased significantly after psyllium administration. Conclusions:The results obtained indicate a beneficial therapeutic effect of psyllium (Plantaben 1 ) in the metabolic control of type 2 diabetics as well as in lowering the risk of coronary heart disease. We also conclude that consumption of this fibre does not adversely affect either mineral or vitamin A and E concentrations. Finally, for a greater effectiveness, psyllium treatment should be individually evaluated.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Therapeutic effects of psyllium in type 2 diabetic patients

et al. 2002

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“…Psyllium in a supplemental drink form, has been specifically shown to lower postprandial glycemia in individuals with Type 2 DM when consumed just before a meal (Anderson et al, 1999;Sierra et al, 2002) and to have a residual effect after a second meal (Pastors et al, 1991;Anderson et al, 1999). Few studies have examined second meal responses to soluble fiber (Pastors et al, 1991;Sierra et al, 2002), but there is limited data on glycemic load and soluble fiber in influencing Type 2 DM (Salmeron et al, 1997;Liu et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Effects of breakfast meal composition on second meal metabolic responses in adults with type 2 diabetes mellitus

et al. 2006

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Objective: We tested the relative importance of a low-glycemic response versus a high glycemic response breakfast meal on postprandial serum glucose, insulin and free fatty acid (FFA) responses after consumption of a standardized mid-day meal in adult individuals with Type 2 diabetes mellitus (DM). Design: Following an overnight fast of 8-10 h, a randomized crossover intervention using control and test meals was conducted over a 3-week-period. A fasting baseline measurement and postprandial measurements at various time intervals after the breakfast and mid-day meal were taken. Subjects: Forty-five Type 2 DM subjects completed the requirements and were included in the study results. Interventions: Two different breakfast meals were administered during the intervention: (A) a high glycemic load breakfast meal consisting of farina (kJ 1833; carbohydrate (CHO) 78 g and psylium soluble fiber 0 g), (B) a low-glycemic load breakfast meal consisting of a fiber-loop cereal (kJ 1515; CHO 62 g and psyllium soluble fiber 6.6 g). A standardized lunch was provided approximately 4 h after breakfast. Blood plasma concentrations and area under the curve (AUC) values for glucose, insulin and FFA were measured in response to the breakfast and mid-day lunch. Statistical analyses were performed using SAS software (8.02). Comparisons between diets were based on adjusted Bonferroni t-tests. Results: In post-breakfast analyses, Breakfast B had significantly lower area under the curve (AUC) values for plasma glucose and insulin compared to Breakfast A (Po0.05) (95% confidence level). The AUC values for FFA were higher for Breakfast B than for Breakfast A (Po0.05) (95% confidence level). Post-lunch analyses indicated similar glucose responses for the two breakfast types. Insulin AUC values for Breakfasts B were significantly lower than Breakfast A (Po0.05) (95% confidence level). The AUC values for FFA were unaffected by breakfast type. Conclusions: These data indicate that ingesting a low-glycemic load meal containing psyllium soluble fiber at breakfast significantly improves the breakfast postprandial glycemic, insulinemic and FFA responses in adults with Type 2 DM. These data revealed no residual postprandial effect of the psyllium soluble fiber breakfast meal beyond the second meal consumed. Thus, there was no evidence of an improvement postprandially in the glycemic, insulinemic and FFA responses after the consumption of the lunch meal. Sponsorship: This study was supported with an unrestricted grant from Kellogg Company, Battle Creek, Michigan.

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Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non-insulin-dependent diabetes

Cited by 107 publications

References 18 publications

Therapeutic effects of psyllium in type 2 diabetic patients

Therapeutic effects of psyllium in type 2 diabetic patients

Effects of breakfast meal composition on second meal metabolic responses in adults with type 2 diabetes mellitus

Cereal‐Based Functional Foods

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