11-18-2017 | Diet | Book chapter | Article
11. Fiber in Type 2 Diabetes Prevention and Management
Author: Mark L. Dreher
Publisher: Springer International Publishing
Abstract
The prevalence of prediabetes and diabetes has increased globally in parallel with the rising levels of obesity in adults and children, a phenomenon sometimes called diabesity. If this global trend continues, by 2030 an estimated one billion people are expected to have prediabetes and diabetes.
As much as 90% of diabetes risk management is attributed to modifiable risk factors such as diet and physical activity and their effect on increased risk of overweight and obesity.
Prospective cohort studies consistently show that increased intake of total fiber and cereal fiber and lower glycemic index and glycemic load diets is effective in reducing diabetes risk.
Meta-analyses of randomized controlled trials (RCTs) including people with prediabetes and diabetes consistently show that increased fiber intake from diets and supplements significantly lowers fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) levels compared to control diets.
Whole oat products such as oatmeal and psyllium, a gel-forming, low fermentable fiber supplement, have been shown clinically to be among the most effective fiber sources in lowering FBG and HbA1c in diabetic and prediabetic individuals compared to placebo.
The primary mechanisms related to adequate fiber intake and diabetes prevention and management are (1) reducing the risk of obesity and visceral fat accumulation, (2) promoting and maintaining a healthy microbiota ecosystem, (3) attenuating elevated systemic inflammation, and (4) controlling postprandial and fasting glycemic responses and protecting against insulin resistance.