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 Researchers focused on supplements containing viscous fiber, a type
of soluble fiber that forms a thick gel when mixed with water. Foods
like legumes, asparagus, oats, and flax contain viscous fiber;
supplements with this type of fiber include guar gum, psyllium and
pectin.
To examine the connection between viscous fiber supplements and
blood sugar, researchers examined data from 28 clinical trials with
a total of 1,394 participants with diabetes. People were randomly
chosen to take viscous fiber supplements or to use other types of
supplements without viscous fiber or no supplements at all.
Among the people taking viscous fiber supplements, half consumed
doses above 13 grams daily, for periods ranging from three weeks to
a year. Compared to participants who didn't take viscous fiber,
those who did had better blood sugar control. They had lower levels
of hemoglobin A1c, which reflects average blood sugar over about
three months. They also had lower blood sugar levels on an empty
stomach, known as fasting glucose levels.
These results "suggest that intake of around 1 tablespoon of
concentrated viscous fibers such as konjac, guar, pectin or psyllium
would result in reductions in A1c and other diabetes risk factors,"
said senior study author Dr. Vladimir Vuksan of St. Michael's
Hospital and the University of Toronto in Canada.
People with diabetes have long been advised to consume more fiber as
one way to help lower their blood sugar. But many, particularly
those who follow a typical Western diet with lots of meat and
potatoes, don't get anywhere near enough fiber to make a meaningful
difference in diabetes, the study authors note in Diabetes Care.
Supplements have become an increasingly common way for these
patients to get more fiber. While the reason viscous fiber seems to
lower blood sugar isn't clear, scientists think that it might work
in a variety of ways, including improving microbial health in the
gut.
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Most trials in the study focused on hemoglobin A1c levels. Readings
above 6.5 percent signal diabetes. Fiber supplements were associated
with average A1c reductions of 0.58 percent, which is greater than
the minimum 0.3 percent reduction the U.S. Food and Drug
Administration looks for in evaluating new diabetes drugs, the study
authors note.
In addition to HbA1c, other markers of diabetes including fasting
glucose and insulin sensitivity were also improved.
One limitation of the analysis is that some studies were too small
and brief to draw broad conclusions about the long-term impact of
fiber supplements on all patients with diabetes.
It's also possible that so-called publication bias, or the
disclosure of only positive trial results, may have made fiber
supplements appear more effective than they really are, the study
authors note.
"These results suggest that viscous fiber supplements could be
considered in the management of type 2 diabetes," said Nour Makarem,
a researcher at Columbia University Irving Medical Center in New
York City who wasn't involved in the study.
"However, additional studies are needed to further examine the
effects of different types of fiber on blood glucose regulation and
to comprehensively study the health effects and the optimization of
incorporating viscous fiber supplements into a healthful diet
pattern," Marakem said by email.
SOURCE: https://bit.ly/2TenDoP Diabetes Care, online January 7,
2019.
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