武汉协和医院：改善血糖，糖尿病人每天补充多少可溶性纤维为佳？ | 热心肠日报

Clinical Nutrition

[IF:6.36]

Effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials

补充可溶性纤维对2型糖尿病患者血糖控制的影响：对随机对照试验的系统性综述与荟萃分析

10.1016/j.clnu.2020.10.032

10-22, Article

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Background & aims: Soluble dietary fiber is prompted as an important part of reducing blood glucose, ameliorating insulin resistance and controlling body weight. Thus, we performed this systematic review and meta-analysis of randomized controlled trials (RCTs) to quantify and synthesize the effects of soluble fiber supplementation on glycemic control and BMI modification in adults with type 2 diabetes.
Methods: We searched MEDLINE, Embase, Web of Science, ClinicalTrials.gov, and Cochrane databases until February 13, 2020 to identify RCTs that detected the effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes. A random-effects model with the generic inverse variance method was used to analyze the pooled data. The meta-regression and subgroup analyses were conducted to identify the variables that influenced the pooled results. The robust error meta-regression model was used to conduct the dose–response test. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was undertaken to evaluate the overall quality of the evidence.
Results: A total of 29 RCTs (33 comparisons) involving 1517 participants were identified in this meta-analysis. Results showed that supplemental soluble dietary fiber significantly reduced glycosylated hemoglobin (HbA1c, MD -0.63%, 95% CI [-0.90, −0.37]; P < 0.00001), fasting plasma glucose (FPG, MD -0.89 mmol/L, 95% CI [-1.28, −0.51]; P < 0.00001), fasting insulin (SMD -0.48, 95% CI [-0.80, −0.17]; P = 0.003), homeostatic model assessment of insulin resistance (HOMA-IR, SMD -0.58, 95% CI [-0.86, −0.29], P < 0.0001), fructosamine (SMD -1.03, 95% CI [-1.51, −0.55]; P < 0.0001), 2-h postprandial plasma glucose (SMD -0.74, 95% CI [-1.00, −0.48]; P < 0.00001), and BMI (SMD -0.31, 95% CI [-0.61, −0.00], P = 0.05) compared with control diets in patients with type 2 diabetes. Specifically, dose–response meta-analyses presented that a daily dosage of 7.6–8.3 g was recommended.
Conclusion: Intake of soluble fiber supplementation is effective in improving glycemic control and BMI level in type 2 diabetes and is also a convenient way to help individuals meet standard dietary fiber needs. But due to the evidence of substantial heterogeneity in most pooled estimates, further long-term and high-quality RCTs are needed.

First Authors:
Yajuan Xie

Correspondence Authors:
Lulu Chen

All Authors:
Yajuan Xie,Luoning Gou,Miaomiao Peng,Juan Zheng,Lulu Chen