Effect of Additional Prebiotics on Glycemia and Lipid Profile in Individuals with Type 2 Diabetes

Yıl 2024, , 1 - 10, 30.04.2024

Ayşe Ayda Demirtaş , Nilüfer Acar Tek

https://doi.org/10.59124/guhes.1399261

Öz

This study was conducted to determine the effect of prebiotic fiber intake on glycemia and lipemia in individuals with Type 2 Diabetes Mellitus (Type 2 DM). Over a 8-week period, 14 individuals with Type 2 DM between the ages of 20-50 with a Body Mass Index (BMI) above 25 kg/m² were randomly assigned to either an intervention group, in which participants were given additional prebiotic fiber with diabetic diet (n = 8, consuming 10 g/d of oligofructose-enriched inulin to diabetic diet) or to a control group, in which participants were given only with a diabetic diet (n = 6, consuming only diabetic diet). Fasting Plasma Glucose (FPG), fasting insulin, insulin resistance (HOMA-IR), glycosylated hemoglobin (HbA1c), Triglyceride (TG), Total Cholesterol (Total-C), High-Density Lipoprotein Cholesterol (HDL-C), Low-Density Lipoprotein Cholesterol (LDL-C) and Very Low-Density Lipoprotein Cholesterol (VLDL-C) values were measured at the beginning and end of the study. There was no significant difference between the initial and last measurements in HbA1c, fasting insulin, HOMA-IR, and HDL-C values only in the diabetic diet group (p>0.05); whereas FPG, TG, Total-C, LDL-C, and VLDL-C levels decreased (p<0.05). In the group that received additional prebiotics in the diet, the FPG, HbA1c, TG, Total-C, VLDL-C, and LDL-C levels decreased significantly (p<0.05) at the end of the study compared to the beginning; HDL-C (p<0.05) was elevated. Prebiotics can be used as a new option in the treatment of many metabolic diseases, especially diabetes. Prebiotics will make a positive contribution to metabolic markers by changing the composition of the microbiota.

Anahtar Kelimeler

gycemic control, lipemia, prebiotic, Type 2 diabetes

Etik Beyan

The study has been approved by the ethics committee of Gazi University (Decision No: 14.06.2021 / 578).

Teşekkür

The authors would like to thank Gazi University Academic Writing Application and Research Center for proofreading the article.

Kaynakça

• Baigent, C., Keech, A., Kearney, P. M., Blackwell, L., Buck, G., Pollicino, C., Kirby, A., Sourjina, T., Peto, R., Collins, R., Simes, R., & Cholesterol Treatment Trialists, C. (2005). Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet, 366(9493), 1267-1278. https://doi.org/10.1016/S0140-6736(05)67394-1
• Birkeland, E., Gharagozlian, S., Gulseth, H. L., Birkeland, K. I., Hartmann, B., Holst, J. J., Holst, R., & Aas, A. M. (2021). Effects of prebiotics on postprandial GLP-1, GLP-2 and glucose regulation in patients with type 2 diabetes: A randomised, double-blind, placebo-controlled crossover trial. Diabetic Medicine, 38(10), e14657. https://doi.org/10.1111/dme.14657
• Brighenti, F. (2007). Dietary fructans and serum triacylglycerols: a meta-analysis of randomized controlled trials. The Journal of Nutrition, 137(11 Suppl), 2552S-2556S. https://doi.org/10.1093/jn/137.11.2552S
• Cani, P. D., Lecourt, E., Dewulf, E. M., Sohet, F. M., Pachikian, B. D., Naslain, D., De Backer, F., Neyrinck, A. M., & Delzenne, N. M. (2009). Gut microbiota fermentation of prebiotics increases satietogenic and incretin gut peptide production with consequences for appetite sensation and glucose response after a meal. The American Journal of Clinical Nutrition, 90(5), 1236-1243. https://doi.org/10.3945/ajcn.2009.28095
• Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods, 8(3). https://doi.org/10.3390/foods8030092
• Dehghan, P., Farhangi, M. A., Tavakoli, F., Aliasgarzadeh, A., & Akbari, A. M. (2016). Impact of prebiotic supplementation on T-cell subsets and their related cytokines, anthropometric features and blood pressure in patients with type 2 diabetes mellitus: A randomized placebo-controlled Trial. Complementary Therapies in Medicine, 24, 96-102. https://doi.org/10.1016/j.ctim.2015.12.010
• Dehghan, P., Pourghassem Gargari, B., & Asghari Jafar-abadi, M. (2014). Oligofructose-enriched inulin improves some inflammatory markers and metabolic endotoxemia in women with type 2 diabetes mellitus: a randomized controlled clinical trial. Nutrition, 30(4), 418-423. https://doi.org/10.1016/j.nut.2013.09.005
• ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., . . . on behalf of the American Diabetes, A. (2023). 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2023. Diabetes Care, 46(Supple 1), S68-S96. https://doi.org/10.2337/dc23-S005
• Gholizadeh, P., Mahallei, M., Pormohammad, A., Varshochi, M., Ganbarov, K., Zeinalzadeh, E., Yousefi, B., Bastami, M., Tanomand, A., Mahmood, S. S., Yousefi, M., Asgharzadeh, M., & Kafil, H. S. (2019). Microbial balance in the intestinal microbiota and its association with diabetes, obesity and allergic disease. Microbial Pathogenesis, 127, 48-55. https://doi.org/10.1016/j.micpath.2018.11.031
• Gurung, M., Li, Z., You, H., Rodrigues, R., Jump, D. B., Morgun, A., & Shulzhenko, N. (2020). Role of gut microbiota in type 2 diabetes pathophysiology. eBioMedicine, 51, 102590. https://doi.org/10.1016/j.ebiom.2019.11.051
• Ho, J., Reimer, R. A., Doulla, M., & Huang, C. (2016). Effect of prebiotic intake on gut microbiota, intestinal permeability and glycemic control in children with type 1 diabetes: study protocol for a randomized controlled trial. Trials, 17(1), 347. https://doi.org/10.1186/s13063-016-1486-y
• International Diabetes Federation. (2021, 09.06.2023). IDF Diabetes Atlas. https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf
• Larsen, N., Vogensen, F. K., van den Berg, F. W., Nielsen, D. S., Andreasen, A. S., Pedersen, B. K., Al-Soud, W. A., Sorensen, S. J., Hansen, L. H., & Jakobsen, M. (2010). Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults. PLoS One, 5(2), e9085. https://doi.org/10.1371/journal.pone.0009085
• Liu, F., Prabhakar, M., Ju, J., Long, H., & Zhou, H. W. (2017). Effect of inulin-type fructans on blood lipid profile and glucose level: a systematic review and meta-analysis of randomized controlled trials European Journal of Clinical Nutrition, 71(1), 9-20. https://doi.org/10.1038/ejcn.2016.156
• Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., Graham, I. M., Halliday, A., Landmesser, U., Mihaylova, B., Pedersen, T. R., Riccardi, G., Richter, D. J., Sabatine, M. S., Taskinen, M. R., . . . Group, E. S. C. S. D. (2020). 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. European Heart Journal, 41(1), 111-188. https://doi.org/10.1093/eurheartj/ehz455
• Mifflin, M. D., St Jeor, S. T., Hill, L. A., Scott, B. J., Daugherty, S. A., & Koh, Y. O. (1990). A new predictive equation for resting energy expenditure in healthy individuals. The American Journal of Clinical Nutrition, 51(2), 241-247. https://doi.org/10.1093/ajcn/51.2.241
• Parnell, J. A., & Reimer, R. A. (2012). Prebiotic fibres dose-dependently increase satiety hormones and alter Bacteroidetes and Firmicutes in lean and obese JCR:LA-cp rats. British Journal of Nutrition, 107(4), 601-613. https://doi.org/10.1017/S0007114511003163
• Paul, P., Kaul, R., Harfouche, M., Arabi, M., Al-Najjar, Y., Sarkar, A., Saliba, R., & Chaari, A. (2022). The effect of microbiome-modulating probiotics, prebiotics and synbiotics on glucose homeostasis in type 2 diabetes: A systematic review, meta-analysis, and meta-regression of clinical trials. Pharmacological Research, 185, 106520. https://doi.org/10.1016/j.phrs.2022.106520
• Pourghassem Gargari, B., Dehghan, P., Aliasgharzadeh, A., & Asghari Jafar-Abadi, M. (2013). Effects of high performance inulin supplementation on glycemic control and antioxidant status in women with type 2 diabetes. Diabetes & Metabolism Journal, 37(2), 140-148. https://doi.org/10.4093/dmj.2013.37.2.140
• Reis, S. A., Conceicao, L. L., Rosa, D. D., Dias, M. M., & Peluzio Mdo, C. (2014). Mechanisms used by inulin-type fructans to improve the lipid profile. Nutricion Hospitalaria, 31(2), 528-534. https://doi.org/10.3305/nh.2015.31.2.7706
• Roshanravan, N., Mahdavi, R., Alizadeh, E., Jafarabadi, M. A., Hedayati, M., Ghavami, A., Alipour, S., Alamdari, N. M., Barati, M., & Ostadrahimi, A. (2017). Effect of Butyrate and Inulin Supplementation on Glycemic Status, Lipid Profile and Glucagon-Like Peptide 1 Level in Patients with Type 2 Diabetes: A Randomized Double-Blind, Placebo-Controlled Trial. Hormone and Metabolic Research 49(11), 886-891. https://doi.org/10.1055/s-0043-119089
• Silva, F. M., Kramer, C. K., de Almeida, J. C., Steemburgo, T., Gross, J. L., & Azevedo, M. J. (2013). Fiber intake and glycemic control in patients with type 2 diabetes mellitus: a systematic review with meta-analysis of randomized controlled trials. Nutrition Reviews, 71(12), 790-801. https://doi.org/10.1111/nure.12076
• Tawfick, M. M., Xie, H., Zhao, C., Shao, P., & Farag, M. A. (2022). Inulin fructans in diet: Role in gut homeostasis, immunity, health outcomes and potential therapeutics. International Journal of Biological Macromolecules, 208, 948-961. https://doi.org/10.1016/j.ijbiomac.2022.03.218
• TEMD. (2022). TEMD Diabetes Mellitus ve Komlikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2022. Türkiye Endokrinoloji ve Metobolizma Derneği. https://file.temd.org.tr/Uploads/publications/guides/documents/diabetes-mellitus_2022.pdf
• Wang, L., Yang, H., Huang, H., Zhang, C., Zuo, H. X., Xu, P., Niu, Y. M., & Wu, S. S. (2019). Inulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials. Journal of Translational Medicine, 17(1), 410. https://doi.org/10.1186/s12967-019-02159-0
• Wang, X., Yang, J., Qiu, X., Wen, Q., Liu, M., Zhou, D., & Chen, Q. (2021). Probiotics, Pre-biotics and Synbiotics in the Treatment of Pre-diabetes: A Systematic Review of Randomized Controlled Trials. Frontiers in Public Health, 9, 645035. https://doi.org/10.3389/fpubh.2021.645035
• Woldeamlak, B., Yirdaw, K., & Biadgo, B. (2019). Role of Gut Microbiota in Type 2 Diabetes Mellitus and Its Complications: Novel Insights and Potential Intervention Strategies. The Korean Journal of Gastroenterology, 74(6), 314-320. https://doi.org/10.4166/kjg.2019.74.6.314
• Xie, Y., Gou, L., Peng, M., Zheng, J., & Chen, L. (2021). 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. Clinical Nutrition, 40(4), 1800-1810. https://doi.org/10.1016/j.clnu.2020.10.032