The Effect of Dietary Fibre Intake on Type 2 Diabetes Mellitus Patients: A Meta-analysis

Abstract

Background and aim: The rate of progression of the chronic metabolic disorder, type 2 diabetes mellitus (T2DM), can be reduced by alterations in lifestyle behaviours, such as exercising and following a healthy diet. Adding fibre to the diet influences various aspects of wellbeing in both healthy and T2DM patients (1). Such factors include haemoglobin A1c (HbA1c), fasting blood glucose (FBG), homeostatic model assessment of insulin resistance (HOMA-IR) and Creactive protein (CRP). The aim of the current meta-analysis is to establish the advantages of dietary fibre on serum glucose levels in individuals living with T2DM. the results in the meta-analysis were discussed by illustrating the effects of fibre intake on the gastric emptying, satiety, the hunger-related hormone, gut microbiome, and the inflammatory cytokines. Methods: A literature search was carried out using the PubMed, Science Direct and Cochrane Library databases for possible publications to include in a meta-analysis of randomised controlled trials in patients with T2DM which had investigated the impact of ingesting dietary fibre. Inclusion criteria encompassed recently published articles which had assessed individuals with T2DM and evaluated at least one of the listed serum variables: HbA1c; FBG; HOMA-IR and CRP. The data from the identified papers were extracted; statistical analysis was carried out utilising the randomised effect model, and facilitated by the software, Review Manager. Results: Dietary fibre intake illustrated a significant impact in reducing HbA1c (–0.73, 95% CL –108 to 0.37, p < 0.0001, Z = 4.3) with low statistical heterogeneity (χ2 = 6.82, p = 0.23, I2 = 27%). In addition, FBG was significantly reduced in patients’ ingestion high fibre diets with a reduction of 1.72 mmol/l (95% CL = –2.10 to –1.34, p < 0.00001, Z = 8.87) with very low statistical heterogeneity (χ2 = 2.31, p = 0.68, I2 = 0%). Insulin sensitivity improved with a significant reduction in HOMA-IR of 2.00 mg/Id in comparison with the control group (95% CL = –2.91 to –1.10, p < 0.0001, Z = 4.34) with moderate to high statistical heterogeneity (χ2 = 11.00, p = 0.01, I2 = 73%). Additionally, the intervention group demonstrated a fall in the inflammatory marker C-RP of 5.33 mg/L (95% CL –9.09 to –0.82, p = 0.005, Z = 2.78). Conclusion: high fibre diet has a beneficial effect on people with type two diabetes and the studies showed that there was a significant reduction in HbA1c, FBG, HOMA-IR and C-RP.