| Clin Excell Nurse Pract 2000 Sep;4(5):272-6
fiber and type 2 diabetes.
Tabatabai A, Li S.
Rush Presbyterian-St. Luke's Medical Center, Chicago, Illinois,
This article addresses the current theory, research, and implications
of dietary fiber in the management of type 2 diabetes mellitus
(DM; non-insulin-dependent DM). Dietary fiber shows promise
in the management of type 2 DM. The inclusion of sufficient
dietary fiber in a meal flattens the postprandial glycemic and
insulinemic excursions and favorably influences plasma lipid
levels in patients with type 2 DM. Water-soluble fiber appears
to have a greater potential to reduce postprandial blood glucose,
insulin, and serum lipid levels than insoluble fiber. Viscosity
of the dietary fiber is important; the greater the viscosity,
the greater the effect. Possible mechanisms for metabolic improvements
with dietary fiber include delay of glucose absorption, increase
in hepatic extraction of insulin, increased insulin sensitivity
at the cellular level, and binding of bile acids. Patients with
type 2 DM should increase their dietary fiber intake to 20 to
35 g/d and be aware of the considerations when increasing fiber
intake. The nurse practitioner is in an ideal position to promote
dietary fiber intake in such patients.