Dietary fiber and type 2 diabetes.
Clin Excell Nurse Pract. 2000 Sep;4(5):272-6.
Tabatabai A, Li S.
Rush Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
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.