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Efficacy of increased resistant starch consumption in human type 2 diabetes.

Bodinham CL, Smith L, Thomas EL, Bell JD, Swann JR, Costabile A, Russell-Jones D, Umpleby AM, Robertson MD - Endocr Connect (2014)

Bottom Line: Fasting non-esterified fatty acid (NEFA) concentrations were significantly lower (P=0.004) and NEFA suppression was greater during the clamp with HAM-RS2 (P=0.001).Fasting triglyceride (TG) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 (P=0.039 and P=0.027 respectively).Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption (P=0.049), postprandial GLP1 excursions during the MTT were significantly greater (P=0.009).

View Article: PubMed Central - PubMed

Affiliation: NutritionMetabolism and Diabetes Research Group, Faculty of Health and Medical Sciences, University of Surrey, Leggett Building, Guildford, Surrey GU2 7WG, UK Metabolic and Molecular Imaging GroupMRC Clinical Sciences Centre, Imperial College, London W12 0HS, UK Department of Food and Nutritional SciencesUniversity of Reading, Whiteknights Campus, Reading RG6 6AP, UK.

ABSTRACT
Resistant starch (RS) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome, but its effects on human type 2 diabetes (T2DM) are unknown. This study aimed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postprandial metabolites and body fat in T2DM. Seventeen individuals with well-controlled T2DM (HbA1c 46.6±2 mmol/mol) consumed, in a random order, either 40 g of type 2 RS (HAM-RS2) or a placebo, daily for 12 weeks with a 12-week washout period in between. AT THE END OF EACH INTERVENTION PERIOD, PARTICIPANTS ATTENDED FOR THREE METABOLIC INVESTIGATIONS: a two-step euglycemic-hyperinsulinemic clamp combined with an infusion of [6,6-(2)H2] glucose, a meal tolerance test (MTT) with arterio-venous sampling across the forearm, and whole-body imaging. HAM-RS2 resulted in significantly lower postprandial glucose concentrations (P=0.045) and a trend for greater glucose uptake across the forearm muscle (P=0.077); however, there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity, or on HbA1c. Fasting non-esterified fatty acid (NEFA) concentrations were significantly lower (P=0.004) and NEFA suppression was greater during the clamp with HAM-RS2 (P=0.001). Fasting triglyceride (TG) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 (P=0.039 and P=0.027 respectively). Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption (P=0.049), postprandial GLP1 excursions during the MTT were significantly greater (P=0.009). HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM, but demonstrated beneficial effects on meal handling, possibly due to higher postprandial GLP1.

No MeSH data available.


Related in: MedlinePlus

Postprandial glucose concentrations (A), glucose flux into the muscle tissue measured with arterio-venous sampling across the forearm muscle (B), and change from baseline postprandial GLP1 concentrations (C) during the MTT at the end of 12 weeks supplementation with HAM-RS2 (filled circle) compared with placebo (open circle). Mean+s.e.m.s for 16 patients (A and C) and 12 patients (B). There was a significant treatment×time interaction for the postprandial glucose concentrations as assessed by repeated measures ANOVA (P=0.045), which corresponded to a significantly reduced AUC0–120 min following the HAM-RS2 supplement (P=0.036) compared with paired t-test. Repeated measures ANOVA showed a trend for increased glucose uptake with the HAM-RS2 compared with the placebo (P=0.077). There was a significantly greater GLP1 response with HAM-RS2 compared with the placebo (P=0.009) compared with paired t-test on the iAUC0–120 min.
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fig1: Postprandial glucose concentrations (A), glucose flux into the muscle tissue measured with arterio-venous sampling across the forearm muscle (B), and change from baseline postprandial GLP1 concentrations (C) during the MTT at the end of 12 weeks supplementation with HAM-RS2 (filled circle) compared with placebo (open circle). Mean+s.e.m.s for 16 patients (A and C) and 12 patients (B). There was a significant treatment×time interaction for the postprandial glucose concentrations as assessed by repeated measures ANOVA (P=0.045), which corresponded to a significantly reduced AUC0–120 min following the HAM-RS2 supplement (P=0.036) compared with paired t-test. Repeated measures ANOVA showed a trend for increased glucose uptake with the HAM-RS2 compared with the placebo (P=0.077). There was a significantly greater GLP1 response with HAM-RS2 compared with the placebo (P=0.009) compared with paired t-test on the iAUC0–120 min.

Mentions: During the two-step euglycemic–hyperinsulinemic clamp, no difference was observed between interventions in EGP at basal (placebo, 11.5±0.6 μmol/kg per min and HAM-RS2, 10.7±0.7 μmol/kg per min) or during the low dose insulin infusion (placebo, 4.6±0.3 μmol/kg per min and HAM-RS2, 5.0±0.4 μmol/kg per min). No significant differences were observed between interventions for glucose Rd at basal (placebo, 11.9±0.5 μmol/kg per min and HAM-RS2, 10.7±0.8 μmol/kg per min) or during the high dose insulin infusions (placebo, 47.0±5.4 μmol/kg per min and HAM-RS2, 47.3±6.0 μmol/kg per min). There were no differences in insulin concentrations throughout the clamp study. Postprandial glucose concentrations during the MTT exhibited a significant treatment by time interaction (P=0.045; Fig. 1A); this translated as a significant reduction in glucose AUC0–120 min with the HAM-RS2 (P=0.036). The A-V sampling across the forearm muscle also showed a trend for higher glucose uptake with HAM-RS2 compared with the placebo (P=0.077; Fig. 1B).


Efficacy of increased resistant starch consumption in human type 2 diabetes.

Bodinham CL, Smith L, Thomas EL, Bell JD, Swann JR, Costabile A, Russell-Jones D, Umpleby AM, Robertson MD - Endocr Connect (2014)

Postprandial glucose concentrations (A), glucose flux into the muscle tissue measured with arterio-venous sampling across the forearm muscle (B), and change from baseline postprandial GLP1 concentrations (C) during the MTT at the end of 12 weeks supplementation with HAM-RS2 (filled circle) compared with placebo (open circle). Mean+s.e.m.s for 16 patients (A and C) and 12 patients (B). There was a significant treatment×time interaction for the postprandial glucose concentrations as assessed by repeated measures ANOVA (P=0.045), which corresponded to a significantly reduced AUC0–120 min following the HAM-RS2 supplement (P=0.036) compared with paired t-test. Repeated measures ANOVA showed a trend for increased glucose uptake with the HAM-RS2 compared with the placebo (P=0.077). There was a significantly greater GLP1 response with HAM-RS2 compared with the placebo (P=0.009) compared with paired t-test on the iAUC0–120 min.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3987287&req=5

fig1: Postprandial glucose concentrations (A), glucose flux into the muscle tissue measured with arterio-venous sampling across the forearm muscle (B), and change from baseline postprandial GLP1 concentrations (C) during the MTT at the end of 12 weeks supplementation with HAM-RS2 (filled circle) compared with placebo (open circle). Mean+s.e.m.s for 16 patients (A and C) and 12 patients (B). There was a significant treatment×time interaction for the postprandial glucose concentrations as assessed by repeated measures ANOVA (P=0.045), which corresponded to a significantly reduced AUC0–120 min following the HAM-RS2 supplement (P=0.036) compared with paired t-test. Repeated measures ANOVA showed a trend for increased glucose uptake with the HAM-RS2 compared with the placebo (P=0.077). There was a significantly greater GLP1 response with HAM-RS2 compared with the placebo (P=0.009) compared with paired t-test on the iAUC0–120 min.
Mentions: During the two-step euglycemic–hyperinsulinemic clamp, no difference was observed between interventions in EGP at basal (placebo, 11.5±0.6 μmol/kg per min and HAM-RS2, 10.7±0.7 μmol/kg per min) or during the low dose insulin infusion (placebo, 4.6±0.3 μmol/kg per min and HAM-RS2, 5.0±0.4 μmol/kg per min). No significant differences were observed between interventions for glucose Rd at basal (placebo, 11.9±0.5 μmol/kg per min and HAM-RS2, 10.7±0.8 μmol/kg per min) or during the high dose insulin infusions (placebo, 47.0±5.4 μmol/kg per min and HAM-RS2, 47.3±6.0 μmol/kg per min). There were no differences in insulin concentrations throughout the clamp study. Postprandial glucose concentrations during the MTT exhibited a significant treatment by time interaction (P=0.045; Fig. 1A); this translated as a significant reduction in glucose AUC0–120 min with the HAM-RS2 (P=0.036). The A-V sampling across the forearm muscle also showed a trend for higher glucose uptake with HAM-RS2 compared with the placebo (P=0.077; Fig. 1B).

Bottom Line: Fasting non-esterified fatty acid (NEFA) concentrations were significantly lower (P=0.004) and NEFA suppression was greater during the clamp with HAM-RS2 (P=0.001).Fasting triglyceride (TG) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 (P=0.039 and P=0.027 respectively).Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption (P=0.049), postprandial GLP1 excursions during the MTT were significantly greater (P=0.009).

View Article: PubMed Central - PubMed

Affiliation: NutritionMetabolism and Diabetes Research Group, Faculty of Health and Medical Sciences, University of Surrey, Leggett Building, Guildford, Surrey GU2 7WG, UK Metabolic and Molecular Imaging GroupMRC Clinical Sciences Centre, Imperial College, London W12 0HS, UK Department of Food and Nutritional SciencesUniversity of Reading, Whiteknights Campus, Reading RG6 6AP, UK.

ABSTRACT
Resistant starch (RS) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome, but its effects on human type 2 diabetes (T2DM) are unknown. This study aimed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postprandial metabolites and body fat in T2DM. Seventeen individuals with well-controlled T2DM (HbA1c 46.6±2 mmol/mol) consumed, in a random order, either 40 g of type 2 RS (HAM-RS2) or a placebo, daily for 12 weeks with a 12-week washout period in between. AT THE END OF EACH INTERVENTION PERIOD, PARTICIPANTS ATTENDED FOR THREE METABOLIC INVESTIGATIONS: a two-step euglycemic-hyperinsulinemic clamp combined with an infusion of [6,6-(2)H2] glucose, a meal tolerance test (MTT) with arterio-venous sampling across the forearm, and whole-body imaging. HAM-RS2 resulted in significantly lower postprandial glucose concentrations (P=0.045) and a trend for greater glucose uptake across the forearm muscle (P=0.077); however, there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity, or on HbA1c. Fasting non-esterified fatty acid (NEFA) concentrations were significantly lower (P=0.004) and NEFA suppression was greater during the clamp with HAM-RS2 (P=0.001). Fasting triglyceride (TG) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 (P=0.039 and P=0.027 respectively). Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption (P=0.049), postprandial GLP1 excursions during the MTT were significantly greater (P=0.009). HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM, but demonstrated beneficial effects on meal handling, possibly due to higher postprandial GLP1.

No MeSH data available.


Related in: MedlinePlus