The Impact of Soluble Dietary Fibre on Gastric Emptying, Postprandial Blood Glucose and Insulin in Patients with Type 2 Diabetes

可溶性膳食纤维对2型糖尿病患者胃排空、餐后血糖和胰岛素的影响

Kang Yu ； Mei-Yun Ke ； Wen-Hui Li ； Shu-Qin Zhang ； Xiu-Cai Fang

《Asia Pacific Journal of Clinical Nutrition》 23卷2期 (2014/06) Pp. 210-218

https://doi.org/10.6133/apjcn.2014.23.2.01

摘要

膳食纤维在控制糖尿病患者餐后血糖和胰岛素反应中扮演重要角色。膳食纤维延缓健康者胃排空。糖尿病患者摄入含纤维液体后胃排空与餐后血糖的关系需要进一步研究。本文旨在研究可溶性膳食纤维（SDF）对2型糖尿病胃排空、餐后血糖和胰岛素的影响。30例2型糖尿病（DM）及10例性别和年龄相匹配的健康者（HS）被随机交叉在两个独立日分别接受无SDF（500毫升，500千卡）及等能量含SDF（燕麦β-葡聚糖7.5克，500毫升，500千卡）液体试餐。两次试餐间有6天洗脱期。餐后2小时用B超每隔30分钟测定胃排空，并测定空腹及餐后180分钟内每隔30-60分钟的血糖及胰岛素。SDF使DM（p = 0.001）及HS（p = 0.037）近端胃排空延迟，使DM远端胃排出量减少（p ＜ 0.05）。SDF显著降低DM餐后血糖（p = 0.001）及胰岛素（p = 0.001）。DM餐后血糖（r = -0.547, p = 0.047）及胰岛素（r = -0.566, p = 0.004）与远端胃排空呈负相关。HbA1c ≥ 6.5%（p = 0.021）或有并发症（p = 0.011）的DM患者，SDF显著延迟远程胃排空。SDF改善餐后血糖与延迟胃排空相关。

關鍵字

糖尿病 ； 可溶性膳食纤维 ； 胃排空 ； 血糖 ； 血浆胰岛素

並列摘要

Dietary fibre plays an important role in controlling postprandial glycemic and insulin response in diabetic patients. The intake of dietary fibre has been shown to delay the gastric emptying in healthy subjects. The relationship between gastric emptying and postprandial blood glucose in diabetic patients with fibre-load liquids needs to be investigated. To investigate the impact of soluble dietary fibre (SDF) on gastric emptying, postprandial glycemic and insulin response in patients with type 2 diabetes. 30 patients with type 2 diabetes (DM) and 10 healthy subjects (HS) matched for gender and age were randomized to receive SDF-free liquid (500 mL, 500 Kcal) and isoenergetic SDF liquid (oat β-glucan 7.5 g, 500 mL, 500 Kcal) on two separate days based on a cross-over with 6-day wash-out period. Gastric emptying was monitored by ultrasonography at intervals of 30 min for 2 hours. Fasting and postprandial blood was collected at intervals of 30-60 min for 180 min to determine plasma glucose and insulin. Proximal gastric emptying was delayed by SDF-treatment both in DM (p = 0.001) and HS (p = 0.037). SDF resulted in less output volume in the distal stomach in DM (p ＜ 0.05). SDF decreased postprandial glucose (p = 0.001) and insulin (p = 0.001) in DM subjects. Postprandial glucose (r = -0.547, p = 0.047) and insulin (r = -0.566, p = 0.004) were negatively correlated with distal emptying of SDF in DM subjects. Distal gastric emptying was delayed significantly in DM subjects with HbA1c levels ≥ 6.5% (p = 0.021) or with complications (p = 0.011) by SDF, respectively. SDF improved postprandial glycaemia which was related to slowing of gastric emptying.

並列關鍵字

diabetes ； soluble dietary fibre ； gastric emptying ； blood glucose ； plasma insulin