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Inulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials.
J Transl Med. 2019 12 05; 17(1):410.JT

Abstract

BACKGROUND

Currently, many clinical trials have shown that inulin-type fructans (ITF) supplementation is associated with glycemic control; nevertheless, the results are inconclusive. The aim of this meta-analysis of randomized controlled trials was to assess the effects of ITF supplementation on glycemic control.

METHODS

PubMed, EMBASE and the Cochrane Library were searched for eligible articles up to March 6, 2019. A random-effects model was used to analyze the pooled results, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was applied to assess the quality of evidence. The dose-response model was used to recommend the daily dose and duration for ITF supplementation.

RESULTS

Thirty-three trials involving 1346 participants were included. Overall, ITF supplementation could significantly reduce concentrations of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR). In the prediabetes and type 2 diabetes (T2DM) population, a more significant reduction in FBG [weighted mean difference (WMD): - 0.60 mmol/l; 95% CI - 0.71, - 0.48 mmol/l; high rate], HbA1c (WMD: - 0.58%; 95% CI - 0.83, - 0.32%; high rate), FINS (WMD: - 1.75 µU/ml; 95% CI - 2.87, - 0.63 µU/ml; low rate), and HOMA-IR (WMD: - 0.69; 95% CI - 1.10, - 0.28; low rate) were observed, and ITF supplementation with a daily dose of 10 g for a duration of 6 weeks and longer was recommended. Moreover, subgroup analyses suggested that the effects of glycemic control were significantly influenced by the sex of the subjects and the type and the method of intake of ITF.

CONCLUSIONS

Our analyses confirmed that these four main glycemic indicators were significantly reduced by ITF supplementation, particularly in the prediabetes and T2DM population. Evidence supports that reasonable administration of ITF supplementation may have potential clinical value as an adjuvant therapy for prediabetes and T2DM management. Trial registration The trial was registered at PROSPERO as CRD42018115875 on November 23, 2018.

Authors+Show Affiliations

Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, No. 32, South Renmin Road, Shiyan, 442000, China.Department of Histology and Embryology, School of Basic Medical Sciences, Hubei University of Medicine, No. 30, South Renmin Road, Shiyan, 442000, China. Hubei Key Laboratory of Embryonic Stem Cell Research, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China.Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, No. 32, South Renmin Road, Shiyan, 442000, China.Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, No. 32, South Renmin Road, Shiyan, 442000, China.Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, No. 32, South Renmin Road, Shiyan, 442000, China.Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, No. 32, South Renmin Road, Shiyan, 442000, China.Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, No. 32, South Renmin Road, Shiyan, 442000, China. n4oneone@126.com.Department of Histology and Embryology, School of Basic Medical Sciences, Hubei University of Medicine, No. 30, South Renmin Road, Shiyan, 442000, China. sunshine.ashton@qq.com.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

31805963

Citation

Wang, Long, et al. "Inulin-type Fructans Supplementation Improves Glycemic Control for the Prediabetes and Type 2 Diabetes Populations: Results From a GRADE-assessed Systematic Review and Dose-response Meta-analysis of 33 Randomized Controlled Trials." Journal of Translational Medicine, vol. 17, no. 1, 2019, p. 410.
Wang L, Yang H, Huang H, et al. Inulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials. J Transl Med. 2019;17(1):410.
Wang, L., Yang, H., Huang, H., Zhang, C., Zuo, H. X., Xu, P., Niu, Y. M., & Wu, S. S. (2019). Inulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials. Journal of Translational Medicine, 17(1), 410. https://doi.org/10.1186/s12967-019-02159-0
Wang L, et al. Inulin-type Fructans Supplementation Improves Glycemic Control for the Prediabetes and Type 2 Diabetes Populations: Results From a GRADE-assessed Systematic Review and Dose-response Meta-analysis of 33 Randomized Controlled Trials. J Transl Med. 2019 12 5;17(1):410. PubMed PMID: 31805963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials. AU - Wang,Long, AU - Yang,Hong, AU - Huang,Hao, AU - Zhang,Chao, AU - Zuo,Hong-Xia, AU - Xu,Pan, AU - Niu,Yu-Ming, AU - Wu,Shi-Shi, Y1 - 2019/12/05/ PY - 2019/09/29/received PY - 2019/11/27/accepted PY - 2019/12/7/entrez PY - 2019/12/7/pubmed PY - 2020/9/10/medline KW - Glycemic control KW - Inulin-type fructans supplementation KW - Meta-analysis KW - Prediabetes KW - Type 2 diabetes SP - 410 EP - 410 JF - Journal of translational medicine JO - J Transl Med VL - 17 IS - 1 N2 - BACKGROUND: Currently, many clinical trials have shown that inulin-type fructans (ITF) supplementation is associated with glycemic control; nevertheless, the results are inconclusive. The aim of this meta-analysis of randomized controlled trials was to assess the effects of ITF supplementation on glycemic control. METHODS: PubMed, EMBASE and the Cochrane Library were searched for eligible articles up to March 6, 2019. A random-effects model was used to analyze the pooled results, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was applied to assess the quality of evidence. The dose-response model was used to recommend the daily dose and duration for ITF supplementation. RESULTS: Thirty-three trials involving 1346 participants were included. Overall, ITF supplementation could significantly reduce concentrations of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR). In the prediabetes and type 2 diabetes (T2DM) population, a more significant reduction in FBG [weighted mean difference (WMD): - 0.60 mmol/l; 95% CI - 0.71, - 0.48 mmol/l; high rate], HbA1c (WMD: - 0.58%; 95% CI - 0.83, - 0.32%; high rate), FINS (WMD: - 1.75 µU/ml; 95% CI - 2.87, - 0.63 µU/ml; low rate), and HOMA-IR (WMD: - 0.69; 95% CI - 1.10, - 0.28; low rate) were observed, and ITF supplementation with a daily dose of 10 g for a duration of 6 weeks and longer was recommended. Moreover, subgroup analyses suggested that the effects of glycemic control were significantly influenced by the sex of the subjects and the type and the method of intake of ITF. CONCLUSIONS: Our analyses confirmed that these four main glycemic indicators were significantly reduced by ITF supplementation, particularly in the prediabetes and T2DM population. Evidence supports that reasonable administration of ITF supplementation may have potential clinical value as an adjuvant therapy for prediabetes and T2DM management. Trial registration The trial was registered at PROSPERO as CRD42018115875 on November 23, 2018. SN - 1479-5876 UR - https://www.unboundmedicine.com/medline/citation/31805963/Inulin_type_fructans_supplementation_improves_glycemic_control_for_the_prediabetes_and_type_2_diabetes_populations:_results_from_a_GRADE_assessed_systematic_review_and_dose_response_meta_analysis_of_33_randomized_controlled_trials_ L2 - https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-019-02159-0 DB - PRIME DP - Unbound Medicine ER -