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Effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials.
Clin Nutr. 2021 04; 40(4):1800-1810.CN

Abstract

BACKGROUND & AIMS

Soluble dietary fiber is prompted as an important part of reducing blood glucose, ameliorating insulin resistance and controlling body weight. Thus, we performed this systematic review and meta-analysis of randomized controlled trials (RCTs) to quantify and synthesize the effects of soluble fiber supplementation on glycemic control and BMI modification in adults with type 2 diabetes.

METHODS

We searched MEDLINE, Embase, Web of Science, ClinicalTrials.gov, and Cochrane databases until February 13, 2020 to identify RCTs that detected the effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes. A random-effects model with the generic inverse variance method was used to analyze the pooled data. The meta-regression and subgroup analyses were conducted to identify the variables that influenced the pooled results. The robust error meta-regression model was used to conduct the dose-response test. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was undertaken to evaluate the overall quality of the evidence.

RESULTS

A total of 29 RCTs (33 comparisons) involving 1517 participants were identified in this meta-analysis. Results showed that supplemental soluble dietary fiber significantly reduced glycosylated hemoglobin (HbA1c, MD -0.63%, 95% CI [-0.90, -0.37]; P < 0.00001), fasting plasma glucose (FPG, MD -0.89 mmol/L, 95% CI [-1.28, -0.51]; P < 0.00001), fasting insulin (SMD -0.48, 95% CI [-0.80, -0.17]; P = 0.003), homeostatic model assessment of insulin resistance (HOMA-IR, SMD -0.58, 95% CI [-0.86, -0.29], P < 0.0001), fructosamine (SMD -1.03, 95% CI [-1.51, -0.55]; P < 0.0001), 2-h postprandial plasma glucose (SMD -0.74, 95% CI [-1.00, -0.48]; P < 0.00001), and BMI (SMD -0.31, 95% CI [-0.61, -0.00], P = 0.05) compared with control diets in patients with type 2 diabetes. Specifically, dose-response meta-analyses presented that a daily dosage of 7.6-8.3 g was recommended.

CONCLUSION

Intake of soluble fiber supplementation is effective in improving glycemic control and BMI level in type 2 diabetes and is also a convenient way to help individuals meet standard dietary fiber needs. But due to the evidence of substantial heterogeneity in most pooled estimates, further long-term and high-quality RCTs are needed.

Authors+Show Affiliations

Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China; Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China. Electronic address: cheria_chen@126.com.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

33162192

Citation

Xie, Yajuan, et al. "Effects of Soluble Fiber Supplementation On Glycemic Control in Adults With Type 2 Diabetes Mellitus: a Systematic Review and Meta-analysis of Randomized Controlled Trials." Clinical Nutrition (Edinburgh, Scotland), vol. 40, no. 4, 2021, pp. 1800-1810.
Xie Y, Gou L, Peng M, et al. Effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr. 2021;40(4):1800-1810.
Xie, Y., Gou, L., Peng, M., Zheng, J., & Chen, L. (2021). Effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. Clinical Nutrition (Edinburgh, Scotland), 40(4), 1800-1810. https://doi.org/10.1016/j.clnu.2020.10.032
Xie Y, et al. Effects of Soluble Fiber Supplementation On Glycemic Control in Adults With Type 2 Diabetes Mellitus: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Clin Nutr. 2021;40(4):1800-1810. PubMed PMID: 33162192.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. AU - Xie,Yajuan, AU - Gou,Luoning, AU - Peng,Miaomiao, AU - Zheng,Juan, AU - Chen,Lulu, Y1 - 2020/10/23/ PY - 2020/08/20/received PY - 2020/10/09/revised PY - 2020/10/19/accepted PY - 2020/11/10/pubmed PY - 2021/8/31/medline PY - 2020/11/9/entrez KW - Glycemic control KW - Meta-analysis KW - Soluble fiber supplementation KW - Type 2 diabetes SP - 1800 EP - 1810 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 40 IS - 4 N2 - BACKGROUND & AIMS: Soluble dietary fiber is prompted as an important part of reducing blood glucose, ameliorating insulin resistance and controlling body weight. Thus, we performed this systematic review and meta-analysis of randomized controlled trials (RCTs) to quantify and synthesize the effects of soluble fiber supplementation on glycemic control and BMI modification in adults with type 2 diabetes. METHODS: We searched MEDLINE, Embase, Web of Science, ClinicalTrials.gov, and Cochrane databases until February 13, 2020 to identify RCTs that detected the effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes. A random-effects model with the generic inverse variance method was used to analyze the pooled data. The meta-regression and subgroup analyses were conducted to identify the variables that influenced the pooled results. The robust error meta-regression model was used to conduct the dose-response test. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was undertaken to evaluate the overall quality of the evidence. RESULTS: A total of 29 RCTs (33 comparisons) involving 1517 participants were identified in this meta-analysis. Results showed that supplemental soluble dietary fiber significantly reduced glycosylated hemoglobin (HbA1c, MD -0.63%, 95% CI [-0.90, -0.37]; P < 0.00001), fasting plasma glucose (FPG, MD -0.89 mmol/L, 95% CI [-1.28, -0.51]; P < 0.00001), fasting insulin (SMD -0.48, 95% CI [-0.80, -0.17]; P = 0.003), homeostatic model assessment of insulin resistance (HOMA-IR, SMD -0.58, 95% CI [-0.86, -0.29], P < 0.0001), fructosamine (SMD -1.03, 95% CI [-1.51, -0.55]; P < 0.0001), 2-h postprandial plasma glucose (SMD -0.74, 95% CI [-1.00, -0.48]; P < 0.00001), and BMI (SMD -0.31, 95% CI [-0.61, -0.00], P = 0.05) compared with control diets in patients with type 2 diabetes. Specifically, dose-response meta-analyses presented that a daily dosage of 7.6-8.3 g was recommended. CONCLUSION: Intake of soluble fiber supplementation is effective in improving glycemic control and BMI level in type 2 diabetes and is also a convenient way to help individuals meet standard dietary fiber needs. But due to the evidence of substantial heterogeneity in most pooled estimates, further long-term and high-quality RCTs are needed. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/33162192/Effects_of_soluble_fiber_supplementation_on_glycemic_control_in_adults_with_type_2_diabetes_mellitus:_A_systematic_review_and_meta_analysis_of_randomized_controlled_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(20)30575-6 DB - PRIME DP - Unbound Medicine ER -