Design and Validation of a Diet Rich in Slowly Digestible Starch for Type 2 Diabetic Patients for Significant Improvement in Glycemic Profile

Abstract

This study aimed at designing a—diet high in slowly digestible starch (SDS) by carefully selecting high-SDS starchy products and to validate its implementation, acceptance, and impact on the postprandial glycemic response in patients with type 2 diabetes (T2D). Starchy products were screened and classified as being either high (high-SDS) or low (low-SDS) in SDS (in vitro SDS method). A randomized controlled cross-over pilot study was performed: Eight patients with T2D consumed randomly a high-SDS or a low-SDS diet for one week each, while their glycemic profile was monitored for 6 days. Based on 250 food product SDS analyses and dietary recommendations for patients with T2D, the high-SDS and low-SDS diets were designed. The high-SDS diet significantly increased SDS intake and the SDS/carbohydrates proportion compared to the low-SDS diet (61.6 vs. 11.6 g/day and 30% vs. 6%; p < 0.0001, respectively). Increasing the SDS/carbohydrate proportion to 50% of the meal was significantly correlated with a 12% decrease in tAUC0–120 min and a 14% decrease in the glycemic peak value (p < 0.001 for both). A high-SDS diet can be easily designed by carefully selecting commercial starchy products and providing relevant recommendations for T2D to improve their glycemic profile.

Physicochemical, Rheological, In-Vitro Digestibility, and Emulsifying Properties of Starch Extracted from Pineapple Stem Agricultural Waste

“…SDS is usually considered the most preferred dietary starch because it is completely but slowly digested in the small intestine [39]. In addition, SDS is likely associated with beneficial health effects such as improved satiety and mental performance, blood sugar control, and diabetes management [5,39,40].…”

Slowly Digestible Carbohydrate Diet Ameliorates Hyperglycemia and Hyperlipidemia in High-Fat Diet/Streptozocin-Induced Diabetic Mice

“…Currently, it is recommended that 45-60% energy of the daily total calorie intake for T2DM patients should come from carbohydrates (6). The American Diabetes Association suggested that the carbohydrate quality, rather than their quantity, is key in the care of T2DM patients (7).…”

The impact of slowly digestible and resistant starch on glucose homeostasis and insulin resistance

“…After 1 weekintake of a published 60 g of SDS-diet per day, several parameters of glycemic variability (GV) decreased compared to a low-SDS diet: Standard deviation (SD) was lowered by 17% and mean amplitude of glucose excursions (MAGE) was lowered by 23%; less time was spent in high glycemic target and lower postprandial glycemic excursions have been observed. As some of these parameters have repeatedly been correlated with HbA1c, these results are predictive of a longer-term HbA1c reduction with the diet [38][39][40]. However, the amount of available CHO between the low and high-SDS diets was not similar and it was a relatively short-term pilot study.…”