Resistant Starch Consumption Effects on Glycemic Control and Glycemic Variability in Patients with Type 2 Diabetes: A Randomized Crossover Study

Abstract

We previously observed beneficial effects of native banana starch (NBS) with a high resistant starch (RS) content on glycemic response in lean and obese participants. Here, we aimed to determine the effects of NBS and high-amylose maize starch (HMS) on glycemic control (GC) and glycemic variability (GV) in patients with type 2 diabetes (T2D) when treatments were matched for digestible starch content. In a randomized, crossover study, continuous glucose monitoring (CGM) was performed in 17 participants (aged 28–65 years, BMI ≥ 25 kg/m2, both genders) consuming HMS, NBS, or digestible maize starch (DMS) for 4 days. HMS and NBS induced an increase in 24 h mean blood glucose during days 2 to 4 (p < 0.05). CONGA, GRADE, and J-index values were higher in HMS compared with DMS only at day 4 (p < 0.05). Yet, NBS intake provoked a reduction in fasting glycemia changes from baseline compared with DMS (p = 0.0074). In conclusion, under the experimental conditions, RS from two sources did not improve GC or GV. Future longer studies are needed to determine whether these findings were affected by a different baseline microbiota or other environmental factors.

A comparison of the effects of resistant starch types on glycemic response in individuals with type 2 diabetes or prediabetes: A systematic review and meta-analysis

“…Of the studies which could not be included in the meta-analysis, three reported that the addition of resistant starch to the diet did not affect fasting glucose or insulin ( 36 , 39 , 40 ). One study ( 38 ), reported that resistant starch type 2 lowered fasting glucose but did not affect fasting insulin. Conversely, Ble-Castillo et al ( 37 ), reported that resistant starch type 2 significantly reduced fasting insulin but did not affect fasting glucose.…”

“…Two studies reported that the addition of resistant starch 2 to the diet, had no significant effect on HOMA-IR ( 36 , 38 ) or HOMA-%B and -%S ( 36 ). However, Ble-Castillo et al ( 37 ) reported an increase in HOMA-IR after resistant starch supplementation.…”

The Effect of Prebiotics and Oral Anti-Diabetic Agents on Gut Microbiome in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials

“…In the study by Arias-Córdova et al [ 36 ], it was found that the native banana starch (NBS) with a content of 70.5% resistant starch and 10% digestible starch caused a reduction in fasting blood glucose from baseline compared with digestible maize starch with 100% digestible starch content. There was improvement in insulin sensitivity and significant improvement in glycaemic control including significant reduction in parameters such as HbA1c, postprandial blood glucose and fasting blood glucose levels in patients with type 2 diabetes who consumed prebiotic diets compared with control in some studies [ 31 , 38 , 41 , 43 , 44 , 48 ].…”

“… Graphs showing ( a ) risk of bias ( b ) risk of bias summary [ 18 , 31 , 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. …”

“… Network Meta-analysis ( a ) and Meta-analysis ( b ) of the effect of treatments versus control on Fasting Blood Glucose [ 32 , 36 , 38 , 39 , 40 , 41 , 43 , 45 , 46 , 48 ]. …”