Should Viscous Fiber Supplements Be Considered in Diabetes Control? Results From a Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract

Evidence from randomized controlled trials (RCTs) suggests that viscous dietary fiber may offer beneficial effects on glycemic control and, thus, an improved cardiovascular disease risk profile. Our purpose was to conduct a systematic review and meta-analysis of RCTs to synthesize the therapeutic effect of viscous fiber supplementation on glycemic control in type 2 diabetes. RESEARCH DESIGN AND METHODS MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched through 15 June 2018. We included RCTs ‡3 weeks in duration that assessed the effects of viscous fiber on markers of glycemic control in type 2 diabetes. Two independent reviewers extracted data. Data were pooled using the generic inverse variance method and expressed as mean differences (MD) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I 2 statistic). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the overall certainty of the evidence. RESULTS We identified 28 eligible trial comparisons (n = 1,394). Viscous fiber at a median dose of ∼13.1 g/day significantly reduced HbA 1c (

Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses

“…We excluded a number of trials included in the 2013 review, which involved changes in other nutrients in addition to an increase in dietary fibre [77,78], comparisons of one type of fibre with another [79][80][81], or compared a fibre-rich diet with another dietary intervention [82]. Two more recent reviews have been published; one considered the effects of viscous fibre [15], and the other was an umbrella review which provided no new analyses [16].…”

“…Previous meta-analyses of clinical trials have demonstrated the potential of fibre supplements derived from psyllium [89] or viscous sources [15] to improve glycaemic control and cardiometabolic risk factors. European guidelines for the management of type 1 and type 2 diabetes have emphasised the benefits of soluble forms of dietary fibre from legumes [90].…”

“…Other randomised trials and a 2013 systematic review and meta-analysis of trials demonstrated in people with type 2 diabetes the benefit of dietary fibre on glycaemic control when total carbohydrate intake remained constant [13,14]. There have been 2 more recent reviews, one related to the effects of viscous fibre [15], and the other was an umbrella review that did not provide any new analyses [16].…”

Effects of Extrinsic Wheat Fiber Supplementation on Fecal Weight; A Randomized Controlled Trial

“…Dietary fibers have been shown to exhibit different physiological effects and to provide a plethora of positive health outcomes, such as satiation [1,2], and regulation of digestion [3] and cardiovascular disease [4,5], thereby reducing the risk of numerous diet-related diseases such as diabetes mellitus type 2 [6,7]. Regarding glucose metabolism, besides insoluble resistant starch [8] and soluble dietary fibers [9], the consumption of highly purified insoluble dietary fibers from wheat was associated with reducing the post-prandial glucose response [10].…”

Nutritional Strategies for Prevention and Management of Diabetes: Consensus and Uncertainties

“…The meta-analysis paper by Jovanovski et al ( 3 ), which analyzed 28 soluble fiber supplementation RCTs, found that fiber supplementation significantly improved HbA 1c , fasting glucose, fasting insulin, and HOMA of insulin resistance among patients with diabetes. Given the short duration of these trials (median of ∼8 weeks), the longer-term effects of fiber supplementation in diabetes management are still uncertain.…”