Prebiotic Fibre Supplement May Boost Life Quality, Reduce Blood Sugar in T2D
A supplement containing prebiotic fibre may boost the quality of life and reduce blood sugar levels in people living with type 2 diabetes (T2D), according to new findings.
Compared to the placebo group, individuals consuming the prebiotic fibre supplement had significantly reduced symptoms of diabetes distress and glycated haemoglobin (HbA1c) – the average blood sugar levels over two to three months.
“A microbiome-targeting nutritional formula significantly improved CT2-DDAS [core Type 2 Diabetes Distress Assessment System] and HbA1c, suggesting the potential for prebiotic fibre as a complement to lifestyle and/or pharmaceutical interventions for managing type 2 diabetes,” the researchers wrote.
The study, “A microbiome-targeting fibre-enriched nutritional formula is well-tolerated and improves the quality of life and haemoglobin A1c in type 2 diabetes: A double-blind, randomised, placebo-controlled trial,” was published in Diabetes, Obesity and Metabolism.
Prebiotics are dietary fibres that feed specific gut bacteria, causing them to grow and produce beneficial substances, including short-chain fats that promote health. Prebiotics are naturally found in food such as asparagus, onions, Jerusalem artichokes, onions, and oats but are also commercially available as supplements, including inulin, psyllium, resistant starch and oat beta-glucan.
Studies investigating prebiotic foods and fibre supplements show that they improve blood sugar control by altering gut bacteria and satiety hormones and blocking glucose-transport proteins. Despite their benefits for blood sugar control and health, only 5% of Americans meet the recommended daily fibre intake – 30 g for men and 25 g for women.
Diabetes distress, a feeling of frustration, defeat, or overwhelm, affects up to 50% of people with diabetes in any 18 months, according to Centres for Disease Control (CDC). It is linked to poor glucose control and impaired emotional well-being. Evidence suggests that short-chain fats from prebiotic fibres can positively influence emotional well-being.
Now, a team of researchers investigated if a prebiotic fibre-enriched nutrition supplement could improve well-being and glucose control in people with T2D.
They enrolled 192 people [average age 54 years, 62% female, 62.5% white, 19.3% black, 14.6% Hispanic/Latino] in the 12-week study. Participants were divided into three groups: prebiotic supplement, placebo (a fibre-free supplement) and standard diet advice. Those in the prebiotic supplement group were given two supplements daily, with at least one replacing a meal. At the study’s start (baseline) and week 12, participants provided stool samples to analyse their gut bacteria and short-chain fats. Their HbA1c, fasting blood glucose, body weight, blood pressure and diabetes distress score were also measured. Diabetes distress was measured using the cT2-DDAS – a scale that measures eight contributing areas of distress.
Diabetes distress was reduced significantly in the prebiotic supplement group compared to the placebo group, with participants reporting improvements in seven areas. They also reported improvements in sleep, energy and mood. Interestingly, diabetes distress increased in the placebo group and remained unchanged in the dietary advice group.
Blood pressure reduction, health-related quality of life improvements and weight loss were significantly greater in the prebiotic supplement group than in the dietary advice group. In addition, blood sugar control, measured as HbA1c, improved in the prebiotic supplement group compared to the placebo and dietary advice group. Moreover, in a subset of patients wearing continuous glucose monitors, glucose management index and time-in-range improved significantly. However, fasting plasma glucose remained the same in all three groups.
The researchers believe that the sugar substitutes in the prebiotic supplement may have contributed to the effects. “Allulose may have contributed to the decrease in HbA1c in the active arm [prebiotic supplement group], while sucralose or maltodextrin may have contributed to the increase in HbA1c in the placebo arm,” the researchers wrote. Of note, allulose is a naturally-occurring sugar found in figs and molasses that does not raise blood sugar or insulin. Sucralose does not affect blood sugar but raises insulin; maltodextrin raises blood sugar and insulin.
Gut bacteria did not change after 12 weeks of the prebiotic supplement. However, the amounts of prebiotic bacteria breaking down resistant starch and producing beneficial short-chain fats (butyrate) increased significantly compared to the dietary advice group. Notably, the fibre supplement did not cause severe side effects or hypoglycaemia (severe blood sugar dips) and improved heartburn, burping, bloating and nausea.
The researchers highlighted some limitations, including the study’s short duration and conduction during the holidays – US Thanksgiving, Christmas and Hanukkah.
Still, the results suggest that the prebiotic supplement may complement lifestyle and medication to improve life quality in people with T2D.
“Future studies powered for metabolic outcomes such as HbA2c will be necessary to confirm these findings,” the researchers wrote.
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