Improvement of the metabolic syndrome profile by soluble fibre – guar gum – in patients with type 2 diabetes: a randomised clinical trial

Abstract

A diet rich in fibre seems to protect against the metabolic syndrome (MetS), but there is scarce information about the role of fibre intake in patients with the MetS and diabetes. The aim of the present study was to evaluate the effects of soluble fibre from partially hydrolysed guar gum (PHGG) on the MetS and cardiovascular risk factors in patients with type 2 diabetes. In the present randomised controlled clinical trial, forty-four patients with type 2 diabetes (males 38·6 %, age 62 (sd 9) years, diabetes duration 14·2 (sd 9·6) years) and the MetS underwent clinical, laboratory and dietary evaluations at baseline, 4 and 6 weeks. All patients followed their usual diet and the intervention group (n 23) received an additional 10 g/d of PHGG. In the intervention group, waist circumference (WC), glycated Hb (HbA1c), 24 h urinary albumin excretion (UAE) and serum trans-fatty acids (FA) were reduced in comparison with baseline after 4 and 6 weeks: WC 103·5 (sd 9·5) to 102·1 (sd 10) to 102·3 (sd 9·7) cm; HbA1c 6·88 (sd 0·99) to 6·64 (sd 0·94) to 6·57 (sd 0·84) %; 24 h UAE 6·8 (interquartile range 3·0–17·5) to 4·5 (interquartile range 3·0–10·5) to 6·2 (interquartile range 3·0–9·5) mg; trans-FA 71 (interquartile range 46–137) to 67 (interquartile range 48–98) to 57 (interquartile range 30–110) mg/l (P< 0·05 for all). The only change in the control group was weight reduction: 77·0 (sd 13·5) to 76·2 (sd 13·3) to 76·1 (sd 13·4) kg (P= 0·005). Other MetS components (blood pressure, TAG, HDL-cholesterol, fasting plasma glucose), total and LDL-cholesterol, C-reactive protein and endothelin-1 did not change in either group. In patients with type 2 diabetes and the MetS, the addition of PHGG to the usual diet improved cardiovascular and metabolic profiles by reducing WC, HbA1c, UAE and trans-FA.