Metabolic and Anthropometric Parameters of Persons at Risk of Developing Type 2 Diabetes Mellitus Before and After 3 Months of Consuming Insoluble Dietary Fiber.

Background: Observational studies have shown that insoluble fiber (IF) can be effective in preventing type 2 diabetes (T2D), but there is a lack of experimental data on the effect of short-term consumption of IF on metabolic parameters. We tried to investigate whether there was an improvement in glycemia and body composition in individuals at risk for T2D after 3 months of IF consumption. Methods: This "Type 2 Diabetes Mellitus Prevention Ukraine (T2DPUA)" study describes participants with impaired fasting glucose (IFG) as determined by ADA criteria. The study involved 30 people, including 21 women (70%). Daily, 15 g of IF derived from wheat was used. T2DPUA did not have a placebo group and the intervention lasted 3 months. Evaluation of fasting plasma glucose (FPG) and 2h plasma glucose (2hPG), glycated hemoglobin (HbA1c), total cholesterol, HDL-cholesterol, triacylglycerols, uric acid, and γ-glutamyl transferase was performed. The baseline and 3-monthly anthropometric examinations included measurements of weight, waist and hip circumference. Fat mass was assessed by bioelectrical impedance analysis. Paired samples t-test or Wilcoxon test were used. Result: A decrease of FPG (P = .042), HbA1c (P < .001), 2hPG (P = .005), weight (P < .001), body mass index (P < .001), the proportion of body fat (P = .006), and the absolute amount of fat (P < .001), increases in systolic (P < .001) and diastolic (P = .008) blood pressure was shown. The number of people with hypertension did not change. The absolute amount of body fat decreased by almost 5% and tolerance to the standard glucose load improved by 15%. The dynamics of other metabolic parameters were not revealed. Conclusion and Recommendation: Data about improvement of glycemia and body composition over a short period of using IF by individuals with IFG are new and deserve larger studies.

Evaluation of type 2 diabetes prevention through diet modification in people with impaired glucose regulation: A population-based study.

PURPOSE: A few interventional studies to date have specifically assessed the association between dairy products and/or sugar consumption and the risk of type 2 diabetes mellitus (T2D) incidence. The aim of this study was to assess the effectiveness of diet modification in people with impaired glucose regulation (IGR) as defined by a glucose tolerance test (GTT). METHODS: A quasi-experimental study design was used for this study. A total of 318 randomly selected 18-year-old or older participants from the rural area of the Kyiv region of Ukraine who had not been registered as T2D patients before underwent GTT between June 2013 and June 2017. For those who had been diagnosed with IGR, World Health Organization (WHO)/International Diabetes Federation criteria were used. Of 318 participants screened for T2D, 123 (74% of them females) were diagnosed with IGR. They were aged 18 to 79 years old with a median (QI - QIII) age of 62 (52-68) years. They were repeatedly tested during the study and completed a questionnaire on average 2.8 (1.1) years (standard deviation [SD]), after they had received their lifestyle-based T2D prevention recommendations. In addition to basic recommendations, they were advised to consume approximately 200 g of low-fat dairy products and less than 25 g of sugar daily. Cases of screen-detected diabetes mellitus (SDDM) were diagnosed and reported as an outcome variable if a fast capillary blood glucose level reached 6.1 mmol/L and above. To define the association between implementation of recommendations and the risk of SDDM, the Cox proportional-hazards regression analysis was used. RESULTS: During the study observation period, 56 (45.5%) of 123 IGR-positive participants were recognized as SDDM cases. Those individuals with IGR (n = 111) who confirmed their adherence to preventive recommendations had a significantly lower risk of identifying SDDM, age- and gender-adjusted hazard ratio (HR) 0.26 (95% CІ; 0.09-0.72). This effect appears to be related to the recommendation to reduce the daily intake of sugar to less than 25 g (n = 99), corresponding to age- and gender-adjusted HR 0.44 (95% CІ; 0.2-0.99). We cannot prove that increasing consumption of dairy products, vegetables, and fruit or increased physical activity had similar effectiveness. CONCLUSIONS: After 2.8 years of follow-up, the individuals who are IGR-positive and who confirmed their adherence to lifestyle-based preventive recommendations had a significantly lower risk of identifying SDDM. This effect appears to be related to recommendations to reduce the daily intake of sugar to less than 25 g.