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Efficacy of increased resistant starch consumption in human type 2 diabetes

Efficacy of increased resistant starch consumption in human type 2 diabetes
Efficacy of increased resistant starch consumption in human type 2 diabetes

Resistant starch (RS) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome, but its effects on human type 2 diabetes (T2DM) are unknown. This study aimed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postprandial metabolites and body fat in T2DM. Seventeen individuals with well-controlled T2DM (HbA1c 46.6±2 mmol/mol) consumed, in a random order, either 40 g of type 2 RS (HAM-RS2) or a placebo, daily for 12 weeks with a 12-week washout period in between. At the end of each intervention period, participants attended for three metabolic investigations: a two-step euglycemic–hyperinsulinemic clamp combined with an infusion of [6,6-2H2] glucose, a meal tolerance test (MTT) with arterio-venous sampling across the forearm, and whole-body imaging. HAM-RS2 resulted in significantly lower postprandial glucose concentrations (P=0.045) and a trend for greater glucose uptake across the forearm muscle (P=0.077); however, there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity, or on HbA1c. Fasting non-esterified fatty acid (NEFA) concentrations were significantly lower (P=0.004) and NEFA suppression was greater during the clamp with HAM-RS2 (P=0.001). Fasting triglyceride (TG) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 (P=0.039 and P=0.027 respectively). Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption (P=0.049), postprandial GLP1 excursions during the MTT were significantly greater (P=0.009). HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM, but demonstrated beneficial effects on meal handling, possibly due to higher postprandial GLP1.

2049-3614
75-84
Bodinham, C L
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Smith, L
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Thomas, E L
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Bell, J D
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Swann, J R
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Costabile, A
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Russell-Jones, D
d1cb2fe4-e6ed-47ec-b49f-bd2bbb0ee3d6
Umpleby, A M
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Robertson, M D
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Bodinham, C L
c8fa5a95-a5d7-4e96-9558-a94e5edae91a
Smith, L
a898092e-cd1a-40ea-9100-77038f7b095c
Thomas, E L
f50b3f27-a567-460d-a470-56e8ff8af23a
Bell, J D
c540a6af-cd13-4066-8bd9-96daa3b21f53
Swann, J R
7c11a66b-f4b8-4dbf-aa17-ad8b0561b85c
Costabile, A
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Russell-Jones, D
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Umpleby, A M
e4673c3c-ca62-4eb4-b0cb-064cb8b16ed1
Robertson, M D
cf2fcfb2-eeda-4c6e-9338-dd1f631c51ff

Bodinham, C L, Smith, L, Thomas, E L, Bell, J D, Swann, J R, Costabile, A, Russell-Jones, D, Umpleby, A M and Robertson, M D (2014) Efficacy of increased resistant starch consumption in human type 2 diabetes. Endocrine Connections, 3 (2), 75-84. (doi:10.1530/EC-14-0036).

Record type: Article

Abstract

Resistant starch (RS) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome, but its effects on human type 2 diabetes (T2DM) are unknown. This study aimed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postprandial metabolites and body fat in T2DM. Seventeen individuals with well-controlled T2DM (HbA1c 46.6±2 mmol/mol) consumed, in a random order, either 40 g of type 2 RS (HAM-RS2) or a placebo, daily for 12 weeks with a 12-week washout period in between. At the end of each intervention period, participants attended for three metabolic investigations: a two-step euglycemic–hyperinsulinemic clamp combined with an infusion of [6,6-2H2] glucose, a meal tolerance test (MTT) with arterio-venous sampling across the forearm, and whole-body imaging. HAM-RS2 resulted in significantly lower postprandial glucose concentrations (P=0.045) and a trend for greater glucose uptake across the forearm muscle (P=0.077); however, there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity, or on HbA1c. Fasting non-esterified fatty acid (NEFA) concentrations were significantly lower (P=0.004) and NEFA suppression was greater during the clamp with HAM-RS2 (P=0.001). Fasting triglyceride (TG) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 (P=0.039 and P=0.027 respectively). Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption (P=0.049), postprandial GLP1 excursions during the MTT were significantly greater (P=0.009). HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM, but demonstrated beneficial effects on meal handling, possibly due to higher postprandial GLP1.

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Accepted/In Press date: 26 March 2014
e-pub ahead of print date: 1 June 2014

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Local EPrints ID: 439405
URI: http://eprints.soton.ac.uk/id/eprint/439405
ISSN: 2049-3614
PURE UUID: 618f2c12-835e-4087-bfba-ca8e500eb5ac
ORCID for J R Swann: ORCID iD orcid.org/0000-0002-6485-4529

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Date deposited: 21 Apr 2020 16:52
Last modified: 17 Mar 2024 04:00

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Contributors

Author: C L Bodinham
Author: L Smith
Author: E L Thomas
Author: J D Bell
Author: J R Swann ORCID iD
Author: A Costabile
Author: D Russell-Jones
Author: A M Umpleby
Author: M D Robertson

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