Dietary fiber and diabetes: what else do we need to know?

Abstract

When dietary fiber was reaching its peak in popularity for use in diabetes one research title claimed ‘A high carbohydrate leguminous fiber diet improves all aspects of diabetes control’ [ 11. Other authors, however, pointed out that ‘Guar gum is not a panacea in diabetes management’ [2]. More recently, this topic was debated in the British Medical Journal [ 3,4]. These articles [ l-41 and recent review [ 5-71 indicate that many questions regarding dietary fiber and diabetes remain to be answered. These questions relate to whether fiber has a significant effect on glycemic control in diabetes, whether the general benefits of fiber outweigh the risks in diabetes, and, finally, how fiber works. Does dietary fiber intake have a significant effect on glycemic control in diabetes? This question has not been rigorously approached using either a long-term clinical trial or an objective analytical technique such as meta-analysis. Recently, we updated a handbook chapter [8] and tabulated scientific articles published in the English language between 1976 and 1990 related to clinical studies of human diabetic individuals using dietary fiber [ 91. Review of 35 clinical studies [ 91 indicates that soluble fibers such as guar significantly reduce postprandial hyperglycemia in individuals with either insulin-dependent diabetes mellitus (IDDM or Type 1) or non-insulindependent diabetes mellitus (NIDDM or Type 2).