Abstract
Background Insulin resistance (IR) is a physiological condition related to type 2 diabetes mellitus (T2DM) and obesity, which is associated with high blood insulin and glucose. Inulin-type carbohydrate (ITC) is a kind of fermentable fructan that can reduce glucose and ameliorate IR in an animal model, but the effect in clinical trials is controversial. Objective The authors conducted a systematic literature review to evaluate the effect of ITC supplementation in ameliorating IR in T2DM and obese patients. Methods Multiple databases were queried for studies before December 25, 2018, which involved supplementation with ITC in ameliorating IR in T2DM and obese patients. Studies that involved meta-analysis of the body mass index (BMI), fasting plasma glucose (FPG), fasting insulin (FI), HbA1c, homeostatic model assessment IR (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) of T2DM subjects were included. HOMA-IR and QUICKI were identified as the primary outcomes. A systematic review was performed to evaluate the effect of ITC on IR in obese patients. Results The database search yielded 25 studies, which met the inclusion criteria; 11 articles were meta-analyzed, and 5 other articles on T2DM and 9 articles on simple obesity were systematically reviewed. Our results did not find ITC supplementation decrease postintervention and reduction data of BMI (P = 0.08). However, it can significantly decrease postintervention and reduction data of FPG, FI, HbA1c, and HOMA-IR. Heterogeneity was eliminated by subgroup analysis according to baseline BMI. There was no significant difference in the amelioration of QUICKI between the ITC and control groups. However, the difference was statistically significant and the heterogeneity was eliminated after subgroup analysis according to intakes of ITC. 14 articles for a systematic review found that the results of blood glucose, insulin, and HbA1c were controversial. Only one of the seven studies on simple obesity concluded that ITC intervention significantly ameliorated HOMA-IR, while the other six did not. Conclusion Supplementation of ITC can ameliorate IR in T2DM, especially in obese T2DM patients, but the effects are controversial in obese patients.
Highlights
Type 2 diabetes mellitus (T2DM) is considered a multifactorial disease, promoted by both genetic and environmental factors, which is characterized by chronic hyperglycemia and insulin resistance (IR) [1, 2]
After screening titles and abstracts, 45 full-text articles were reviewed. 20 of these articles did not meet inclusion criteria, and the remaining 11 articles which comprised 634 type 2 diabetes mellitus (T2DM) patients were included in this meta-analysis [24,25,26,27,28,29,30,31,32,33,34]
We made this review involving 25 randomized clinical trial (RCT) of parallel or crossover; to our knowledge, this was the first systematic analysis to evaluate the role of Inulin-type carbohydrate (ITC) supplementation in ameliorating Insulin resistance (IR) in T2DM and obese patients
Summary
Type 2 diabetes mellitus (T2DM) is considered a multifactorial disease, promoted by both genetic and environmental factors, which is characterized by chronic hyperglycemia and insulin resistance (IR) [1, 2]. Insulin resistance (IR) is a physiological condition related to type 2 diabetes mellitus (T2DM) and obesity, which is associated with high blood insulin and glucose. The authors conducted a systematic literature review to evaluate the effect of ITC supplementation in ameliorating IR in T2DM and obese patients. Multiple databases were queried for studies before December 25, 2018, which involved supplementation with ITC in ameliorating IR in T2DM and obese patients. Studies that involved meta-analysis of the body mass index (BMI), fasting plasma glucose (FPG), fasting insulin (FI), HbA1c, homeostatic model assessment IR (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) of T2DM subjects were included. Our results did not find ITC supplementation decrease postintervention and reduction data of BMI (P = 0 08) It can significantly decrease postintervention and reduction data of FPG, FI, HbA1c, and HOMA-IR. Supplementation of ITC can ameliorate IR in T2DM, especially in obese T2DM patients, but the effects are controversial in obese patients
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