Health Sciences I.
INTRODUCTION
Diabetes mellitus is a major worldwide health problem, in which properly planned diet plays a keyrole. However, many patients have difficulties in keeping a low carbohydrate diet after diagnosis. Fibers are carbohydrate polymers, which are neither digested nor absorbed in the human small intestine. The findings from previous studies showed that the addition of dietary fiber could normalise blood glucose levels in patients with diabetes.
AIM
Several dietary fibers are available as a food supplement with various solubility, taste and physiological effect. To our konwledge no previous study has ranked their efficacy yet. Therefore we performed this systematic review and network meta-analysis to rank the effects of different types of soluble dietary fibers on glycemic in patients with type 2 diabetes.
METHODS
We performed our systematic search on the 20th of November, 2022. Eligible randomized controlled trials (RCTs) included adult patients with T2DM; compared soluble dietary fiber intake with another type of dietary fiber or no fiber. The outcomes were related to glycemic levels. The Bayesian method was used to perform a network meta-analysis and to calculate the surface under the cumulative ranking curve (SUCRA) values to rank interventions. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was undertaken to evaluate the overall quality of the evidence.
RESULTS
We identified 46 RCTs, including data from 2685 patients receiving 16 types of dietary fibers as intervention. Galactomannan had the highest effect on reducing hemoglobin A1c (SUCRA 92.33%), and fasting blood glucose (SUCRA 85.12%). Regarding fasting insulin level and HOMA-IR, B glucan (SUCRA 73.45%) and psyllium (SUCRA 96.67%) were the most effective interventions. Moreover, galactomannan showed significant results in almost all outcomes compared to no fiber. Most comparisons had low or moderate certainty of evidence.
CONCLUSION
The most effecive dietary fiber was the galactomannan for reducing hemoglobin A1c and fasting blood glucose levels in patients with type 2 diabetes. Our results showed that supplemental fibers can influence metabolic parameters and using dietary fibers as a supplement besides the medical therapy is an effective way for managing type 2 diabetes.
FUNDING
None to declare.