Separate influence of dietary carbohydrate and fibre on the metabolic control in diabetes

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Abstract
To clarify the separate influences of digestible carbohydrate and of dietary fibre on blood glucose control and serum lipoproteins, 14 diabetic patients (six Type 1 and eight Type 2) were submitted to three weight-maintaining diets for 10 days each: (1) low carbohydrate/low fibre diet with 42% carbohydrate and 20g fibre; (2) high carbohydrate/low fibre diet (carbohydrate 53%, fibre 16g); (3) high carbohydrate/ high fibre diet (carbohydrate 53%, fibre 54 g). In comparison with the low carbohydrate/low fibre diet, the 2-h post-prandial blood glucose and the daily blood glucose profile decreased significantly on the high carbohydrate/high fibre diet, without significant changes during the high carbohydrate/low fibre diet. The diet-induced modifications of blood glucose control were similar in both types of diabetic patients (twoway analysis of variance: F=5.86, pppp<0.005). In conclusion: (1) a simple increase of digestible carbohydrate without a parallel increase of dietary fibre does not help in improving the metabolic control of diabetic patients; (2) the hypoglycaemic and hypolipidaemic effects of high carbohydrate/high-fibre diets are due principally to dietary fibre.