[Effects of resistant starch on insulin resistance of type 2 diabetes mellitus patients]. Baseline insulin sensitivity affects response to high-amylose maize resistant starch in women: a randomized, controlled trial Effects of wheat bran extract rich in arabinoxylan oligosaccharides and resistant starch on overnight glucose tolerance and markers of gut fermentation in healthy young adults Resistant starch supplementation influences blood lipid concentrations and glucose control in overweight subjects. Resistant Starches Types 2 and 4 Have Differential Effects on the Composition of the Fecal Microbiota in Human Subjects Structural Alteration of Gut Microbiota during the Amelioration of Human Type 2 Diabetes with Hyperlipidemia by Metformin and a Traditional Chinese Herbal Formula: a Multicenter, Randomized, Open Label Clinical Trial A Randomized Placebo Controlled Clinical Trial to Determine the Impact of Digestion Resistant Starch MSPrebiotic® on Glucose, Insulin, and Insulin Resistance in Elderly and Mid-Age Adults Variable responses of human microbiomes to dietary supplementation with resistant starch Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects. Effects of resistant starch on the colon in healthy volunteers: possible implications for cancer prevention. Postprandial glycaemic and insulinaemic responses to GM-resistant starch-enriched rice and the production of fermentation-related H2 in healthy Chinese adults. Phylotypes related to Ruminococcus bromii are abundant in the large bowel of humans and increase in response to a diet high in resistant starch. Limited effect of consumption of uncooked (RS2) or retrograded (RS3) resistant starch on putative risk factors for colon cancer in healthy men. Strong and persistent effect on liver fat with a Paleolithic diet during a two-year intervention Efficacy of increased resistant starch consumption in human type 2 diabetes Docosahexaenoic acid supplementation improved lipocentric but not glucocentric markers of insulin sensitivity in hypertriglyceridemic men. Pre-teen insulin resistance predicts weight gain, impaired fasting glucose, and type 2 diabetes at age 18-19 y: a 10-y prospective study of black and white girls. Acute ingestion of resistant starch reduces food intake in healthy adults. Resistant starch intake at breakfast affects postprandial responses in type 2 diabetics and enhances the glucose-dependent insulinotropic polypeptide--insulin relationship following a second meal. Resistant Starch Bagels Reduce Fasting and Postprandial Insulin in Adults at Risk of Type 2 Diabetes. A Novel Fasting Blood Test for Insulin Resistance and Prediabetes Effects of insulin resistance and insulin secretion on the efficacy of interventions to retard development of type 2 diabetes mellitus: the DA Qing IGT and Diabetes Study. Restoration of acute insulin response in T2DM subjects 1 month after biliopancreatic diversion.
OBJECTIVE To observe the effects of resistant starch ( RS ) on insulin resistance ( IR ) in type 2 diabetes mellitus patients . METHODS All 40 patients with type 2 diabetes mellitus were r and omly divided into two groups : Group A and Group B. Cross- design of two stages ( I , II ) was used during observation . Group A received RS 30 g/d as an intervention group for ahead of 4 weeks ( I stage ) , while group B as a control group . Group B was given RS in late 4 weeks ( II stage ) , while Group A as served control group . Blood was taken the first day and on the latest day in each stage . Fasting blood glucose ( FBG ) , post blood glucose ( PBG ) , fructosamine ( FMN ) , total cholesterol ( TC ) , triglyceridemic ( TG ) , insulin sensitive index ( ISI ) , and body mass index ( BMI ) were measured , respectively . RESULTS As Compared with the control group , ISI was higher and FBG , PBG , TC , TG , FMN and BMI were significantly lower in intervention group ( P < 0.05 ) . CONCLUSION RS should be effective in improving IR of type 2 diabetes mellitus patients Background Resistant starch ( RS ) is a type of dietary fiber that can improve glucose metabolism , but its effects may be modulated by sex or baseline insulin sensitivity . This study was design ed to examine the effect of high-amylose maize resistant starch ( HAM-RS2 ) on insulin sensitivity ( SI ) in women , and to determine if SI status affects the response to RS . Methods This was a r and omized , placebo-controlled , double-blind , cross-over study . Participants were 40 healthy , non-diabetic women aged 22–67 years in the normal-weight to obese BMI range ( 20.6–47.4 kg/m2 ) . Two doses of HAM-RS2 were tested , 15 and 30 g per day , administered in the form of cookies . Participants were r and omized to the order in which they received the experimental and placebo product . Each arm was 4 weeks , with a 4-week wash-out period in between . SI was assessed at the end of each 4-week arm of product consumption by frequently- sample d , insulin-modified , intravenous glucose tolerance test and minimal modeling . Participants were categorized as being insulin resistant ( IR ; SI < 7.8 ) or insulin sensitive ( IS ; SI ≥ 7.8 ) based on Gaussian analysis . The effect of treatment arm on SI was examined by mixed-model analysis within IR and IS sub-groups , using all available data . In addition , SI was examined by ANOVA among just those women who completed all three arms of the study with valid SI results . Results Among IR participants , SI was on average ~16 % higher after the 30 g arm when compared to the control arm by mixed-model analysis ( n = 40 , P < 0.05 ) , and tended to be 23 % higher by ANOVA among women who completed all arms ( n = 23 , P = 0.06 ) . HAM-RS2 did not affect SI in IS women . Conclusion Consumption of HAM-RS2 at 30 g/day in the form of a snack food item was associated with improved insulin sensitivity in women with insulin resistance . Clinical trials registry numberNCT01521806 Abstract Purpose Specific combinations of dietary fiber ( DF ) have been observed to result in improved glucose tolerance at a subsequent st and ardized breakfast . Arabinoxylan oligosaccharides ( AXOS ) are considered as DF with prebiotic potential , but so far no studies have investigated their metabolic effects in humans . This r and omized cross-over study evaluated the overnight impact of breads containing AXOS-rich wheat bran extract and resistant starch ( RS , Hi-Maize ) , separately or combined , on glucose tolerance , related metabolic parameters and markers of gut fermentation in healthy subjects . Methods Evening reference and test products were : ( 1 ) reference white wheat flour bread ( WWB ) , WWB supplemented with ( 2 ) AXOS and RS ( WWB + AXOS + RS ) , ( 3 ) an increased content of either AXOS ( WWB + hiAXOS ) or ( 4 ) RS ( WWB + hiRS ) . At the subsequent st and ardized breakfast , blood was sample d for 3 h to monitor glucose , insulin , nonesterified fatty acids , glucagon-like peptide (GLP)-1 and GLP-2 . Breath hydrogen ( H2 ) and short chain fatty acids ( SCFA ) were measured as markers of gut fermentation , and subjective appetite was rated using visual analog scales . Results Dose-dependent decreases in glucose responses were observed with increased AXOS over the duration of 3 h. Insulin sensitivity index was improved in the morning after the WWB + hiAXOS evening meal . An increase in breath H2 concentration and circulating SCFA was observed in the morning after both evening meals containing AXOS . Conclusion The present study indicates that AXOS have the potential of improving glucose tolerance in an overnight perspective and suggested mechanisms are improved insulin sensitivity and increased gut fermentation Resistant starch ( RS ) includes the sum of starch and degradation products of starch that resist small intestinal digestion and enter the colon . This study was planned to examine the effect of resistant starch on hypolipidemic actions , blood glucose , insulin levels and humoral immune responses in healthy overweight subjects . Healthy overweight subjects ( over 120 % of their ideal body weights ) were fed either 24 g/d of resistant corn starch ( RS ) or regular corn starch ( CS ) for 21 d with their regular meals . Although this double-blind feeding regiment result ed in no significant changes in their weights or other physical parameters for the relatively acute period of intakes , there were significant lowering effects of serum total cholesterol ( p < 0.05 ) and serum LDL-cholesterol ( p < 0.05 ) in subjects supplemented RS . Compared with the control starch group , the RS supplementation also reduced the mean fasting serum glucose concentrations ( p < 0.05 ) . Resistant starch supplement result ed in the increase in serum immunoglobulin G ( IgG ) concentrations . Serum insulin and complement 3 ( C3 ) were unaffected . Tested resistant starch supplementation was reported to be palatable with minimal bowel discomfort . These results suggest that RS supplementation improves the blood lipid profile and controls the blood glucose levels in healthy overweight subjects without bowel discomfort . Therefore , RS has a potential to be used as one of the promising food ingredients for reducing risk factors involved in the development of atherosclerosis and type 2 diabetes in overweight individuals . However , in order to prove RS as a novel therapeutic agent of cardiovascular diseases and diabetes , controlled trials with larger sample sizes and longer duration are warranted Background To systematic ally develop dietary strategies based on resistant starch ( RS ) that modulate the human gut microbiome , detailed in vivo studies that evaluate the effects of different forms of RS on the community structure and population dynamics of the gut microbiota are necessary . The aim of the present study was to gain a community wide perspective of the effects of RS types 2 ( RS2 ) and 4 ( RS4 ) on the fecal microbiota in human individuals . Methods and Findings Ten human subjects consumed crackers for three weeks each containing either RS2 , RS4 , or native starch in a double-blind , crossover design . Multiplex sequencing of 16S rRNA tags revealed that both types of RS induced several significant compositional alterations in the fecal microbial population s , with differential effects on community structure . RS4 but not RS2 induced phylum-level changes , significantly increasing Actinobacteria and Bacteroidetes while decreasing Firmicutes . At the species level , the changes evoked by RS4 were increases in Bifidobacterium adolescentis and Parabacteroides distasonis , while RS2 significantly raised the proportions of Ruminococcus bromii and Eubacterium rectale when compared to RS4 . The population shifts caused by RS4 were numerically substantial for several taxa , leading for example , to a ten-fold increase in bifidobacteria in three of the subjects , enriching them to 18–30 % of the fecal microbial community . The responses to RS and their magnitudes varied between individuals , and they were reversible and tightly associated with the consumption of RS . Conclusion Our results demonstrate that RS2 and RS4 show functional differences in their effect on human fecal microbiota composition , indicating that the chemical structure of RS determines its accessibility by groups of colonic bacteria . The findings imply that specific bacterial population s could be selectively targeted by well design ed functional carbohydrates , but the inter-subject variations in the response to RS indicates that such strategies might benefit from more personalized approaches ABSTRACT Accumulating evidence implicates gut microbiota as promising targets for the treatment of type 2 diabetes mellitus ( T2DM ) . With a r and omized clinical trial , we tested the hypothesis that alteration of gut microbiota may be involved in the alleviation of T2DM with hyperlipidemia by metformin and a specifically design ed herbal formula ( AMC ) .  Four hundred fifty patients with T2DM and hyperlipidemia were r and omly assigned to either the metformin- or AMC-treated group . After 12 weeks of treatment , 100 patients were r and omly selected from each group and assessed for clinical improvement . The effects of the two drugs on the intestinal microbiota were evaluated by analyzing the V3 and V4 regions of the 16S rRNA gene by Illumina sequencing and multivariate statistical methods . Both metformin and AMC significantly alleviated hyperglycemia and hyperlipidemia and shifted gut microbiota structure in diabetic patients . They significantly increased a coabundant group represented by Blautia spp . , which significantly correlated with the improvements in glucose and lipid homeostasis . However , AMC showed better efficacies in improving homeostasis model assessment of insulin resistance ( HOMA-IR ) and plasma triglyceride and also exerted a larger effect on gut microbiota . Furthermore , only AMC increased the coabundant group represented by Faecalibacterium spp . , which was previously reported to be associated with the alleviation of T2DM in a r and omized clinical trial . Metformin and the Chinese herbal formula may ameliorate type 2 diabetes with hyperlipidemia via enriching beneficial bacteria , such as Blautia and Faecalibacterium spp . IMPORTANCE Metabolic diseases such as T2DM and obesity have become a worldwide public health threat . Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases , and thus the gut microbiota serves as a promising target for disease control . In this study , we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs : metformin and a specifically design ed Chinese herbal formula ( AMC ) for diabetic patients with hyperlipidemia . Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota . Blautia spp . were identified as being associated with improvements in glucose and lipid homeostasis for both drugs . AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels , which were associated with the enrichment of Faecalibacterium spp . In brief , these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula . Metabolic diseases such as T2DM and obesity have become a worldwide public health threat . Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases , and thus the gut microbiota serves as a promising target for disease control . In this study , we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs : metformin and a specifically design ed Chinese herbal formula ( AMC ) for diabetic patients with hyperlipidemia . Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota . Blautia spp . were identified as being associated with improvements in glucose and lipid homeostasis for both drugs . AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels , which were associated with the enrichment of Faecalibacterium spp . In brief , these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula Introduction Type 2 diabetes ( T2D ) has reached epidemic proportions in North America . Recent evidence suggests that prebiotics can modulate the gut microbiome , which then plays an important role in regulating lipid metabolism , blood glucose , and insulin sensitivity . As such , prebiotics are appealing potential therapeutic strategies for prediabetes and T2D . The key objectives of this study were to determine the tolerability as well as the glucose and insulin modulating ability of  MSPrebiotic ® digestion resistant starch ( DRS ) in healthy mid-age ( MID ) and elderly ( ELD ) adults . Material s and methods This was a prospect i ve , blinded , placebo-controlled study . Prediabetes and diabetes were among the exclusion factors . ELD ( > 70 years ) and MID ( 30–50 years ) Canadian adults were recruited and , after 2 weeks of consuming placebo , they were r and omized to consume 30 g of either MSPrebiotic ® or placebo per day for 12 weeks . In total , 42 ELD and 42 MID participants completed the study . Blood sample s were collected over the 14-week study and analyzed for glucose , lipid profile , and CRP , lipid particles , TNF-α , IL-10 , insulin , and insulin resistance ( IR ) . Results At baseline , the ELD population had a significantly higher percentage ( p < 0.01 ) with elevated glucose and significantly higher TNF-α ( p < 0.01 ) compared to MID adults .  MSPrebiotic ® DRS was well tolerated in both MID and ELD adults . There was a significant difference over time in blood glucose ( p = 0.0301 ) and insulin levels ( p = 0.009 ) , as well as IR ( HOMA-IR ; p = 0.009 ) in ELD adults who consumed MSPrebiotic ® compared to placebo . No significant changes were found in MID adults . Conclusion Our results suggest that dietary supplementation with prebiotics such as MSPrebiotic ® may be part of an effective strategy to reduce IR , a major risk factor for developing T2D , in the ELD . Clinical Trial Registration NCT01977183 listed on NIH website : Clinical Trials.gov , The meta data generated in this study have been su bmi tted to the NCBI Sequence Read Archive ( http://www.ncbi.nlm.nih.gov/bioproject/381931 ) Background The fermentation of dietary fiber to various organic acids is a beneficial function provided by the microbiota in the human large intestine . In particular , butyric acid contributes to host health by facilitating maintenance of epithelial integrity , regulating inflammation , and influencing gene expression in colonocytes . We sought to increase the concentration of butyrate in 20 healthy young adults through dietary supplementation with resistant starch ( unmodified potato starch — resistant starch ( RS ) type 2 ) . Methods Fecal sample s were collected from individuals to characterize butyrate concentration via liquid chromatography and composition of the microbiota via surveys of 16S rRNA-encoding gene sequences from the Illumina MiSeq platform . R and om Forest and LEfSe analyses were used to associate responses in butyrate production to features of the microbiota . Results RS supplementation increased fecal butyrate concentrations in this cohort from 8 to 12 mmol/kg wet feces , but responses varied widely between individuals . Individuals could be categorized into three groups based upon butyrate concentrations before and during RS : enhanced , high , and low ( n = 11 , 3 , and 6 , respectively ) . Fecal butyrate increased by 67 % in the enhanced group ( from 9 to 15 mmol/kg ) , while it remained ≥11 mmol/kg in the high group and ≤8 mmol/kg in the low group . Microbiota analyses revealed that the relative abundance of RS-degrading organisms — Bifidobacterium adolescentis or Ruminococcus bromii — increased from ~2 to 9 % in the enhanced and high groups , but remained at ~1.5 % in the low group . The lack of increase in RS-degrading bacteria in the low group may explain why there was no increase in fecal butyrate in response to RS . The microbiota of individuals in the high group were characterized by an elevated abundance of the butyrogenic microbe Eubacterium rectale ( ~6 % in high vs. 3 % in enhanced and low groups ) throughout the study . Conclusions We document the heterogeneous responses in butyrate concentrations  upon RS supplementation and identify characteristic of the microbiota that appear to underlie this variation . This study complements and extends other studies that call for personalized approaches to manage beneficial functions provided by gut microbiomes BACKGROUND Diets with a low glycemic index ( GI ) have been shown to improve glucose tolerance in both healthy and diabetic subjects . Two potential mechanisms are discussed in relation to long-term metabolic effects : a decreased dem and for insulin in the postpr and ial phase and formation of short-chain fatty acids from fermentation of indigestible carbohydrates in the colon . OBJECTIVE The objective was to study the effect of the GI and the indigestible carbohydrate -- resistant starch ( RS ) and dietary fiber (DF)--content of cereal-based breakfasts on glucose tolerance at a second meal ( lunch ) in healthy subjects . DESIGN The effects of 7 test breakfasts with known GIs ( GI : 52 - 99 ) and RS + DF contents ( 2 - 36 g ) were evaluated . White-wheat bread was used as a reference breakfast ( high GI , low RS + DF content ) . Glucose and insulin responses after the second meal were measured in healthy subjects . In addition , the satiating capacity of 4 of the 7 test breakfasts was estimated before and during the second meal . RESULTS Two of the 4 low-GI breakfasts improved glucose tolerance at the second meal . Only these 2 breakfasts were capable of postponing the in-between-meal fasting state . There was no measurable effect of fermentable carbohydrates on glucose tolerance at the second meal . The highest satiety score was associated with the barley breakfast that had a low GI and a high RS + DF content . CONCLUSIONS Glucose tolerance can improve in a single day . Slow absorption and digestion of starch from the breakfast meal , but not the content of indigestible carbohydrates in the breakfast meal , improved glucose tolerance at the second meal ( lunch ) Recent evidence suggests that resistant starch ( RS ) is the single most important substrate for bacterial carbohydrate fermentation in the human colon . During two 4-wk periods . 12 healthy volunteers consumed a controlled basal diet enriched with either amylomaize starch ( 55.2 + /- 3.5 g RS/d ; high-RS diet ) or available cornstarch ( 7.7 + /- 0.3 g RS/d ; low-RS diet ) . Approximately 90 % of the RS consumed disappeared during intestinal passage ; increased fermentation was verified by elevated breath-hydrogen excretion . During the high-RS diet , fecal wet and dry weight increased 49 % and 56 % , respectively ( P < or = 0.005 ) , whereas stool water content did not change significantly . Fecal concentrations and daily excretion of short-chain fatty acids were not different in the two study periods . During the high-RS diet , bacterial beta-glucosidase activity decreased by 26 % ( P < or = 0.05 ) . Fecal concentrations of total and secondary bile acids were significantly lower during the high-RS than during the low-RS period [ a decrease of 30 % ( P < or = 0.05 ) and 32 % ( P < or = 0.01 ) , respectively , in total and secondary bile acids ] whereas concentrations of primary bile acids were unaffected by RS consumption . During the high-RS diet , fecal concentrations of total neutral sterols decreased by 30 % ( P < or = 0.005 ) and fecal concentrations of 4-cholesten-3-one decreased by 36 % ( P < or = 0.05 ) . These data suggest that RS has potentially important effects on bacterial metabolism in the human colon that may be relevant for cancer prevention Consumption of resistant starch (RS)-enriched foods is associated with decrease in the postpr and ial glycaemic and insulinaemic responses , accompanied by the production of fermentation-related gases in the large bowel . The present study aim ed to determine the postpr and ial glycaemic and insulinaemic responses to the GM RS-enriched rice and the fermentation-related production of H2 in young and healthy Chinese adults . A total of sixteen young adults ( nine men and seven women ) were recruited and divided into three groups . Their postpr and ial glycaemic and insulinaemic responses to 40 g glucose , carbohydrates of RS or wild-type ( WT ) rice were tested by a crossover model with a washout period of 7 d. The concentrations of blood glucose and insulin as well as breath H2 were measured before and after food intake . Although the mean concentrations of fasting blood glucose , insulin and breath H2 were similar , consumption of the RS rice significantly decreased the values of glycaemic index ( GI ) and insulin index ( II ) , as compared with the intake of WT rice ( 48.4 ( sem 21.8 ) v. 77.4 ( sem 34.9 ) for GI , 34.2 ( sem 18.9 ) v. 54.4 ( sem 22.4 ) for II , P < 0.05 ) , respectively . Conversely , intake of the RS rice meal significantly elevated the concentrations of breath H2 , as compared with WT rice ( 38.9 ( sem 17.6 ) v. 10.5 ( sem 3.7 ) parts per million for peak levels of breath H2 , P < 0.05 ) through a period of 16-h tests . Consumption of the GM RS-enriched rice meal decreased the postpr and ial glycaemic and insulinaemic responses and promoted RS fermentation-related production of H2 in the large bowel of young and healthy Chinese adults To further underst and how diets containing high levels of fibre protect against  colorectal cancer  , we examined the effects of diets high in nonstarch polysaccharides ( NSP ) or high in NSP plus resistant starch ( RS ) on the composition of the faecal microbial community in 46 healthy adults in a r and omized crossover intervention study . Changes in bacterial population s were examined using denaturing gradient gel electrophoresis ( DGGE ) of 16S rRNA gene fragments . Bacterial profiles demonstrated changes in response to the consumption of both RS and NSP diets [ analysis of similarities ( ANOSIM ) : R=0.341 - 0.507 , P<0.01 ] . A number of different DGGE b and s with increased intensity in response to dietary intervention were attributed to as-yet uncultivated bacteria closely related to Ruminococcus bromii . A real-time PCR assay specific to the R. bromii group was applied to faecal sample s from the dietary study and this group was found to comprise a significant proportion of the total community when individuals consumed their normal diets ( 4.4+/-2.6 % of total 16S rRNA gene abundance ) and numbers increased significantly ( + /-67 % , P<0.05 ) with the RS , but not the NSP , dietary intervention . This study indicates that R. bromii-related bacteria are abundant in humans and may be significant in the fermentation of complex carbohydrates in the large bowel To investigate whether resistant starch ( RS ) affects putative risk factors for colon cancer , 24 healthy men consumed a daily RS supplement for 4 wk in addition to their habitual diet in a single-blind , r and omized , balanced multiple crossover trial . During the first week , all subjects consumed the control supplement containing glucose . Subsequently , each subject consumed , in r and om order , a supplement with RS2 ( uncooked high-amylose cornstarch ) , RS3 ( extruded and retro grade d high-amylose cornstarch ) , and glucose , each for 1 wk . The RS2 and RS3 supplements provided 32 g RS/d . Lithium was added to the supplements to measure compliance . Feces , 24-h urine , and breath sample s , as well as a 24-h food-consumption recall were obtained weekly from each subject . Compliance as measured by urinary lithium recovery was satisfactory . The mean composition of the background diet did not differ between the various supplementation periods . Breath-hydrogen excretion , stool weight , and fecal starch excretion were significantly higher during RS than during glucose supplementation , but did not differ during RS2 and RS3 supplementation . There were no significant differences in fecal dry weight , pH , or short-chain fatty acid concentrations , nor in the pH , bile acid concentrations , cytotoxicity , or osmolality of fecal water . It is concluded that in healthy men , supplementing the habitual diet for 1 wk with 32 g RS2 or RS3/d compared with glucose had no effect on putative risk factors for colon cancer , except for increasing stool weight and colonic fermentative activity . There were no significant differences between the effects of RS2 and RS3 on the indexes studied Background / Objectives : Our objective was to investigate changes in liver fat and insulin sensitivity during a 2-year diet intervention . An ad libitum Paleolithic diet ( PD ) was compared with a conventional low-fat diet (LFD).Subjects/ Methods : Seventy healthy , obese , postmenopausal women were r and omized to either a PD or a conventional LFD . Diet intakes were ad libitum . Liver fat was measured with proton magnetic resonance spectroscopy . Insulin sensitivity was evaluated with oral glucose tolerance tests and calculated as homeostasis model assessment -insulin resistance (HOMA-IR)/liver insulin resistance ( Liver IR ) index for hepatic insulin sensitivity and oral glucose insulin sensitivity (OGIS)/Matsuda for peripheral insulin sensitivity . All measurements were performed at 0 , 6 and 24 months . Forty-one women completed the examinations for liver fat and were included . Results : Liver fat decreased after 6 months by 64 % ( 95 % confidence interval : 54–74 % ) in the PD group and by 43 % ( 27–59 % ) in the LFD group ( P<0.01 for difference between groups ) . After 24 months , liver fat decreased 50 % ( 25–75 % ) in the PD group and 49 % ( 27–71 % ) in the LFD group . Weight reduction between baseline and 6 months was correlated to liver fat improvement in the LFD group ( rs=0.66 , P<0.01 ) but not in the PD group ( rs=0.07 , P=0.75 ) . Hepatic insulin sensitivity improved during the first 6 months in the PD group ( P<0.001 for Liver IR index and HOMA-IR ) , but deteriorated between 6 and 24 months without association with liver fat changes . Conclusions : A PD with ad libitum intake had a significant and persistent effect on liver fat and differed significantly from a conventional LFD at 6 months . This difference may be due to food quality , for example , a higher content of mono- and polyunsaturated fatty acids in the PD . Changes in liver fat did not associate with alterations in insulin sensitivity 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 aim ed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postpr and ial metabolites and body fat in T2DM . Seventeen individuals with well-controlled T2DM ( HbA1c 46.6±2 mmol/mol ) consumed , in a r and om 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 result ed in significantly lower postpr and ial 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 ) , postpr and ial 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 h and ling , possibly due to higher postpr and ial GLP1 BACKGROUND Increase in obesity and metabolic syndrome are associated with increases in insulin resistance ( IR ) and type 2 diabetes mellitus . Results from animal intervention studies and human epidemiological studies suggest that n-3 polyunsaturated fatty acids can prevent and reverse IR , but results from human intervention studies have varied . Results from some human and animal studies suggest that docosahexaenoic acid ( 22:6n-3 ; DHA ) may be more effective than eicosapentaenoic acid ( 20:5n-3 ; EPA ) in the prevention of IR . METHODS By using a placebo-controlled , parallel study design , we examined the effects of DHA supplementation ( 3 grams/day , 90 days ) in the absence of EPA on glucocentric and lipocentric markers of IR in hypertriglyceridemic men ( n=14 - 17/group ) . RESULTS DHA supplementation increased fasting plasma glucose concentration by 4.7 % ( P<0.05 ) , but did not alter other indices of IR based on fasting ( insulin and homeostasis model assessment of insulin resistance [ HOMA-IR ] ) or postpr and ial insulin and glucose concentrations ( areas under curves for insulin and glucose , Matsuda index ) . Glucose increased by 2.7 % in the placebo group and was not significant ; increases in glucose in the two groups did not differ from each other . DHA decreased circulating concentrations of several lipocentric markers of IR , including plasma concentrations of nonesterified fatty acids ( 13.0 % ) , small , dense low-density lipoprotein ( LDL ) particles ( 21.7 % ) , and ratio of tryglycerides to high-density lipoprotein cholesterol ( TG/HDL-C ) ( 34.0 % ) ( P<0.05 ) . None of the variables changed in the placebo group . CONCLUSIONS Our results suggest that lipocentric markers of IR are more responsive to DHA supplementation than the glucocentric markers . Future studies with  DHA  in prediabetic subjects and direct measures of insulin sensitivity are needed BACKGROUND Identifying early pre-teen predictors of  adolescent weight gain and the development of impaired fasting glucose ( IFG ) and type 2 diabetes ( T2DM ) at age 18 - 19 y could provide avenues for prevention . OBJECTIVE We evaluated possible pre-teen predictors for development of IFG , T2DM , and changes in body mass index at age 18 - 19 y in black and white girls . DESIGN In a prospect i ve cohort study , body habitus and fasting insulin and glucose were measured at ages 9 - 10 and 18 - 19 y , and multiple 3-d diet records were collected . Factors predicting 10-y change in body mass index and development of IFG and T2DM together were assessed . RESULTS In multivariate analyses , 10-y change in homeostatic model assessment of insulin resistance ( HOMA-IR ) and the age 9 - 10 y HOMA-IR x percentage of calories from fat interaction were positive predictors of 10-y changes in body mass index . At age 18 - 19 y , there were 5 incident cases of T2DM , 37 cases of IFG , and 597 noncases . Age 9 - 10 y IFG and HOMA-IR ( or insulin ) , 10-y change in HOMA-IR ( or insulin ) , and the age 9 - 10 y insulin x total caloric intake interaction predicted IFG and T2DM at age 18 - 19 y. CONCLUSIONS Pre-teen IFG , insulin resistance ( and insulin ) , and rapidly increasing insulin resistance during adolescence identifies girls who are at greater risk of future IFG and T2DM . In addition , insulin resistance , interacting with high-fat diets , identifies girls who are at risk of greater weight gain . These findings could open avenues to primary prevention of obesity , IFG , and T2DM in children Resistant starch ( RS ) , a non-viscous dietary fibre , may have postpr and ial effects on appetite regulation and metabolism , although the exact effects and mechanisms are unknown . An acute r and omised , single-blind crossover study , aim ed to determine the effects of consumption of 48 g RS on appetite compared to energy and available carbohydrate-matched placebo .  Twenty young healthy adult males consumed either 48 g RS or the placebo divided equally between two mixed meals on two separate occasions . Effects on appetite were assessed , using an ad libitum test meal and 24-h diet diaries for energy intake , and using visual analogue scales for subjective measures . Changes to postpr and ial glucose , insulin and C-peptide were also assessed . There was a significantly lower energy intake following the RS supplement compared to the placebo supplement at both the ad libitum test meal ( 5241 ( sem 313 ) v. 5606 ( sem 345 ) kJ , P = 0.033 ) and over the 24 h ( 12 603 ( sem 519 ) v. 13 949 ( sem 755 ) kJ , P = 0.044 ) . However , there was no associated effect on subjective appetite measures . Postpr and ial plasma glucose concentrations were not significantly different between supplements , but there was a significantly lower postpr and ial insulin response following the RS supplement ( P = 0.029 ) . The corresponding C-peptide concentrations were not significantly different , although the ratio of C-peptide to insulin was higher following the RS supplement compared to placebo ( P = 0.059 ) . These results suggest that consumption of 48 g RS , over a 24-h period , may be useful in the management of the metabolic syndrome and appetite . Further studies are required to determine the exact mechanisms Resistant starch ( RS ) consumption can modulate postpr and ial metabolic responses , but its effects on carbohydrate ( CHO ) h and ling in type 2 diabetics ( T2D ) are unclear . It was hypothesized that a bagel high in RS would improve glucose and insulin homeostasis following the 1st meal , regardless of the amount of available CHO , and that in association with incretins , the effects would carry over to a 2nd meal . Using a r and omized crossover design , 12 T2D ingested four different bagel treatments ( their 1st meal ) determined by available CHO and the weight or amount of bagel consumed : treatment A , without RS ( 50 g of available CHO ) ; treatment B , with RS ( same total CHO as in A ) ; treatment C , with RS ( same available CHO as in A ) ; and treatment D , with the same RS as in B and available CHO as in A and C. A st and ard 2nd meal was ingested 3 h later . Following the first meal , B elicited a lower glucose incremental area under the curve ( iAUC ) than C ( P < 0.05 ) , D ( P < 0.05 ) , and A ( trend ; P = 0.07 ) , lower insulin iAUC than A ( P < 0.05 ) and C ( P < 0.05 ) , and lower glucose-dependent insulinotropic polypeptide ( GIP ) iAUC than A ( P < 0.05 ) . There was a positive correlation ( P < 0.05 ) between GIP and insulin iAUCs after the 2nd meal , and C had a 3 times greater slope than the other treatments ( r = 0.91 , P < 0.001 ) , yet lacked a significant concomitant improvement in glucose disposal . These results show that for the 1st meal , RS was effective when it replaced a portion of the available CHO , while ingesting more RS influenced the GIP-insulin axis following the 2nd meal BACKGROUND Type 2 diabetes ( T2D ) incidence continues to rise . Although increasing dietary fiber intake is an established strategy for improved glycemic control , most adults consume insufficient amounts . Fiber-enhanced functional foods can increase fiber intake , and there is particular interest in resistant starch ( RS ) as a high-fiber ingredient . Studies show that high-amylose maize resistant starch , type 2 ( HAM-RS2 ) improves acute and chronic glycemic responses , but more studies are needed in individuals at high risk of T2D with RS delivered in commonly consumed foods . OBJECTIVE The objective of this study was to examine the chronic effects of consuming bagels high in HAM-RS2 on fasting and postpr and ial glycemic markers in adults at increased risk of T2D . METHODS With the use of a r and omized , double-blind crossover design , 24 men and women with a mean ± SE age of 55.3 ± 1.59 y and body mass index ( in kg/m2 ) of 30.2 ± 0.57 consumed 1 bagel containing 25 g HAM-RS2/d or 1 control wheat bagel/d for 56 d each , separated by a 4-wk washout . Fasting and postpr and ial oral-glucose-tolerance test ( OGTT ) glucose and insulin were measured on study days 1 and 57 of each bagel treatment . RESULTS The RS bagel treatment result ed in significantly lower fasting ( 22.1 % , P = 0.04 ) , 2-h ( 23.3 % , P < 0.008 ) , and 3-h ( 18.9 % , P = 0.05 ) insulin incremental areas under the curve and fasting insulin resistance ( homeostasis model assessment of insulin resistance ; 23.1 % , P = 0.04 ) than did the control bagel treatment . Fasting and postpr and ial OGTT glucose concentrations did not differ between the RS and control bagel treatments on study days 1 or 57 . CONCLUSIONS These data suggest that consumption of a high-HAM-RS2 bagel improves glycemic efficiency by reducing the amount of insulin required to manage postpr and ial glucose while improving fasting insulin sensitivity in adults at increased risk of T2D . This research provides support for a feasible dietary strategy for T2D risk reduction . This trial was registered at clinical trials.gov as NCT02129946 Background : Insulin resistance ( IR ) can precede the dysglycemic states of prediabetes and type 2 diabetes mellitus ( T2DM ) by a number of years and is an early marker of risk for metabolic and cardiovascular disease . There is an unmet need for a simple method to measure IR that can be used for routine screening , prospect i ve study , risk assessment , and therapeutic monitoring . We have reported several metabolites whose fasting plasma levels correlated with insulin sensitivity . These metabolites were used in the development of a novel test for IR and prediabetes . Methods : Data from the Relationship between Insulin Sensitivity and Cardiovascular Disease Study were used in an iterative process of algorithm development to define the best combination of metabolites for predicting the M value derived from the hyperinsulinemic euglycemic clamp , the gold st and ard measure of IR . Subjects were divided into a training set and a test set for algorithm development and validation . The result ing calculated M score , MQ , was utilized to predict IR and the risk of progressing from normal glucose tolerance to impaired glucose tolerance ( IGT ) over a 3 year period . Results : MQ correlated with actual M values , with an r value of 0.66 . In addition , the test detects IR and predicts 3 year IGT progression with areas under the curve of 0.79 and 0.70 , respectively , outperforming other simple measures such as fasting insulin , fasting glucose , homeostatic model assessment of IR , or body mass index . Conclusions : The result , Quantose ™ , is a simple test for IR based on a single fasting blood sample and may have value as an early indicator of risk for the development of prediabetes and T2DM OBJECTIVE To investigate the effects of insulin resistance ( IR ) and insulin secretion ( IS ) on the development of diabetes mellitus in individuals with impaired glucose tolerance ( IGT ) who underwent lifestyle interventions .  METHODS 284 out of 577 individuals with IGT identified by population -based screening in Da Qing , China , who were r and omized to undergo diet change and /or increased physical activity  had baseline fasting and 2 h post-load insulin determinations . They were followed for 6 years for the development of diabetes . IR and IS were assessed using calculated indices based on fasting plasma insulin and glucose . The interactions of IR , IS , obesity and plasma glucose and the effects of the lifestyle interventions were evaluated using Cox Proportional Hazards analysis . RESULTS Both IR and IS were significantly associated with the development of diabetes . Lifestyle interventions were more effective in those with lower IT and higher IS at baseline . Diet plus exercise interventions result ed in significantly lower incidence of diabetes , even after controlling for IR , IS , BMI and 2hrPG . CONCLUSION Both IR and beta-cell function were predictors of diabetes in Chinese with IGT . Lifestyle intervention reduced the incidence of DM and these interventions were more effective in those with less IR OBJECTIVE Biliopancreatic diversion ( BPD ) restores normal glucose tolerance in a few weeks in morbid obese subjects with type 2 diabetes , improving insulin sensitivity . However , there is less known about the effects of BPD on insulin secretion . We tested the early effects of BPD on insulin secretion in obese subjects with and without type 2 diabetes . METHODS AND PROCEDURES Twenty-one consecutive morbid obese subjects , 9 with type 2 diabetes ( T2DM ) and 12 with normal fasting glucose ( NFG ) were evaluated , just before and 1 month after BPD , by measuring body weight ( BW ) , glucose , adipocitokines , homeostasis model assessment of insulin resistance ( HOMA-IR ) , acute insulin response ( AIR ) to e.v . glucose and the insulinogenic index adjusted for insulin resistance ( [DeltaI5/DeltaG5]/HOMA-IR ) . RESULTS Preoperatively , those with T2DM differed from those with NFG in showing higher levels of fasting glucose , reduced AIR ( 57.9 + /- 29.5 vs. 644.9 + /- 143.1 pmol/l , P < 0.01 ) and reduced adjusted insulinogenic index ( 1.0 + /- 0.5 vs. 17.6 + /- 3.9 1/mmol(2 ) , P < 0.001 ) . One month following BPD , in both groups BW was reduced ( by approximately 11 % ) , but all subjects were still severely obese ; HOMA-IR and leptin decreased significanlty , while high-molecular weight ( HMW ) adiponectin and adjusted insulinogenic index increased . In the T2DM group , fasting glucose returned to non-diabetic values . AIR did not change in the NFG group , while in the T2DM group it showed a significant increase ( from 58.0 + /- 29.5 to 273.8 + /- 47.2 pmol/l , P < 0.01 ) . In the T2DM group , the AIR percentage variation from baseline was significantly related to changes in fasting glucose ( r = 0.70 , P = 0.02 ) , suggesting an important relationship exists between impaired AIR and hyperglycaemia . DISCUSSION BPD is able to restore AIR in T2DM even just 1 month after surgery . AIR restoration is associated with normalization of fasting glucose concentrations
The results indicated that there was no significant difference in the amelioration of BMI , HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation .
There was no significant difference between RS and non-RS supplements in patients with simple obesity .
Conclusion RS supplementation can ameliorate IR in T2DM , especially for the patients of T2DM with obesity , but not in simple obesity
Background Resistant starch ( RS ) is a starch that can be fermented by the microbial flora within gut lumen .
Insulin resistance ( IR ) is a pathophysiological condition related to diabetes and obesity .
RS could reduce blood glucose and ameliorate IR in animals , but its effect in human population is controversial .
Objective The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity .