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 .
Efficacy of increased resistant starch consumption in human type 2 diabetes
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
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 .