Diabetes Care 1997 Nov; 20(11):1774-80 Wursch P, Pi-Sunyer FX. Nestle Research Centre, Lausanne, Switzerland.
Recent recommendations for the dietary management of diabetes mellitus state that diet needs to be individualized so that there is improved glucose and lipid control in the patient. In a majority of individuals with diabetes, this is best done with a diet that is low in fat and high in carbohydrate, particularly that of cereal origin. However, symptoms of hyper- and hypoglycemia must be averted. Most cereal products, however, tend to have a high glycemic index Cereals such as Prowashonupana barley or fractions of oat bran are particularly high in the soluble fiber beta-glucan, which when taken with a meal increases the viscosity of the meal bolus once it has reached the small intestine, where the absorption of nutrients occurs. This high viscosity delays absorption. A 50% reduction in glycemic peak can be achieved with a concentration of 10% beta-glucan in a cereal food. A significant lowering of plasma LDL cholesterol concentrations can also be anticipated with the daily consumption of > or = 3 g of beta-glucan. Diabetic individuals can benefit from diets that are high in beta-glucan, which, as a component of oats and barley, can be incorporated into breakfast cereals and other products.
Publication Types: Review;
PMID: 9353622 [PubMed - indexed for MEDLINE]
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Diabetes Care 1996 Aug;19(8):831-4 Tappy L, Gugolz E, Wursch P. Polyclinique Medicale Universitaire, Lausanne, Switzerland.
OBJECTIVE: To determine whether increasing doses (amounts) of beta-glucan present in an extruded breakfast cereal affect the glycemic and insulinemic responses in eight NIDDM subjects, compared with the same responses after a continental breakfast (bread, milk, cheese, ham). RESEARCH DESIGN AND METHODS: Breakfast cereals were produced using various proportions of oat bran enriched in fiber, which contain an unusually high amount of a viscous polysaccharide, called beta-glucan, and oat bran. The carbohydrate load was 35 g. RESULTS: The maximum increases observed in plasma glucose after the breakfast cereal were 67% (P < 0.05), 42% (P < 0.001), and 38% (P < 0.001) with 4.0, 6.0, and 8.4 g beta-glucan, respectively, compared with the continental breakfast. There was a linear inverse relationship between dose of beta-glucan and plasma glucose peak or area under the glucose curve (R2 = 0.94, P < 0.05). Postprandial insulin increase was only 59-67% (P < 0.01) as high as the continental breakfast after all three levels of beta-glucan. CONCLUSIONS: The 50% decrease in glycemic response that was observed after the ingestion of 35 g carbohydrate is estimated to occur with approximately 5 g beta-glucan. This dose of beta-glucan can easily be attained without the loss of taste by incorporating oat bran concentrate in products.
PMID: 8842600 [PubMed - indexed for MEDLINE]
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J Pediatr Gastroenterol Nutr 2001 Jan;32(1):34-6 Rami B, Zidek T, Schober E. Department of Paediatrics, University of Vienna, Austria.
BACKGROUND: The high prevalence of low nocturnal blood glucose levels is a major problem in the treatment of children with diabetes. METHODS: The effect of a beta-glucan-enriched bedtime snack on nocturnal blood glucose levels was examined in comparison with an equicaloric conventional snack in 38 children with diabetes during a 12-night study period. RESULTS: A significant influence of the type of bedtime snack on the blood glucose course until 2 AM could be observed (P < 0.05). However, there was no difference in the prevalence of nocturnal hypoglycemic blood glucose levels, which was 27% at 2 AM. CONCLUSION: Silent nocturnal hypoglycemia is common in children with diabetes. The introduction of a fiber-enriched bedtime snack may flatten the blood glucose curve before midnight but cannot prevent low 2 AM blood glucose. Other therapeutic strategies that reduce the risk of asymptomatic and symptomatic nocturnal hypoglycemia would be beneficial to many children with diabetes.
PMID: 11176321 [PubMed - in process]
Diabet Med 1994 Apr;11(3):312-8. Braaten JT, Scott FW, Wood PJ, Riedel KD, Wolynetz MS, Brule D, Collins MW. Division of Endocrinology and Metabolism, Ottawa Civic Hospital, University of Ottawa, Ontario, Canada.
The aim of the current study was to characterize the effects of isolated and native sources of beta-glucan, oat gum, and oat bran, respectively, when incorporated into a complete meal. Fasting control subjects and subjects with Type 2 diabetes were fed porridge meals containing either wheat farina, wheat farina plus oat gum or oat bran. Blood samples were collected for 3 h after the test meals and plasma glucose and insulin were measured. Oat bran and wheat farina plus oat gum meals reduced the postprandial plasma glucose excursions and insulin levels when compared with the control wheat farina meal in both control and Type 2 diabetic subjects. This study shows that both the native cell wall fibre of oat bran and isolated oat gum, when incorporated into a meal, act similarly by lowering postprandial plasma glucose and insulin levels. A diet rich in beta-glucan may therefore be of benefit in the regulation of postprandial plasma glucose levels in subjects with Type 2 diabetes.
PMID: 8033532 [PubMed - indexed for MEDLINE]
Diabetes Res Clin Pract 1992 Aug;17(2):75-9 Books Kida K, Inoue T, Kaino Y, Goto Y, Ikeuchi M, Ito T, Matsuda H, Elliott RB. Department of Pediatrics, Ehime University School of Medicine, Japan.
The preventive effect of an immunopotentiator, beta-1,6;1,3 D-glucan, on the development of diabetes and insulitis was studied in BB rats. The intravenous administration of 1 mg kg-1 week-1 of beta-1,6;1,3 D-glucan from the age of 4 weeks decreased the cumulative incidence of diabetes from 43.3% (13/30) to 6.7% (2/30) (P less than 0.005) and also the incidence of insulitis from 82.4% (14/17) to 26.3% (5/19) at the age of 20 weeks (P less than 0.002). Eight of nine rats were free from diabetes for 5 weeks after stopping beta-1,6;1,3 D-glucan at the age of 20 weeks. The total numbers of leukocytes in the peripheral blood and spleen of the rats were increased by beta-1,6;1,3 D-glucan treatment (P less than 0.05), whereas their T lymphocytes subsets were not changed. These data indicate that immunopotentiators could modulate the autoimmune mechanisms directed to pancreatic islets and inhibit the development of diabetes in BB rats.
PMID: 1425150 [PubMed - indexed for MEDLINE]
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Babineau TJ, Marcello P, Swails W, Kenler A, Bistrian B, Forse RA. Department of Surgery, Deaconess Hospital, Harvard Medical School, Boston, Massachusetts.
OBJECTIVE: The safety and efficacy of PGG-glucan in surgical patients at high risk for postoperative infection who underwent major thoracic or abdominal surgery were determined. SUMMARY BACKGROUND DATA: Recent studies have reported a 25% to 27% infectious complication rate in patients undergoing major surgery with an average cost per infected patient of $12,000. The efficacy of PGG-glucan pretreatment in prevention of sepsis has been demonstrated in rodent models for gram-negative and gram-positive bacterial and yeast infections. In vitro studies have demonstrated enhanced microbial killing by monocytes and neutrophils in healthy volunteers after PGG-glucan administration. Thus, PGG-glucan may play a role in decreasing the infectious complication rate in patients undergoing major surgery. METHODS: A double-blind, placebo-controlled randomized study was performed in 34 high-risk patients undergoing major abdominal or thoracic surgery. RESULTS: There were no adverse drug experiences associated with PGG-glucan infusion. Patients who received PGG-glucan had significantly fewer infectious complications (3.4 infections per infected patient vs. 1.4 infections per infected patient, p = 0.05), decreased intravenous antibiotic requirement (10.3 days vs. 0.4 days, p = 0.04) and shorter intensive care unit length of stay (3.3 days vs. 0.1 days, p = 0.03). CONCLUSIONS: PGG-glucan is safe and appears to be effective in the further reduction of the morbidity and cost of major surgery.
PMID: 7979607 [PubMed - indexed for MEDLINE]
de Felippe Junior J, da Rocha e Silva Junior M, Maciel FM, Soares Ad, Mendes NF. Hospital Arthur Ribeiro de Saboya, Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo, Brazil.
In a effect to prevent nosocomial pneumonia and sepsis, we treated patients with severe multiple trauma with an immunomodulator--beta 1-3 polyglucose (glucan). Forty-one patients with no infection at admission were stratified using Trauma Score and included in a randomized double-blind controlled trial. They were divided into a control group (n = 20) and a glucan group (n = 21). Pneumonia occurred in 11 of 20 patients in the control group and in two of 21 recipients of glucan (p < 0.01). Sepsis occurred in seven of 20 patients in the control group and in two of 21 patients treated with glucan (p < 0.05). Considering patients with pneumonia and sepsis, a decrease was observed in nosocomial infection from 65.0 to 14.4 percent (p < 0.001). The mortality rate related to infection was 30.0 percent in patients in the control group and 4.8 percent in the group treated with glucan (p < 0.05). The general mortality rate, cerebral deaths excluded, was 42.1 percent in the control group and 23.5 percent in the glucan group.
PMID: 8211583 [PubMed - indexed for MEDLINE]
Babineau TJ, Hackford A, Kenler A, Bistrian B, Forse RA, Fairchild PG, Heard S, Keroack M, Caushaj P, Benotti P. Department of Surgery, Deaconess Hospital, Harvard Medical School, Boston.
OBJECTIVE: To examine the safety and efficacy of multiple doses of PGG-glucan (poly-[1-6]-B-D-glucopyranosyl-[1-3]-B-D-glucopyranose) in high-risk patients undergoing major thoracic or abdominal surgery. DESIGN: An interventional, multicenter, double-blind, randomized, placebo-controlled study. SETTING: Four university-affiliated medical centers. PATIENTS: Sixty-seven high-risk patients undergoing major thoracic or abdominal surgery. INTERVENTION: Patients were randomized in a 1:1:1:1 ratio to receive saline placebo or PGG-glucan at a dose of 0.1 mg/kg, 0.5 mg/kg, and 1.0 mg/kg or 2.0 mg/kg. One dose was administered before surgery and three doses were administered after surgery. MAIN OUTCOME MEASURES: To examine the safety and efficacy of PGG-glucan infusion and to identify potentially important factors for a planned phase III study. RESULTS: A dose-response trend with regard to infection incidence among patients who received PGG-glucan was observed. Serious infections occurred in four patients who received placebo and in three patients who received PGG-glucan at a dose of 0.1 mg/kg. However, only one patient who received PGG-glucan at a high dose had a serious infection. The incidence and severity of adverse events was comparable in all groups. CONCLUSIONS: PGG-glucan was generally safe and well tolerated, may decrease postoperative infection rates, and warrants further investigation in a planned phase III trial.
PMID: 7979954 [PubMed - indexed for MEDLINE]
Browder W, Williams D, Pretus H, Olivero G, Enrichens F, Mao P, Franchello A. Tulane University, Department of Surgery, New Orleans, LA 70112.
Host immunosuppression after trauma contributes to septic morbidity. The macrophage is a key element in the host immune response. This study evaluated glucan, a macrophage stimulant, in a prospective, randomized, double-blind study of 38 trauma patients undergoing surgery. Glucan (21 patients), 50 mg/m2, or placebo (17 patients) was given intravenously daily for 7 days. Delayed hypersensitivity skin testing was performed on days 1 and 7 after trauma. Serum interleukin-1 (IL-1) and tumor necrosis factor (TNF) were assayed after trauma. While the total mortality rate was significantly less in the glucan group (0% versus 29%) (p less than 0.05), the mortality rate from sepsis was not statistically different (0% versus 17.6%). Glucan therapy significantly decreased septic morbidity (9.5% versus 49%; p less than 0.05). Serum IL-1 had a greater increase in glucan patients on day 3 after trauma (143.4 +/- 19.3% versus 78.6 +/- 11.7%; p less than 0.05), but there was no difference thereafter. Serum TNF did not vary between groups. Early increase in IL-1 correlated with subsequent skin test conversion to positive. Neither serum IL-1 nor TNF was a reliable indicator of future sepsis. Further clinical trials are indicated to evaluate biologic response modifiers that activate macrophages in the trauma patient.
PMID: 2111126 [PubMed - indexed for MEDLINE]
Braaten JT, Wood PJ, Scott FW, Wolynetz MS, Lowe MK, Bradley-White P, Collins MW. Division of Endocrinology and Metabolism, Ottawa Civic Hospital, University of Ottawa, Canada.
OBJECTIVE: Several studies have indicated that consumption of oat bran lowers blood cholesterol and this effect has been attributed specifically to oat bran's soluble fiber (beta-glucan). This study was designed to test this hypothesis. DESIGN: The purified fibre (oat gum, 80% beta-glucan) was isolated, and agglomerated in the presence of maltodextrin to facilitate dispersion in a drink. Subjects consumed the oat gum (2.9 g beta-glucan), or maltodextrin placebo, twice daily for 4 weeks, in a randomized, cross-over design with a 3 week wash-out between phases. Consumption was equivalent to a daily dose of about 70 g of oat bran. SETTING: The study was with free-living individuals. SUBJECTS: Twenty hypercholesterolemic male and female adults entered, and 19 completed, the study. INTERVENTIONS: Blood lipids from fasting individuals were measured weekly throughout the study. Diet was monitored using 3 day food diaries. RESULTS: There were no significant changes (P > 0.05) in blood lipids during the placebo phase. Mean initial total cholesterol (6.76 +/- 0.13 mmol/l) and low density lipoprotein (LDL) cholesterol (4.59 +/- 0.14 mmol/l) levels fell throughout the oat gum phase, and at week 4 each was reduced 9% relative to initial values (P = 0.0004 and 0.005 respectively). When oat gum was discontinued, total and LDL cholesterol returned to initial levels. There were no significant changes in high density lipoprotein (HDL) cholesterol. Triglyceride levels also remained unchanged except for a singular decrease at week 4 of the oat gum phase relative to the initial value, but not compared to the placebo value. The lowered mean total and LDL cholesterol levels occurred in the absence of any dietary changes. CONCLUSIONS: The main component of the soluble fibre of oats, beta-glucan, significantly reduced the total and LDL cholesterol levels of hypercholesterolemic adults without changing HDL cholesterol.
PMID: 7956987 [PubMed - indexed for MEDLINE]
Effect of beta-glucan level in oat fiber extracts on blood lipids in men and women.
Behall KM, Scholfield DJ, Hallfrisch J. Diet and Human Performance Laboratory, Beltsville Human Nutrition Research Center, US Department of Agriculture, Maryland 20705-2350, USA.
OBJECTIVE: An active hypolipidemic component in oats, the soluble fiber beta-glucan, has been concentrated in an oat fiber extract. The oat fiber extract has been used to replace fat in food products. This study was designed to determine if moderate levels of oat fiber extract could be incorporated into a typical diet and whether plasma lipids could be reduced by the amount of beta-glucan added to the diet. METHODS: Oat fiber extracts containing low (1% by weight) or high (10% by weight) beta-glucan were fed to 23 mildly hypercholesterolemic subjects (seven men and 16 women). A maintenance diet was fed for 1 week followed by diet containing an oat extract for 5 weeks each in a crossover pattern. Five percent of the energy from fat in the maintenance diet was replaced with the oat extract in the experimental diets. Caloric intake was adjusted to try to maintain each subject's initial weight. Fasting blood was collected several days apart after separate 12 hour fasts the end of each period. Plasma was analyzed for triglycerides, total cholesterol, and lipoprotein cholesterol fractions. RESULTS: HDL, HDL2, and VLDL cholesterol, and triglyceride levels after the oat extract diets were not significantly different from those after the maintenance diet. Total and LDL cholesterol levels decreased significantly (p < 0.001) from maintenance levels after both diets containing the oat extracts. Total cholesterol levels after the higher beta-glucan extract diet were significantly lower than those after the low beta-glucan diet. CONCLUSIONS: Beneficial reduction of cholesterol was obtained with modest amounts of oat extract incorporated into the diet. A significant dose response due to beta-glucan concentration in the oat extract was observed in total cholesterol levels.
PMID: 9013433 [PubMed - indexed for MEDLINE]
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