Institut de recherches cliniques de Montréal, Montréal, Québec H2W 1R7, Canada; Department of Nutrition, université de Montréal, Montréal, Québec H3T 1A8, Canada.
Institut de recherches cliniques de Montréal, Montréal, Québec H2W 1R7, Canada.
Ann Endocrinol (Paris). 2023 Dec;84(6):767-772. doi: 10.1016/j.ando.2023.02.001. Epub 2023 Feb 9.
Cystic fibrosis (CF)-related diabetes (CFRD) is a common comorbidity in CF. In CFRD, fasting blood glucose level is often normal, but post-prandial glycaemia (PPG) is problematic. Elevated PPG has been associated to a higher risk of developing CFRD, a worst clinical state and a lower pulmonary function. Interventional studies in type 2 diabetes have demonstrated a beneficial impact of fibre supplement on PPG.
Our objective is to evaluate the efficiency of 2 doses of a soluble fibre supplement to lower PPG in CF patients with glucose intolerance (pre-diabetic or CFRD patients). This is a double-blinded crossover interventional study with three interventions: placebo or psyllium fibre (5.1g or 7.7g) of soluble fibre consumed before breakfast. A second meal (lunch) is also eaten four hours later to evaluate a second meal effect. Blood glucose and insulin were measured during the interventions.
In 14 adult CF patients with impaired glucose tolerance (IGT; n=10) or CFRD (n=4), we observed no beneficial effect of fibre supplementation on PPG for both meals. However, all blood glucose levels were lower after the lunch compared to breakfast in spite of the higher carbohydrate content.
An acute treatment with fibre supplementation had no effect on blood glucose control in patients with CF-IGT or CFRD.
囊性纤维化(CF)相关糖尿病(CFRD)是 CF 的常见合并症。在 CFRD 中,空腹血糖水平通常正常,但餐后血糖(PPG)存在问题。升高的 PPG 与更高的 CFRD 发病风险、更差的临床状态和更低的肺功能相关。2 型糖尿病的干预研究表明,纤维补充剂对 PPG 有有益影响。
我们的目的是评估两种剂量的可溶性纤维补充剂对葡萄糖耐量受损(糖尿病前期或 CFRD 患者)的 CF 患者降低 PPG 的效果。这是一项双盲交叉干预研究,有三种干预措施:早餐前服用安慰剂或车前子纤维(5.1g 或 7.7g)的可溶性纤维。四小时后再吃第二餐(午餐),以评估第二餐的效果。在干预期间测量血糖和胰岛素。
在 14 名葡萄糖耐量受损(IGT;n=10)或 CFRD(n=4)的成年 CF 患者中,我们观察到纤维补充剂对两餐的 PPG 均没有有益效果。然而,尽管午餐的碳水化合物含量更高,但午餐后的所有血糖水平均低于早餐后的水平。
急性纤维补充治疗对 CF-IGT 或 CFRD 患者的血糖控制没有影响。