Collins Sineaid M, Bernadette Egan M, Whyte Martin B, Denise Robertson M
Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
Diabet Med. 2025 Jul 9:e70079. doi: 10.1111/dme.70079.
Approximately 40% of the caloric intake of the UK diet consists of starch. Most of which is readily digestible, thereby raising blood glucose. However, resistant starch (RS) evades metabolism in the small intestine, and in healthy adults, partial substitution of the diet with RS lowers postprandial glycaemia. The effect of RS in adults with type 2 diabetes is unknown.
We investigated the effect of substituting ~15% of dietary starch with RS on glycaemic measures in adults with type 2 diabetes in a controlled but free-living setting. This was a single-blinded, crossover design, comparing 4-day RS and control diets. Proportions of resistant and digestible starch in identical food products were the only difference. IPro™2 continuous glucose monitors captured glycaemic excursions and glycaemic variability.
Twenty adults with type 2 diabetes, HbA (52 ± 2 mmol/mol; 6.9 ± 0.3%), age 58 ± 11 years, were enrolled, with 95% completing arms. Mean amplitude of glycaemic excursion (MAGE) was lower over lunch with RS (0.94 mmol/L; p = 0.004), as was SD glucose (0.31 mmol/L; p = 0.027), and peak glucose (0.94 mmol/L; p = 0.028). RS prolonged the time it took glucose to peak by 18 min at lunch (p = 0.046) and 28 min at dinner (p = 0.002). Time in range (TIR; glucose 3.9-10.0 mmol/L) was 7.8% greater with RS (p = 0.021).
Substituting a proportion of starch with RS lowers blood glucose without changing the sensory attributes of foods significantly. There is potential to develop a functional diet for adults with type 2 diabetes to aid glycaemic control.
英国饮食中约40%的热量摄入来自淀粉。其中大部分易于消化，从而会升高血糖。然而，抗性淀粉（RS）在小肠中无法代谢，在健康成年人中，用RS部分替代饮食可降低餐后血糖水平。RS对2型糖尿病成年人的影响尚不清楚。
我们在可控的自由生活环境中，研究了用RS替代约15%的膳食淀粉对2型糖尿病成年人血糖指标的影响。这是一项单盲交叉设计，比较了4天的RS饮食和对照饮食。相同食品中抗性淀粉和可消化淀粉的比例是唯一的差异。IPro™2连续血糖监测仪记录血糖波动和血糖变异性。
招募了20名2型糖尿病成年人，糖化血红蛋白（HbA）为（52±2 mmol/mol；6.9±0.3%），年龄58±11岁，95%的人完成了各阶段试验。午餐时食用RS的血糖波动平均幅度（MAGE）较低（0.94 mmol/L；p = 0.004），血糖标准差（0.31 mmol/L；p = 0.027）和血糖峰值（0.94 mmol/L；p = 0.028）也较低。RS使午餐时血糖达到峰值的时间延长了18分钟（p = 0.046），晚餐时延长了28分钟（p = 0.002）。血糖在目标范围内的时间（TIR；血糖3.9 - 10.0 mmol/L）食用RS时增加了7.8%（p = 0.021）。
用RS替代一部分淀粉可降低血糖，且不会显著改变食物的感官特性。有潜力为2型糖尿病成年人开发一种有助于血糖控制的功能性饮食。
