A Randomised Crossover Trial: The Effect of Inulin on Glucose Homeostasis in Subtypes of Prediabetes

• Published in: Annals of nutrition and metabolism 2016-01, Vol.68 (1), p.26-34
• Main Authors: Guess, Nicola D., Dornhorst, Anne, Oliver, Nick, Frost, Gary S.
• Format: Article
• Language: English
• Subjects: Aged; Aprotinin; Blood Glucose - metabolism; Body Mass Index; Carbohydrates; Cellulose; Cross-Over Studies; Diabetes; Diabetes Mellitus, Type 2 - drug therapy; Double-Blind Method; Fatty acids; Fatty Acids, Nonesterified - blood; Female; Glucagon-Like Peptide 1 - blood; Glucose; Health risks; Homeostasis; Humans; Insulin; Insulin - blood; Insulin Resistance; Inulin - administration & dosage; Male; Middle Aged; Nutrition; Original Paper; Peptides; Prediabetic state; Prediabetic State - drug therapy; Risk Factors; Type 2 diabetes
• ISSN: 0250-6807; 1421-9697
• DOI: 10.1159/000441626

Background: Fermentable carbohydrates (FCHO) have been shown to improve insulin sensitivity in normoglycaemic and insulin-resistant subjects. However, there are no data on subjects with prediabetes. We aimed to investigate the effect of the FCHO inulin, on glucose homeostasis in subjects with prediabetes. Methods: In a double-blind and placebo-controlled crossover study, 40 volunteers with prediabetes were randomly allocated to take 30 g/day of inulin or cellulose for 2 weeks in a crossover trial, following a 4-week dose-escalation run-in. Fasting insulin and glucose were measured for all subjects. Fifteen of the 40 subjects also underwent a meal tolerance test to assess insulin sensitivity, free fatty acids and glucagon-like peptide-1 concentrations. A subanalysis was carried out to examine any differences between the prediabetes subtypes. Results: Inulin was associated with a significant increase in (0-30 min) incremental AUC (iAUC) for insulin (treatment: p < 0.04) and (0-60 min) iAUC for insulin (treatment: p < 0.04) compared to control. There was a significant reduction in insulin resistance measured by the homeostatic model assessment in the isolated-impaired fasting glucose (p < 0.05) but not in the isolated-impaired glucose tolerance groups (p = 0.59). Conclusion: The FCHO, inulin, may have unique metabolic effects that are of particular benefit to people at risk of diabetes, which warrant further investigation.