scholarly journals The Role of Dietary Fibre in Modulating Gut Microbiota Dysbiosis in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3239 ◽  
Author(s):  
Omorogieva Ojo ◽  
Qian-Qian Feng ◽  
Osarhumwese Osaretin Ojo ◽  
Xiao-Hua Wang
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Adverse Events ◽  
Gut Microbiota ◽  
Dietary Fibre ◽  
Meta Analysis ◽  
Glycated Haemoglobin ◽  
Gut Microbiota Dysbiosis

Background: The prevalence of type 2 diabetes is on the increase worldwide, and it represents about 90% of adults who are diagnosed with diabetes. Overweight and obesity, lifestyle, genetic predisposition and gut microbiota dysbiosis have been implicated as possible risk factors in the development of type 2 diabetes. In particular, low intake of dietary fibre and consumption of foods high in fat and sugar, which are common in western lifestyle, have been reported to contribute to the depletion of specific bacterial taxa. Therefore, it is possible that intake of high dietary fibre may alter the environment in the gut and provide the needed substrate for microbial bloom. Aim: The current review is a systematic review and meta-analysis which evaluated the role of dietary fibre in modulating gut microbiota dysbiosis in patients with type 2 diabetes. Methods: This is a systematic review and meta-analysis of randomised controlled trials which relied on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Electronic searches were conducted using EBSCOHost with links to Health Sciences Research Databases, EMBASE and Google Scholar. The reference lists of articles were also searched for relevant studies. Searches were conducted from date of commencement of the database to 5 August 2020. The search strategy was based on the Population, Intervention, Comparator, Outcomes, Studies (PICOS) framework and involved the use of synonyms and medical subject headings (MesH). Search terms were combined with Boolean operators (OR/AND). Results: Nine studies which met the inclusion criteria were selected for the systematic review and meta-analysis, and four distinct areas were identified: the effect of dietary fibre on gut microbiota; the role of dietary fibre on short-chain fatty acids (SCFAs); glycaemic control; and adverse events. There was significant difference (p < 0.01) in the relative abundance of Bifidobacterium with a mean difference of 0.72 (95% CI, 0.56, 0.89) between the dietary fibre group compared with placebo. In relation to the meta-analysis for SCFAs, while there was significant difference (p = 0.02) between the dietary fibre group and placebo with a standardised mean difference of 0.5 (95% CI, 0.08, 0.91) regarding total SCFAs, the differences were not significant (p > 0.05) in relation to acetic acid, propionic acid and butyric acid. There was only significant improvement (p = 0.002) with respect to glycated haemoglobin with a mean difference of −0.18 (95% CI, −0.29, −0.06) between the dietary fibre group and placebo group. Differences between the two groups were not significant (p > 0.05) in relation to fasting blood glucose and homeostatic model assessment of insulin resistance (HOMA-IR). Furthermore, there were no significant differences between the two groups in subjects who reported adverse events. It is possible that the promotion of SCFA producers in greater diversity and abundance by dietary fibre in this review led to improvement in glycated haemoglobin, partly due to increased glucagon-like peptide-1 (GLP-1) production. In addition, Bifidobacterium lactis has been reported to increase glycogen synthesis, decrease expression of hepatic gluconeogenesis genes, improve translocation of glucose transport-4 and promote glucose uptake. It is also possible that the reduction in body weight of participants in the intervention group compared with control may have contributed to the observed improvement in glycated haemoglobin. Conclusion: This systematic review and meta-analysis have demonstrated that dietary fibre can significantly improve (p < 0.05) the relative abundance of Bifidobacterium, total SCFAs and glycated haemoglobin. However, dietary fibre did not appear to have significant effect (p > 0.05) on fasting blood glucose, HOMA-IR, acetic acid, propionic acid, butyric acid and adverse events.

scholarly journals Dietary Fibre, Gut Microbiota Dysbiosis and Type 2 Diabetes

Proceedings ◽  
2020 ◽  
Vol 61 (1) ◽  
pp. 28
Author(s):  
Omorogieva Ojo ◽  
Qianqian Feng ◽  
Osarhumwese Osaretin Ojo ◽  
Xiaohua Wang
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Gut Microbiota ◽  
Dietary Fibre ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Short Chain Fatty Acids ◽  
Model Assessment ◽  
Gut Microbiota Dysbiosis

Background: Diabetes prevalence is on the increase globally and its impact on those with the condition in terms of acute and chronic complications can be profound. People with type 2 diabetes constitute the majority of those with the condition and the risk factors include obesity, lifestyle and gut microbiota dysbiosis. Poor dietary intake has been reported to influence the community of the gut microbiome. Therefore, a higher intake of dietary fibre may alter the environment in the gut and promote microbial growth and proliferation. Aim: This is a systematic review and meta-analysis which examined the effect of dietary fibre on gut microbiota in patients with type 2 diabetes. Method: This review was conducted in line with the PRISMA framework. Databases were searched for relevant articles which were screened based on inclusion and exclusion criteria. Results: Nine articles which met the inclusion criteria were selected for the systematic review and meta-analysis. High dietary fibre intake significantly improved (p < 0.05) the abundance of Bifidobacterium, total short-chain fatty acids (SCFAs) and HbA1c. Discussion: The promotion of SCFA producers in terms of greater diversity and abundance by dietary fibre may have resulted in improvement in glycated haemoglobin, partly due to increased GLP–1 production. Conclusion: High consumption of dietary fibre has a significant (p < 0.05) effect on Bifidobacterium, total SCFAs and HbA1c, but not (p > 0.05) on propionic, butyric and acetic acid, fasting blood glucose and the homeostatic model assessment of insulin resistance HOMAR–IR.

scholarly journals The Effects of Almonds on Gut Microbiota, Glycometabolism, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3377
Author(s):  
Omorogieva Ojo ◽  
Xiao-Hua Wang ◽  
Osarhumwese Osaretin Ojo ◽  
Amanda Rodrigues Amorim Adegboye
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Gut Microbiota ◽  
Inflammatory Markers ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Postprandial Blood Glucose

The use of nutritional interventions for managing diabetes is one of the effective strategies aimed at reducing the global prevalence of the condition, which is on the rise. Almonds are the most consumed tree nut and they are known to be rich sources of protein, monounsaturated fatty acids, essential minerals, and dietary fibre. Therefore, the aim of this review was to evaluate the effects of almonds on gut microbiota, glycometabolism, and inflammatory parameters in patients with type 2 diabetes. Methods: This systematic review and meta-analysis was carried out according to the preferred reporting items for systematic review and meta-analysis (PRISMA). EBSCOhost, which encompasses the Health Sciences Research Databases; Google Scholar; EMBASE; and the reference lists of articles were searched based on population, intervention, control, outcome, and study (PICOS) framework. Searches were carried out from database inception until 1 August 2021 based on medical subject headings (MesH) and synonyms. The meta-analysis was carried out with the Review Manager (RevMan) 5.3 software. Results: Nine randomised studies were included in the systematic review and eight were used for the meta-analysis. The results would suggest that almond-based diets have significant effects in promoting the growth of short-chain fatty acid (SCFA)-producing gut microbiota. Furthermore, the meta-analysis showed that almond-based diets were effective in significantly lowering (p < 0.05) glycated haemoglobin (HbA1c) levels and body mass index (BMI) in patients with type 2 diabetes. However, it was also found that the effects of almonds were not significant (p > 0.05) in relation to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and Tumour necrosis factor α, TNF-α), glucagon-like peptide-1 (GLP-1), homeostatic model assessment of insulin resistance (HOMA–IR), and fasting insulin. The biological mechanisms responsible for the outcomes observed in this review in relation to reduction in HbA1c and BMI may be based on the nutrient composition of almonds and the biological effects, including the high fibre content and the low glycaemic index profile. Conclusion: The findings of this systematic review and meta-analysis have shown that almond-based diets may be effective in promoting short-chain fatty acid-producing bacteria and lowering glycated haemoglobin and body mass index in patients with type 2 diabetes compared with control. However, the effects of almonds were not significant (p > 0.05) with respect to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and TNF-α), GLP-1, HOMA–IR, and fasting insulin.

scholarly journals The Effect of Dietary Fibre on Gut Microbiota, Lipid Profile, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1805
Author(s):  
Omorogieva Ojo ◽  
Osarhumwese Osaretin Ojo ◽  
Nazanin Zand ◽  
Xiaohua Wang
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Gut Microbiota ◽  
Lipid Profile ◽  
Dietary Fibre ◽  
Inflammatory Markers ◽  
Meta Analysis ◽  
Mean Difference ◽  
The Difference

Background: A disequilibrium of the gut microbial community has been closely associated with systemic inflammation and metabolic syndromes including type 2 diabetes. While low fibre and high fat diets may lead to dysbiosis of the gut microbiome as a result of the loss of useful microbes, it has been reported that a high fibre diet may prevent the fermentation of protein and may promote eubiosis of gut microbiota. Aim: This review aims to evaluate the effect of dietary fibre (DF) on gut microbiota, lipid profile, and inflammatory markers in patients with type 2 diabetes. Methods: The PRISMA framework was relied on to conduct this systematic review and meta-analysis. Searches were carried out using electronic databases and reference list of articles. Results: Eleven studies were included in the systematic review, while ten studies were included in the meta-analysis. The findings revealed five distinct areas including the effects of DF on (a) gut microbiota (122 participants); (b) lipopolysaccharides (LPS, 79 participants) and lipopolysaccharides binding protein (LBP, 81 participants); (c) lipid profile; (d) inflammatory markers; and (e) body mass index (BMI, 319 participants). The relative abundance of Bifidobacterium increased by 0.73 (95% CI: 0.57, 0.89) in the DF group in contrast to the control (p < 0.05). With respect to LPS, the level was lower in the DF group than the control and the difference was significant (p < 0.05). The standardised mean difference for LPS was −0.45 (95% CI: −0.90, −0.01) although the difference between the two groups in relation to LBP was not significant (p = 0.08) and the mean difference was 0.92 (95% CI: −0.12, 1.95). While there was a decrease of −1.05 (95% CI: −2.07, −0.02) with respect to total cholesterol (356 participants) in the DF group as compared with the control (p < 0.05), both groups were not significantly different (p > 0.05) in the other lipid parameters. The difference between the groups was significant (p < 0.05) in relation to C-reactive protein, and the mean difference was 0.43 (95% CI: 0.02, 0.84). This could be due to the short duration of the included studies and differences in participants’ diets including the amount of dietary fibre supplements. However, the groups were not significantly different (p > 0.05) with respect to the other inflammatory markers. The meta-analysis of the BMI showed that the DF group decreased by −0.57 (95% CI: −1.02, −0.12) as compared with the control and this was significant (p < 0.01). Conclusion: DF significantly (p < 0.05) increased the relative abundance of Bifidobacterium and significantly decreased (p < 0.05) LPS, total cholesterol, and BMI as compared with the control. However, DF did not seem to have an effect that was significant on LBP, triglyceride, HDL cholesterol, LDL cholesterol, IL-6, TNF-α, adiponectin, and leptin. These findings have implications for public health in relation to the use of dietary fibre in nutritional interventions and as strategies for managing type 2 diabetes.

scholarly journals The Role of Aerobic Training Variables Progression on Glycemic Control of Patients with Type 2 Diabetes: a Systematic Review with Meta-analysis

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Rodrigo Sudatti Delevatti ◽  
Cláudia Gomes Bracht ◽  
Salime Donida Chedid Lisboa ◽  
Rochelle Rocha Costa ◽  
Elisa Corrêa Marson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Aerobic Training ◽  
Meta Analysis

scholarly journals Efficacy and Safety of Resveratrol Supplements on Blood Lipid and Blood Glucose Control in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Tianqing Zhang ◽  
Qi He ◽  
Yao Liu ◽  
Zhenrong Chen ◽  
Hengjing Hu
Keyword(s):  
Systematic Review ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Adverse Events ◽  
Meta Analysis ◽  
Blood Lipid ◽  
Controlled Trials ◽  
Randomized Controlled

Background. Diabetes is a major public health concern. Resveratrol has shown great beneficial effects on hyperglycemia and insulin resistance and as an antioxidant. Methods. We searched the Chinese and English databases (such as CNKI, PubMed, and Embase) and extracted data from randomized controlled trials (RCTs). Then, RevMan 5.3 was used for bias risk assessment and meta-analysis. The primary outcome indicators include insulin-resistance-related indicators and blood-lipid-related indicators. This systematic review and meta-analysis was registered in PROSPERO (CRD42018089521). Results. Fifteen RCTs involving 896 patients were included. For insulin-resistance-related indicators, the summary results showed that, compared with the control group, homeostasis model assessment for insulin resistance (HOMA-IR) in the resveratrol group is lower (WMD: −0.99; 95% CI −1.61, −0.38; P = 0.002 ). For blood-lipid-related indicators, the total cholesterol (TC) and triglyceride (TG) in the resveratrol group is of no statistical significance (for TC, WMD: −7.11; 95% CI −16.28, 2.06; P = 0.13 ; for TG, WMD: −2.15; 95% CI −5.52, 1.22; P = 0.21 ). For adverse events, the summary results showed that there was no statistical difference in the incidence of adverse events between the resveratrol and control groups (WMD: 2; 95% CI 0.44, 9.03; P = 0.37 ). Conclusion. Based on the current evidence, resveratrol may improve insulin resistance, lower fasting blood glucose and insulin levels, and improve oxidative stress in patients with type 2 diabetes mellitus.

scholarly journals Circulating Nesfatin-1 Levels and Type 2 Diabetes: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ting Zhai ◽  
Shi-Zhen Li ◽  
Xin-Tong Fan ◽  
Zhao Tian ◽  
Xiao-Qing Lu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Control Group ◽  
Newly Diagnosed ◽  
Antidiabetic Treatment ◽  
The Relationship ◽  
Diabetes Patients

The role of nesfatin-1 in glucose homeostasis has been investigated previously. However, although numerous studies have examined the relationships between circulating nesfatin-1 levels and type 2 diabetes, the conclusions are contradictory. We aimed to probe the relationship between circulating nesfatin-1 levels and type 2 diabetes by meta-analysis. Seven studies including 328 type 2 diabetes patients and 294 control subjects were included. Although there was no obvious difference in circulating nesfatin-1 levels between patients with type 2 diabetes and the control group (MD = −0.04; 95% CI = −0.32 to −0.23), subgroup analysis showed higher nesfatin-1 levels in newly diagnosed type 2 diabetes patients (MD = 0.59; 95% CI = 0.45 to 0.74) and significantly lower nesfatin-1 levels in type 2 diabetes patients receiving antidiabetic treatment (MD = −0.26; 95% CI = −0.33 to −0.20). In conclusion, the analysis supports a relationship between circulating nesfatin-1 levels and type 2 diabetes, where newly diagnosed type 2 diabetes was associated with an elevated Nesfatin-1 level, and type 2 diabetes patients receiving antidiabetic treatment showed lower circulating nesfatin-1 levels.

scholarly journals Efficacy and Safety of a Sodium-Glucose Co-Transporter-2 Inhibitor Versus Placebo as an Add-on Therapy for People With Type 2 Diabetes Inadequately Treated With Metformin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A469-A470
Author(s):  
Jia Leng Lim ◽  
Georgina Bergero ◽  
Yogesh Acharya ◽  
James Shaw ◽  
Aaron Liew
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Mycotic Infections

Abstract Metformin monotherapy is often insufficient to achieve or sustain glycemic targets in people with type 2 diabetes. Therefore, we performed a systematic review and meta-analysis to assess the efficacy, safety and tolerability of sodium-glucose co-transporter-2 inhibitors versus placebo as add-on therapy after metformin in type 2 diabetes. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search was performed in the PubMed, www.clinicaltrials.gov and Cochrane Central Register of Controlled Trials databases for relevant randomized controlled trials up until 30th October 2020 that compared sodium-glucose co-transporter-2 inhibitors versus placebo as add-on therapy to metformin. A random-effects model was used. Thirteen randomized controlled trials (4270 participants) met the inclusion criteria. Compared with placebo, sodium-glucose co-transporter-2 inhibitor treatment, as add-on therapy to metformin, was associated with a significant reduction in HbA1c level (mean difference [MD]: -0.6%, 95% CI: -0.7, -0.5; p&lt;0.01), fasting plasma glucose level (MD: -1.4mmol/l; 95% CI; -1.5, -1.3; p&lt;0.01), weight (MD: -2.0kg; 95% CI: -2.2, -1.8; p&lt;0.01), systolic blood pressure (MD: -4.7mmHg; 95% Cl: -5.4, -3.9; p&lt;0.01) and diastolic blood pressure (MD: -2.0mmHg; 95% Cl: -2.5, -1.5; p&lt;0.01). Significantly more participants achieved HbA1c &lt;7% (odds ratio [OR]: 3.1; 95% CI: 2.6, 3.6; p&lt;0.01) in the sodium-glucose co-transporter-2 inhibitor group. Genital mycotic infections (OR: 2.6; 95% CI: 1.4, 4.6; p&lt;0.01) were more common with sodium-glucose co-transporter-2 inhibitors, but there was no significant statistical difference in urinary tract infections (OR: 1.4; 95% CI: 1.0, 2.0; p=0.06), in hypoglycemia (OR: 1.5; 95% CI: 1.0, 2.4; p=0.07), or in discontinuation rates due to adverse events (OR: 0.9; 95% CI: 0.6, 1.5; p=0.68) between the two groups. In summary, in comparison with placebo, add-on therapy with a sodium-glucose co-transporter-2 inhibitor is significantly more efficacious in lowering HbA1c, fasting plasma glucose, weight and blood pressure in people with type 2 diabetes following inadequate glycemic control with metformin. The rate of discontinuation due to adverse events was similar despite higher risk of genital mycotic infections.

scholarly journals Selenium and Type 2 Diabetes: Systematic Review

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1924 ◽  
Author(s):  
Lindsay Kohler ◽  
Janet Foote ◽  
Connor Kelley ◽  
Ana Florea ◽  
Colleen Shelly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Observational Studies ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Positive Association ◽  
Significant Positive Association

Several studies have investigated the potential role of selenium (Se) in the development of type 2 diabetes (T2D) with disparate findings. We conducted a systematic review and meta-analysis to synthesize the evidence of any association between Se and T2D. PubMed, Embase, and Scopus were searched following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Approach (PRISMA). Sixteen studies from 15 papers met inclusion criteria defined for this review. Of the 13 observational studies included, 8 demonstrated a statistically significant positive association between concentrations of Se and odds for T2D, with odds ratios (95% confidence intervals) ranging from 1.52 (1.01–2.28) to 7.64 (3.34–17.46), and a summary odds ratio (OR) (95% confidence interval (CI)) of 2.03 (1.51–2.72). In contrast, among randomized clinical trials (RCTs) of Se, a higher risk of T2D was not observed for those who received Se compared to a placebo (OR = 1.18, 95% CI 0.95–1.47). Taken together, the results for the relationship between Se and T2D differ between observational studies and randomized clinical trials (RCTs). It remains unclear whether these differences are the result of uncontrolled confounding in the observational studies, or whether there is a modest effect of Se on the risk for T2D that may vary by duration of exposure. Further investigations on the effects of Se on glucose metabolism are needed.

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