Diabetes Type 1 and 2

DM: Fiber (2014)

Intervention
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of fiber in the diet (no supplements or fiber-added foods), independent of weight loss, on CVD risk factors (lipids and blood pressure)?
- Conclusion
  One study regarding the relationship of differing amounts of dietary fiber in the diet, independent of weight loss, on CVD risk factors reported no significant effect on total cholesterol, HDL-cholesterol or LDL-cholesterol levels in adults with type 2 diabetes. However, reported dietary fiber intake (approximately 20g per day) did not differ among the groups. The high carbohydrate/fiber group reported significantly higher soluble fiber intake compared to the weight management group. The study reported that triglyceride levels were lower among subjects consuming less soluble fiber.
  
  Subjects did not have or were not described as having any disorders of lipid metabolism or hypertension and none of the studies reported on blood pressure or adults with type 1 diabetes. Additional long-term studies are needed to ascertain the relationship of differing amounts of fiber in the diet, independent of weight loss, on lipid profile in adults with diabetes, especially those with disorders of lipid metabolism and hypertension.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of fiber in the diet (no supplements or fiber-added foods), independent of weight loss, on CVD risk factors (lipids and blood pressure)?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Milne RM, Mann JI, Chisholm AW, Williams SM. Long-term comparison of three dietary prescriptions in the treatment of NIDDM. Diabetes Care 1994;17:74-80.
- Search Plan and Results: DM: Fiber 2012
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of fiber in the diet (no supplements or fiber-added foods), independent of weight loss, on glycemia (A1C and/or glucose)?
- Conclusion
  One study with approximate dietary fiber intake of 30g per day in adults with type 1 diabetes reported a beneficial effect on A1C, whereas two studies with approximately 20g per day of dietary fiber intake in adults with type 1 or type 2 diabetes did not report a beneficial effect on A1C.
  
  None of the studies reported on glucose levels. Additional long-term studies are needed to ascertain the relationship of differing amounts of fiber in the diet, independent of weight loss, on glycemia in adults with diabetes.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of fiber in the diet (no supplements or fiber-added foods), independent of weight loss, on glycemia (A1C and glucose)?
- Search Plan and Results: DM: Fiber 2012
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of fiber in the diet (no supplements or fiber-added foods), independent of weight loss, on insulin levels (exogenous/endogenous)?
- Conclusion
  One study reports no significant effect of differing amounts of fiber in the diet (20g vs. 30g of dietary fiber per day), independent of weight loss, on insulin doses in adults with type 1 diabetes.
  
  No studies were identified in subjects with type 2 diabetes or that reported on endogenous insulin levels. Additional long-term studies are needed regarding the relationship of fiber, independent of weight loss, on insulin levels in adults with diabetes.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of fiber in the diet (no supplements or fiber-added foods), independent of weight loss, on insulin levels (exogenous/endogenous)?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    McCulloch DK, Mitchell RD, Ambler J, Tattersall RB. A prospective comparison of "conventional" and high carbohydrate/high fibre/low fat diets in adults with established type 1 (insulin-dependent) diabetes. Diabetologia 1985;28:208-212.
- Search Plan and Results: DM: Fiber 2012