Resistant starch ameliorated insulin resistant in patients of type 2 diabetes with obesity: a systematic review and meta-analysis

Lipids Health Dis. 2019 Nov 24;18(1):205. doi: 10.1186/s12944-019-1127-z.

Abstract

Background: Resistant starch (RS) is a starch that can be fermented by the microbial flora within gut lumen. Insulin resistance (IR) is a pathophysiological condition related to diabetes and obesity. RS could reduce blood glucose and ameliorate IR in animals, but its effect in human population is controversial.

Objective: The authors conducted a systematic literature review to evaluate the effect of RS diet supplement on ameliorating IR in patients with T2DM and simple obesity.

Methods: Databases that supplemented with RS in ameliorating IR in T2DM and simple obesity were queried for studies on or before August 15, 2018. Parameters including fasting insulin, fasting glucose, body mass index (BMI), homeostatic model assessment (HOMA) etc. were extracted from studies to systemically evaluate effects of RS.

Results: The database search yielded 14 parallel or crossover studies that met the inclusion criteria. The results indicated that there was no significant difference in the amelioration of BMI, HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation. However, the fasting blood glucose, fasting insulin and HOMA-IR in T2DM with obesity who supplemented RS were lower than control group, and the subgroup analysis according to the dose of RS supplementation was inconsistency. There was no significant difference between RS and non-RS supplements in patients with simple obesity.

Conclusion: RS supplementation can ameliorate IR in T2DM, especially for the patients of T2DM with obesity, but not in simple obesity.

Keywords: Insulin resistance; Insulin sensitivity; Obesity; Resistant starch; Type 2 diabetes mellitus.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Biotransformation
  • Blood Glucose / metabolism*
  • Body Mass Index
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Dietary Supplements*
  • Fasting / blood
  • Female
  • Humans
  • Insulin / blood
  • Insulin Resistance*
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / metabolism
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / complications
  • Obesity / diet therapy*
  • Starch / administration & dosage*
  • Starch / blood

Substances

  • Blood Glucose
  • Insulin
  • Starch