Effects of the amount and type of carbohydrates used in type 2 diabetes diets in animal models: A systematic review

PLoS One. 2020 Jun 12;15(6):e0233364. doi: 10.1371/journal.pone.0233364. eCollection 2020.

Abstract

Type 2 diabetes mellitus (T2DM) is among the most prevalent diseases in the world, affecting over 420 million people. The disease is marked by a poor metabolic effect of insulin leading to chronic hyperglycaemia, which can result in microvascular complications. It is widely known that postprandial glycaemia is reliant on the total carbohydrate content of a meal. However, the importance of the amount and the source of these carbohydrates remains controversial due to mechanisms other than insulin secretion. Oxidative stress, inflammation, pyruvate production and the quality of the intestinal microbiota, resulting in plasma lipopolysaccharides and short-chain fatty acids production, play an important role in blood sugar control and consequently in type 2 diabetes. Thus, we systematically reviewed the preclinical evidences on the impact of the amount and type of carbohydrate found in different diets and its influence on blood glucose levels in diabetic animals. We used a comprehensive and structured search in biomedical databases Medline (PubMed), Scopus and Web of Science, recovering and analyzing 27 original studies. Results showed that sucrose-rich diets deteriorated diabetic condition in animal models regardless of the total dietary carbohydrate content. On the other hand, fiber, particularly resistant starch, improved blood glucose parameters through direct and indirect mechanisms, such as delayed gastric emptying and improved gut microbiota. All studies used rodents as animal models and male animals were preferred over females. Improvements in T2DM parameters in animal models were more closely related to the type of dietary carbohydrate than to its content on a diet, i. e., resistant starch seems to be the most beneficial source for maintaining normoglycemia. Results show that current literature is at high risk of bias due to neglecting experimental methods.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Animals
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diet / methods
  • Dietary Carbohydrates / analysis*
  • Dietary Carbohydrates / metabolism
  • Dietary Fiber / metabolism
  • Dietary Sucrose / metabolism
  • Disease Models, Animal
  • Female
  • Humans
  • Insulin / metabolism
  • Insulin Secretion / drug effects
  • Male
  • Postprandial Period / physiology
  • Triglycerides / blood

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Dietary Fiber
  • Dietary Sucrose
  • Insulin
  • Triglycerides

Grants and funding

This work was supported by the Fundação do Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG, processes APQ-01895-16, PPM-00687-17 and PPM-00077-18), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, processes 303972/2017-3, 423594/2018-4, 305093/2017-7 and MCTIC 408503/2018-1), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES, finance code 001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.