University of Ghana Medical Centre, Accra, Ghana
DOI:
https://doi.org/10.61336/jdme.0601.03Keywords:
Dietary fiber, type 2 diabetes, glycemic variability, insulin sensitivity, postprandial glucose, nutritionAbstract
Dietary fiber intake may influence postprandial glucose responses and insulin sensitivity in individuals with type 2 diabetes. This study evaluated the association between habitual dietary fiber intake, glycemic variability, and insulin sensitivity in adults with type 2 diabetes. A cross-sectional observational study was conducted among 154 adults receiving routine diabetes care. Dietary intake was assessed using a structured food-frequency questionnaire, while glycemic variability was estimated using continuous glucose monitoring over 14 days. Fasting glucose and insulin were measured, and HOMA-IR was calculated as a surrogate marker of insulin resistance. Participants were categorized into low, moderate, and high dietary fiber intake groups. Individuals with higher fiber intake demonstrated lower mean glucose variability, lower postprandial glucose excursions, and lower HOMA-IR compared with those reporting lower fiber consumption. After adjustment for age, sex, BMI, diabetes duration, physical activity, and total energy intake, higher fiber intake remained inversely associated with glycemic variability and HOMA-IR. These findings suggest that greater dietary fiber consumption may be associated with more stable glucose profiles and better insulin sensitivity in adults with type 2 diabetes.
References
1. American Diabetes Association Professional Practice Committee. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1).
2. Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet. 2019;393(10170):434–445.
3. Weickert MO, Pfeiffer AFH. Impact of dietary fiber consumption on insulin resistance and the prevention of type 2 diabetes. J Nutr. 2018;148(1):7–12.
4. Anderson JW, Randles KM, Kendall CWC, Jenkins DJA. Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and review of the evidence. J Am Coll Nutr. 2004;23(1):5–17.
5. Jenkins DJA, Kendall CWC, Augustin LSA, Mitchell S, Sahye-Pudaruth S, Mejia SB, et al. Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus. Arch Intern Med. 2012;172(21):1653–1660.
6. Reynolds AN, Akerman AP, Mann J. Dietary fibre and whole grains in diabetes management: systematic review and meta-analyses. PLoS Med. 2020;17(3):e1003053.
7. McRorie JW Jr. Understanding and predicting dietary fiber bioactivity: a review of mechanisms and evidence. Nutrients. 2015;7(2):1145–1168.
8. Livesey G, Taylor R, Livesey HF, Buyken AE, Jenkins D, Augustin LSA, et al. Dietary glycemic index and load and the risk of type 2 diabetes: a systematic review and updated meta-analyses. Nutrients. 2019;11(6):1280.
9. DeFronzo RA, Ferrannini E, Groop L, Henry RR, Herman WH, Holst JJ, et al. Type 2 diabetes mellitus. Nat Rev Dis Primers. 2015;1:15019.
10. Samuel VT, Shulman GI. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. J Clin Invest. 2016;126(1):12–22.
11. American Diabetes Association Professional Practice Committee. Glycemic goals and hypoglycemia: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1).
12. American Diabetes Association Professional Practice Committee. Nutrition therapy for adults with diabetes or prediabetes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1).
13. Jenkins DJA, Kendall CWC, McKeown-Eyssen G, Josse RG, Silverberg J, Booth GL, et al. Effect of a low-glycemic index or a high-cereal-fiber diet on type 2 diabetes. JAMA. 2008;300(23):2742–2753.
14. Slavin JL. Dietary fiber and body weight. Nutrition. 2005;21(3):411–418.
