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UNABSORBABLE CARBOHYDRATES AND DIABETES: DECREASED POST-PRANDIAL HYPERGLYCÆMIA

Two test meals were taken in random order on separate days by 8 non-insulin-requiring diabetic volunteers after 14-hour overnight fasts. Addition of 16 g guar and 10 g pectin to the control meal containing 106 g carbohydrate decreased markedly and significantly the rise in blood-glucose between 30 and 90 minutes and also resulted in significantly lower insulin levels between 30 and 120 minutes. When these meals were fed to 3 insulin-dependent diabetic subjects, a similar flattening of the post-prandial glucose rise ensued. This addition of certain forms of dietary fibre to the diet of diabetics significantly decreases post-prandial hyperglycaemia and would be expected to improve the control of blood-glucose concentration.

Effect of pectin, guar gum, and wheat fibre on serum-cholesterol.

36 G of wheat fibre, pectin, or guar gum was given over 2-week periods to healthy volunteers taking normal diet. Mean serum-cholesterol levels fell significantly while the volunteers were taking guar and pectin by 36-3 and 29-2 mg, per 100. respectively, but rose slightly after wheat fibre by 6-7, mg per 100., Attention should be focused on fruit and vegetable gels rather than wheat fibre in the search of natural hypocholesterolaemic agents.

TREATMENT OF DIABETES WITH GUAR GUM: Reduction of Urinary Glucose Loss in Diabetics

When nine diabetic patients supplemented either their normal home diets (four patients) or metabolic ward diets (five patients) with 25 g guar gum daily for 5 or 7 days their mean urinary glucose excretion fell by 46% (P less than 0-05) and 54% (P less than 0-01), respectively. Gel-forming,, unabsorbable carbohydrate may therefore be a useful adjunct to anti-diabetic therapy, irrespective of the type of treatment or insulin dosage used.

PECTIN IN THE DUMPING SYNDROME: REDUCTION OF SYMPTOMS AND PLASMA VOLUME CHANGES

Twelve patients with the dumping syndrome took on one occasion oral hypertonic glucose and on another a similar glucose drink to which pectin was added. After glucose alone eleven patients had symptoms; after glucose with pectin, six had no symptoms and in five symptoms were reduced. Plasma volume changes were significantly less after glucose with pectin, and the hypoglycaemia at 120 min after glucose alone did not occur after glucose with pectin in patients in whom symptoms were abolished. Gastric emptying was prolonged, and serum insulin levels were lower, after glucose with pectin. In those patients to whom gastric emptying rate reverted to near normal with pectin, symptoms were abolished, but symptoms were only reduced in number when gastric emptying, although slowed, remained rapid. The findings suggest that pectin and similar substances may be useful in the day-to-day management of patients with dumping symptoms.