[Effects of resistant starch on insulin resistance of type 2 diabetes mellitus patients]. Baseline insulin sensitivity affects response to high-amylose maize resistant starch in women: a randomized, controlled trial Effects of wheat bran extract rich in arabinoxylan oligosaccharides and resistant starch on overnight glucose tolerance and markers of gut fermentation in healthy young adults Resistant starch supplementation influences blood lipid concentrations and glucose control in overweight subjects. Resistant Starches Types 2 and 4 Have Differential Effects on the Composition of the Fecal Microbiota in Human Subjects Structural Alteration of Gut Microbiota during the Amelioration of Human Type 2 Diabetes with Hyperlipidemia by Metformin and a Traditional Chinese Herbal Formula: a Multicenter, Randomized, Open Label Clinical Trial A Randomized Placebo Controlled Clinical Trial to Determine the Impact of Digestion Resistant Starch MSPrebiotic® on Glucose, Insulin, and Insulin Resistance in Elderly and Mid-Age Adults Variable responses of human microbiomes to dietary supplementation with resistant starch Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects. Effects of resistant starch on the colon in healthy volunteers: possible implications for cancer prevention.
OBJECTIVE To observe the effects of resistant starch ( RS ) on insulin resistance ( IR ) in type 2 diabetes mellitus patients . METHODS All 40 patients with type 2 diabetes mellitus were r and omly divided into two groups : Group A and Group B. Cross- design of two stages ( I , II ) was used during observation . Group A received RS 30 g/d as an intervention group for ahead of 4 weeks ( I stage ) , while group B as a control group . Group B was given RS in late 4 weeks ( II stage ) , while Group A as served control group . Blood was taken the first day and on the latest day in each stage . Fasting blood glucose ( FBG ) , post blood glucose ( PBG ) , fructosamine ( FMN ) , total cholesterol ( TC ) , triglyceridemic ( TG ) , insulin sensitive index ( ISI ) , and body mass index ( BMI ) were measured , respectively . RESULTS As Compared with the control group , ISI was higher and FBG , PBG , TC , TG , FMN and BMI were significantly lower in intervention group ( P < 0.05 ) . CONCLUSION RS should be effective in improving IR of type 2 diabetes mellitus patients Background Resistant starch ( RS ) is a type of dietary fiber that can improve glucose metabolism , but its effects may be modulated by sex or baseline insulin sensitivity . This study was design ed to examine the effect of high-amylose maize resistant starch ( HAM-RS2 ) on insulin sensitivity ( SI ) in women , and to determine if SI status affects the response to RS . Methods This was a r and omized , placebo-controlled , double-blind , cross-over study . Participants were 40 healthy , non-diabetic women aged 22–67 years in the normal-weight to obese BMI range ( 20.6–47.4 kg/m2 ) . Two doses of HAM-RS2 were tested , 15 and 30 g per day , administered in the form of cookies . Participants were r and omized to the order in which they received the experimental and placebo product . Each arm was 4 weeks , with a 4-week wash-out period in between . SI was assessed at the end of each 4-week arm of product consumption by frequently- sample d , insulin-modified , intravenous glucose tolerance test and minimal modeling . Participants were categorized as being insulin resistant ( IR ; SI < 7.8 ) or insulin sensitive ( IS ; SI ≥ 7.8 ) based on Gaussian analysis . The effect of treatment arm on SI was examined by mixed-model analysis within IR and IS sub-groups , using all available data . In addition , SI was examined by ANOVA among just those women who completed all three arms of the study with valid SI results . Results Among IR participants , SI was on average ~16 % higher after the 30 g arm when compared to the control arm by mixed-model analysis ( n = 40 , P < 0.05 ) , and tended to be 23 % higher by ANOVA among women who completed all arms ( n = 23 , P = 0.06 ) . HAM-RS2 did not affect SI in IS women . Conclusion Consumption of HAM-RS2 at 30 g/day in the form of a snack food item was associated with improved insulin sensitivity in women with insulin resistance . Clinical trials registry numberNCT01521806 Abstract Purpose Specific combinations of dietary fiber ( DF ) have been observed to result in improved glucose tolerance at a subsequent st and ardized breakfast . Arabinoxylan oligosaccharides ( AXOS ) are considered as DF with prebiotic potential , but so far no studies have investigated their metabolic effects in humans . This r and omized cross-over study evaluated the overnight impact of breads containing AXOS-rich wheat bran extract and resistant starch ( RS , Hi-Maize ) , separately or combined , on glucose tolerance , related metabolic parameters and markers of gut fermentation in healthy subjects . Methods Evening reference and test products were : ( 1 ) reference white wheat flour bread ( WWB ) , WWB supplemented with ( 2 ) AXOS and RS ( WWB + AXOS + RS ) , ( 3 ) an increased content of either AXOS ( WWB + hiAXOS ) or ( 4 ) RS ( WWB + hiRS ) . At the subsequent st and ardized breakfast , blood was sample d for 3 h to monitor glucose , insulin , nonesterified fatty acids , glucagon-like peptide (GLP)-1 and GLP-2 . Breath hydrogen ( H2 ) and short chain fatty acids ( SCFA ) were measured as markers of gut fermentation , and subjective appetite was rated using visual analog scales . Results Dose-dependent decreases in glucose responses were observed with increased AXOS over the duration of 3 h. Insulin sensitivity index was improved in the morning after the WWB + hiAXOS evening meal . An increase in breath H2 concentration and circulating SCFA was observed in the morning after both evening meals containing AXOS . Conclusion The present study indicates that AXOS have the potential of improving glucose tolerance in an overnight perspective and suggested mechanisms are improved insulin sensitivity and increased gut fermentation Resistant starch ( RS ) includes the sum of starch and degradation products of starch that resist small intestinal digestion and enter the colon . This study was planned to examine the effect of resistant starch on hypolipidemic actions , blood glucose , insulin levels and humoral immune responses in healthy overweight subjects . Healthy overweight subjects ( over 120 % of their ideal body weights ) were fed either 24 g/d of resistant corn starch ( RS ) or regular corn starch ( CS ) for 21 d with their regular meals . Although this double-blind feeding regiment result ed in no significant changes in their weights or other physical parameters for the relatively acute period of intakes , there were significant lowering effects of serum total cholesterol ( p < 0.05 ) and serum LDL-cholesterol ( p < 0.05 ) in subjects supplemented RS . Compared with the control starch group , the RS supplementation also reduced the mean fasting serum glucose concentrations ( p < 0.05 ) . Resistant starch supplement result ed in the increase in serum immunoglobulin G ( IgG ) concentrations . Serum insulin and complement 3 ( C3 ) were unaffected . Tested resistant starch supplementation was reported to be palatable with minimal bowel discomfort . These results suggest that RS supplementation improves the blood lipid profile and controls the blood glucose levels in healthy overweight subjects without bowel discomfort . Therefore , RS has a potential to be used as one of the promising food ingredients for reducing risk factors involved in the development of atherosclerosis and type 2 diabetes in overweight individuals . However , in order to prove RS as a novel therapeutic agent of cardiovascular diseases and diabetes , controlled trials with larger sample sizes and longer duration are warranted Background To systematic ally develop dietary strategies based on resistant starch ( RS ) that modulate the human gut microbiome , detailed in vivo studies that evaluate the effects of different forms of RS on the community structure and population dynamics of the gut microbiota are necessary . The aim of the present study was to gain a community wide perspective of the effects of RS types 2 ( RS2 ) and 4 ( RS4 ) on the fecal microbiota in human individuals . Methods and Findings Ten human subjects consumed crackers for three weeks each containing either RS2 , RS4 , or native starch in a double-blind , crossover design . Multiplex sequencing of 16S rRNA tags revealed that both types of RS induced several significant compositional alterations in the fecal microbial population s , with differential effects on community structure . RS4 but not RS2 induced phylum-level changes , significantly increasing Actinobacteria and Bacteroidetes while decreasing Firmicutes . At the species level , the changes evoked by RS4 were increases in Bifidobacterium adolescentis and Parabacteroides distasonis , while RS2 significantly raised the proportions of Ruminococcus bromii and Eubacterium rectale when compared to RS4 . The population shifts caused by RS4 were numerically substantial for several taxa , leading for example , to a ten-fold increase in bifidobacteria in three of the subjects , enriching them to 18–30 % of the fecal microbial community . The responses to RS and their magnitudes varied between individuals , and they were reversible and tightly associated with the consumption of RS . Conclusion Our results demonstrate that RS2 and RS4 show functional differences in their effect on human fecal microbiota composition , indicating that the chemical structure of RS determines its accessibility by groups of colonic bacteria . The findings imply that specific bacterial population s could be selectively targeted by well design ed functional carbohydrates , but the inter-subject variations in the response to RS indicates that such strategies might benefit from more personalized approaches ABSTRACT Accumulating evidence implicates gut microbiota as promising targets for the treatment of type 2 diabetes mellitus ( T2DM ) . With a r and omized clinical trial , we tested the hypothesis that alteration of gut microbiota may be involved in the alleviation of T2DM with hyperlipidemia by metformin and a specifically design ed herbal formula ( AMC ) .  Four hundred fifty patients with T2DM and hyperlipidemia were r and omly assigned to either the metformin- or AMC-treated group . After 12 weeks of treatment , 100 patients were r and omly selected from each group and assessed for clinical improvement . The effects of the two drugs on the intestinal microbiota were evaluated by analyzing the V3 and V4 regions of the 16S rRNA gene by Illumina sequencing and multivariate statistical methods . Both metformin and AMC significantly alleviated hyperglycemia and hyperlipidemia and shifted gut microbiota structure in diabetic patients . They significantly increased a coabundant group represented by Blautia spp . , which significantly correlated with the improvements in glucose and lipid homeostasis . However , AMC showed better efficacies in improving homeostasis model assessment of insulin resistance ( HOMA-IR ) and plasma triglyceride and also exerted a larger effect on gut microbiota . Furthermore , only AMC increased the coabundant group represented by Faecalibacterium spp . , which was previously reported to be associated with the alleviation of T2DM in a r and omized clinical trial . Metformin and the Chinese herbal formula may ameliorate type 2 diabetes with hyperlipidemia via enriching beneficial bacteria , such as Blautia and Faecalibacterium spp . IMPORTANCE Metabolic diseases such as T2DM and obesity have become a worldwide public health threat . Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases , and thus the gut microbiota serves as a promising target for disease control . In this study , we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs : metformin and a specifically design ed Chinese herbal formula ( AMC ) for diabetic patients with hyperlipidemia . Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota . Blautia spp . were identified as being associated with improvements in glucose and lipid homeostasis for both drugs . AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels , which were associated with the enrichment of Faecalibacterium spp . In brief , these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula . Metabolic diseases such as T2DM and obesity have become a worldwide public health threat . Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases , and thus the gut microbiota serves as a promising target for disease control . In this study , we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs : metformin and a specifically design ed Chinese herbal formula ( AMC ) for diabetic patients with hyperlipidemia . Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota . Blautia spp . were identified as being associated with improvements in glucose and lipid homeostasis for both drugs . AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels , which were associated with the enrichment of Faecalibacterium spp . In brief , these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula Introduction Type 2 diabetes ( T2D ) has reached epidemic proportions in North America . Recent evidence suggests that prebiotics can modulate the gut microbiome , which then plays an important role in regulating lipid metabolism , blood glucose , and insulin sensitivity . As such , prebiotics are appealing potential therapeutic strategies for prediabetes and T2D . The key objectives of this study were to determine the tolerability as well as the glucose and insulin modulating ability of  MSPrebiotic ® digestion resistant starch ( DRS ) in healthy mid-age ( MID ) and elderly ( ELD ) adults . Material s and methods This was a prospect i ve , blinded , placebo-controlled study . Prediabetes and diabetes were among the exclusion factors . ELD ( > 70 years ) and MID ( 30–50 years ) Canadian adults were recruited and , after 2 weeks of consuming placebo , they were r and omized to consume 30 g of either MSPrebiotic ® or placebo per day for 12 weeks . In total , 42 ELD and 42 MID participants completed the study . Blood sample s were collected over the 14-week study and analyzed for glucose , lipid profile , and CRP , lipid particles , TNF-α , IL-10 , insulin , and insulin resistance ( IR ) . Results At baseline , the ELD population had a significantly higher percentage ( p < 0.01 ) with elevated glucose and significantly higher TNF-α ( p < 0.01 ) compared to MID adults .  MSPrebiotic ® DRS was well tolerated in both MID and ELD adults . There was a significant difference over time in blood glucose ( p = 0.0301 ) and insulin levels ( p = 0.009 ) , as well as IR ( HOMA-IR ; p = 0.009 ) in ELD adults who consumed MSPrebiotic ® compared to placebo . No significant changes were found in MID adults . Conclusion Our results suggest that dietary supplementation with prebiotics such as MSPrebiotic ® may be part of an effective strategy to reduce IR , a major risk factor for developing T2D , in the ELD . Clinical Trial Registration NCT01977183 listed on NIH website : Clinical Trials.gov , The meta data generated in this study have been su bmi tted to the NCBI Sequence Read Archive ( http://www.ncbi.nlm.nih.gov/bioproject/381931 ) Background The fermentation of dietary fiber to various organic acids is a beneficial function provided by the microbiota in the human large intestine . In particular , butyric acid contributes to host health by facilitating maintenance of epithelial integrity , regulating inflammation , and influencing gene expression in colonocytes . We sought to increase the concentration of butyrate in 20 healthy young adults through dietary supplementation with resistant starch ( unmodified potato starch — resistant starch ( RS ) type 2 ) . Methods Fecal sample s were collected from individuals to characterize butyrate concentration via liquid chromatography and composition of the microbiota via surveys of 16S rRNA-encoding gene sequences from the Illumina MiSeq platform . R and om Forest and LEfSe analyses were used to associate responses in butyrate production to features of the microbiota . Results RS supplementation increased fecal butyrate concentrations in this cohort from 8 to 12 mmol/kg wet feces , but responses varied widely between individuals . Individuals could be categorized into three groups based upon butyrate concentrations before and during RS : enhanced , high , and low ( n = 11 , 3 , and 6 , respectively ) . Fecal butyrate increased by 67 % in the enhanced group ( from 9 to 15 mmol/kg ) , while it remained ≥11 mmol/kg in the high group and ≤8 mmol/kg in the low group . Microbiota analyses revealed that the relative abundance of RS-degrading organisms — Bifidobacterium adolescentis or Ruminococcus bromii — increased from ~2 to 9 % in the enhanced and high groups , but remained at ~1.5 % in the low group . The lack of increase in RS-degrading bacteria in the low group may explain why there was no increase in fecal butyrate in response to RS . The microbiota of individuals in the high group were characterized by an elevated abundance of the butyrogenic microbe Eubacterium rectale ( ~6 % in high vs. 3 % in enhanced and low groups ) throughout the study . Conclusions We document the heterogeneous responses in butyrate concentrations  upon RS supplementation and identify characteristic of the microbiota that appear to underlie this variation . This study complements and extends other studies that call for personalized approaches to manage beneficial functions provided by gut microbiomes BACKGROUND Diets with a low glycemic index ( GI ) have been shown to improve glucose tolerance in both healthy and diabetic subjects . Two potential mechanisms are discussed in relation to long-term metabolic effects : a decreased dem and for insulin in the postpr and ial phase and formation of short-chain fatty acids from fermentation of indigestible carbohydrates in the colon . OBJECTIVE The objective was to study the effect of the GI and the indigestible carbohydrate -- resistant starch ( RS ) and dietary fiber (DF)--content of cereal-based breakfasts on glucose tolerance at a second meal ( lunch ) in healthy subjects . DESIGN The effects of 7 test breakfasts with known GIs ( GI : 52 - 99 ) and RS + DF contents ( 2 - 36 g ) were evaluated . White-wheat bread was used as a reference breakfast ( high GI , low RS + DF content ) . Glucose and insulin responses after the second meal were measured in healthy subjects . In addition , the satiating capacity of 4 of the 7 test breakfasts was estimated before and during the second meal . RESULTS Two of the 4 low-GI breakfasts improved glucose tolerance at the second meal . Only these 2 breakfasts were capable of postponing the in-between-meal fasting state . There was no measurable effect of fermentable carbohydrates on glucose tolerance at the second meal . The highest satiety score was associated with the barley breakfast that had a low GI and a high RS + DF content . CONCLUSIONS Glucose tolerance can improve in a single day . Slow absorption and digestion of starch from the breakfast meal , but not the content of indigestible carbohydrates in the breakfast meal , improved glucose tolerance at the second meal ( lunch ) Recent evidence suggests that resistant starch ( RS ) is the single most important substrate for bacterial carbohydrate fermentation in the human colon . During two 4-wk periods . 12 healthy volunteers consumed a controlled basal diet enriched with either amylomaize starch ( 55.2 + /- 3.5 g RS/d ; high-RS diet ) or available cornstarch ( 7.7 + /- 0.3 g RS/d ; low-RS diet ) . Approximately 90 % of the RS consumed disappeared during intestinal passage ; increased fermentation was verified by elevated breath-hydrogen excretion . During the high-RS diet , fecal wet and dry weight increased 49 % and 56 % , respectively ( P < or = 0.005 ) , whereas stool water content did not change significantly . Fecal concentrations and daily excretion of short-chain fatty acids were not different in the two study periods . During the high-RS diet , bacterial beta-glucosidase activity decreased by 26 % ( P < or = 0.05 ) . Fecal concentrations of total and secondary bile acids were significantly lower during the high-RS than during the low-RS period [ a decrease of 30 % ( P < or = 0.05 ) and 32 % ( P < or = 0.01 ) , respectively , in total and secondary bile acids ] whereas concentrations of primary bile acids were unaffected by RS consumption . During the high-RS diet , fecal concentrations of total neutral sterols decreased by 30 % ( P < or = 0.005 ) and fecal concentrations of 4-cholesten-3-one decreased by 36 % ( P < or = 0.05 ) . These data suggest that RS has potentially important effects on bacterial metabolism in the human colon that may be relevant for cancer prevention
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 .
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
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 .