Role of Whole Grain Consumption in Glycaemic Control of Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials - PubMed (original) (raw)

Meta-Analysis

Role of Whole Grain Consumption in Glycaemic Control of Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Dengfeng Xu et al. Nutrients. 2021.

Abstract

Background: Observational studies have indicated beneficial effects of whole grain consumption on human health. However, no evidence based on randomized controlled trials has been established. Our objective was to perform a systematic review and meta-analysis of randomized controlled trials to assess the effects of whole grain consumption in glycaemic control of diabetic patients.

Methods: A comprehensive search in four databases (Web of Science, Pubmed, Scopus and Cochrane library) was conducted to collect potential articles which measured the roles of whole grain consumption on glycaemic control up to October 2021.

Results: A total of 16 eligible trials involving 1068 subjects were identified to evaluate the pooled effect. The overall results indicated that compared with the control group, whole grain intake presented a significantly reduced concentration in fast plasma glucose (WMD = -0.51 mmol/L, 95% CI: -0.73, -0.28; I2 = 88.6%, p < 0.001), a homeostasis model assessment of insulin resistance (WMD = -0.39 μU × mol/L2, 95% CI: -0.73, -0.04; I2 = 58.4%, p = 0.014), and glycosylated haemoglobin (WMD = -0.56%, 95% CI: -0.88, -0.25, I2 = 88.5%, p < 0.001), while no significant difference was observed in fast plasma insulin level between groups (SMD = -0.05, 95% CI: -0.25, 0.14; I2 = 40.7%, p = 0.120). In terms of incremental area under the curve (iAUC), data suggested that whole grain effected a significant decrease in Glucose-iAUC (WMD = -233.09 min × mmol/L, 95% CI: -451.62, -14.57; I2 = 96.1%, p < 0.001) and Insulin-iAUC (SMD = -4.80, 95% CI: -8.36, -1.23; I2 = 89.9%, p = 0.002), although only in a small number of studies. Of note, there is evidence for modest unexplained heterogeneity in the present meta-analysis.

Conclusion: Whole grain consumption confers a beneficial effect on glucose metabolism in patients with diabetes. Regrettably, since relevant studies were scarce, we failed to provide confident evidence of whole grain consumption on acute effects including Glucose-iAUC and Insulin-iAUC, which should be addressed in further trials.

Keywords: diabetes mellitus; meta-analysis; randomized controlled trials; whole grains.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

Figure 1

The flow diagram for selected trials.

Figure 2

Figure 2

Forest plot of the effects of whole grain consumption on FPG (A), FPI (B), HOMA-IR (C), HbA1c (D), G-iAUC (E) and I-iAUC (F) in diabetic patients.

Figure 2

Figure 2

Forest plot of the effects of whole grain consumption on FPG (A), FPI (B), HOMA-IR (C), HbA1c (D), G-iAUC (E) and I-iAUC (F) in diabetic patients.

Figure 2

Figure 2

Forest plot of the effects of whole grain consumption on FPG (A), FPI (B), HOMA-IR (C), HbA1c (D), G-iAUC (E) and I-iAUC (F) in diabetic patients.

Figure 3

Figure 3

Funnel plot measuring the publication bias for the effects of whole grain consumption on FPG (A), FPI (B), HOMA-IR (C), and HbA1c (D) in diabetic patients.

Figure 4

Figure 4

Funnel plot measuring the publication bias for the effects of whole grain consumption on G-iAUC (A) and I-iAUC (B) in diabetic patients.

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References

    1. International Diabetes Federation . IDF Diabetes Atlas. 10th ed. International Diabetes Federation; Brussels, Belgium: 2021.
    1. World Health Organization . Global Report on Diabetes. WHO; Geneva, Switzerland: 2016.
    1. Li Y.Z., Teng D., Shi X.G., Qin G.J., Qin Y.F., Quan H.B., Shi B.Y., Sun H., Ba J.M., Chen B., et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: National cross sectional study. BMJ Br. Med. J. 2020;369:m997. doi: 10.1136/bmj.m997. - DOI - PMC - PubMed
    1. De Rosa S., Arcidiacono B., Chiefari E., Brunetti A., Indolfi C., Foti D.P. Type 2 Diabetes Mellitus and Cardiovascular Disease: Genetic and epigenetic Links. Front. Endocrinol. 2018;9:2. doi: 10.3389/fendo.2018.00002. - DOI - PMC - PubMed
    1. Dal Canto E., Ceriello A., Ryden L., Ferrini M., Hansen T.B., Schnell O., Standl E., Beulens J.W.J. Diabetes as a cardiovascular risk factor: An overview of global trends of macro and micro vascular complications. Eur. J. Prev. Cardiol. 2019;26:25–32. doi: 10.1177/2047487319878371. - DOI - PubMed

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