title: Restored synergistic entero-hormonal response after addition of dietary fibre to patients with impaired glucose tolerance and reactive hypoglycaemia.
abstract: Although some dietary fibres (DF) improve glucose tolerance by slowing carbohydrate absorption, other mechanisms are certainly involved. Some of the entero-hormonal responses after DF were investigated in six patients with impaired glucose tolerance and reactive hypoglycaemia. All patients received two different breakfasts, each containing 25 g of starch supplied either as white bread (WB) or a fibre-enriched bread preparation (FB): 4 g hemicellulose and 4 g guar. Metabolic and hormonal responses were evaluated over 5 hours. Compared to WB, the FB had a blunting effect on the resulting blood glucose peak (116 +/- 9 mg/100 ml with FB vs. 148 +/- 15 with WB P less than 0.025) or trough (88 +/- 3 mg/100 ml with FB vs. 79 +/- 5 with WB), and upon the insulin response at 60 min (20 +/- 4 micro U/ml with FB vs. 70 +/- 20 with WB). Gut glucagon immunoreactivity was diminished with FB at 90 min (185 +/- 39 vs. 242 +/- 42 P less than 0.05) and 150 min (180 +/- 39 vs. 242 +/- 40). Pancreatic glucagon was initially similar after FB and WB, but a significant rise was observed with FB at 180 min (116 +/- 17 pg/ml vs. 67 +/- 18 P less than 0.05). The improvement of the blood glucose pattern with DF, especially the suppression of reactive hypoglycaemia, seems to depend partly on reduced and delayed response of the entero-hormonal axis. This in turn results in a better synergistic secretion of insulin and glucagon in the late post-prandial period.
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D004040:Dietary Carbohydrates; D004043:Dietary Fiber; D005260:Female; D005934:Glucagon / Q000097:blood*; D005951:Glucose Tolerance Test; D006801:Humans; D007003:Hypoglycemia / Q000097:blood*; D007328:Insulin / Q000097:blood*; D007413:Intestinal Mucosa / Q000378:metabolism; D007515:Islets of Langerhans / Q000378:metabolism; D007700:Kinetics; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004043:Dietary Fiber; D007328:Insulin; D005934:Glucagon