Konjac-mannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. A randomized controlled metabolic trial.
OBJECTIVE
To examine whether Konjac-mannan (KJM) fiber improves metabolic control as measured by glycemia, lipidemia, and blood pressure in high-risk type 2 diabetic patients.


METHODS
A total of 11 hyperlipidemic and hypertensive type 2 diabetic patients treated conventionally by a low-fat diet and drug therapy participated. After an 8-week baseline, all were randomly assigned to take either KJM fiber-enriched test biscuits (0.7 g/412 kJ [100 kcal] of glucomannan) or matched placebo wheat bran fiber biscuits during two 3-week treatment phases separated by a 2-week washout period. The diet in either case was metabolically controlled and conformed to National Cholesterol Education Program Step 2 guidelines, while medications were maintained constant. Efficacy measures included serum fructosamine, lipid profiles, apolipoproteins, blood pressure, body weight, and nutritional analysis.


RESULTS
Compared with placebo, KJM significantly reduced the metabolic control primary end points: serum fructosamine (5.7%, P = 0.007, adjusted alpha = 0.0167), total:HDL cholesterol ratio (10%, P = 0.03, adjusted alpha = 0.05), and systolic blood pressure (sBP) (6.9%, P = 0.02, adjusted alpha = 0.025). Secondary end points, including body weight, total, LDL, and HDL cholesterol, triglycerides, apolipoproteins A-1, B, and their ratio, glucose, insulin, and diastolic blood pressure, were not significant after adjustment by the Bonferroni-Hochberg procedure.


CONCLUSIONS
KJM fiber added to conventional treatment may ameliorate glycemic control, blood lipid profile, and sBP in high-risk diabetic individuals, possibly improving the effectiveness of conventional treatment in type 2 diabetes.
Vuksan
V
V
Department of Nutritional Sciences, St. Michael's Hospital, Faculty of Medicine, University of Toronto, Ontario, Canada. v.vuksan@utoronto.ca
Jenkins
D J
DJ
Spadafora
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P
Sievenpiper
J L
JL
Owen
R
R
Vidgen
E
E
Brighenti
F
F
Josse
R
R
Leiter
L A
LA
Bruce-Thompson
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C
D001053:Apolipoproteins / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D001835:Body Weight; D002784:Cholesterol / Q000097:blood*; D003327:Coronary Disease / Q000453:epidemiology / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D003927:Diet, Diabetic; D004043:Dietary Fiber / Q000627:therapeutic use*; D005260:Female; D019270:Fructosamine / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008351:Mannans / Q000627:therapeutic use*; D008875:Middle Aged; D009765:Obesity; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D001053:Apolipoproteins; D001786:Blood Glucose; D004043:Dietary Fiber; D007328:Insulin; D008351:Mannans; D014280:Triglycerides; C022901:(1-6)-alpha-glucomannan; D019270:Fructosamine; D002784:Cholesterol