title: A Randomised Crossover Trial: The Effect of Inulin on Glucose Homeostasis in Subtypes of Prediabetes.
abstract: BACKGROUND
  Fermentable carbohydrates (FCHO) have been shown to improve insulin sensitivity in normoglycaemic and insulin-resistant subjects. However, there are no data on subjects with prediabetes. We aimed to investigate the effect of the FCHO inulin, on glucose homeostasis in subjects with prediabetes.
  
  
  METHODS
  In a double-blind and placebo-controlled crossover study, 40 volunteers with prediabetes were randomly allocated to take 30 g/day of inulin or cellulose for 2 weeks in a crossover trial, following a 4-week dose-escalation run-in. Fasting insulin and glucose were measured for all subjects. Fifteen of the 40 subjects also underwent a meal tolerance test to assess insulin sensitivity, free fatty acids and glucagon-like peptide-1 concentrations. A subanalysis was carried out to examine any differences between the prediabetes subtypes.
  
  
  RESULTS
  Inulin was associated with a significant increase in (0-30 min)incremental AUC (iAUC) for insulin (treatment: p < 0.04) and (0-60 min)iAUC for insulin (treatment: p < 0.04) compared to control. There was a significant reduction in insulin resistance measured by the homeostatic model assessment in the isolated-impaired fasting glucose (p < 0.05) but not in the isolated-impaired glucose tolerance groups (p = 0.59).
  
  
  CONCLUSIONS
  The FCHO, inulin, may have unique metabolic effects that are of particular benefit to people at risk of diabetes, which warrant further investigation.
authors.affiliation: Nutrition and Dietetic Research Group, Imperial College, London, Hammersmith Hospital, London, UK.
authors.forename: Nicola D
authors.initials: ND
authors.lastname: Guess
authors.forename: Anne
authors.initials: A
authors.lastname: Dornhorst
authors.forename: Nick
authors.initials: N
authors.lastname: Oliver
authors.forename: Gary S
authors.initials: GS
authors.lastname: Frost
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004311:Double-Blind Method; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007444:Inulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D052216:Glucagon-Like Peptide 1; D007444:Inulin