Skip to main content

Dietary fiber in the Management of Diabetes

  • Chapter
Dietary Fiber

Abstract

Over the past two decades there has been a radical change in dietary guidelines for diabetes, which now stress high carbohydrate and fiber intakes. The initial impetus for the increase in carbohydrate came from early studies of Himsworth (1935–36) and, later, Stone and Connor (1965), showing improved blood lipids and glucose tolerance on a high-carbohydrate diet. Further motivation for change originated in the early 1970s from Trowell’s suggestion (1973) that the development of diabetes might be related to a lack of fiber in the diet. This spurred many new concepts about the dietary treatment of diabetes and lead to the classic studies of Anderson (Kiehm et al., 1976; Anderson and Ward, 1979) and others (Simpson et al., 1981; Rivellese et al., 1980) showing the beneficial effects of high-carbohydrate, high-fiber diets.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  • Ahrens, E. H., Hirsch, J., Oette, K., Farquhar, J. W., and Stein, Y., 1961, Carbohydrate induced and fat induced lipemia, Trans. Assoc. Am. Physicians 74: 134.

    CAS  Google Scholar 

  • American Diabetes Association, 1987, Policy statement: Nutritional recommendations and principles for individuals with diabetes mellitus: 1986, Diabetes Care 10: 126–132.

    Google Scholar 

  • Anderson, J. W., and Chen, W. L., 1979, Plant fiber: Carbohydrate and lipid metabolism, Am. J. Clin. Nutr 32: 346–363.

    CAS  Google Scholar 

  • Anderson, J. W., and Ward, K., 1979, High carbohydrate, high fiber diets for insulin treated men with diabetes mellitus, Am. J. Clin. Nutr 32: 2312–2321.

    CAS  Google Scholar 

  • Aro, A., Uusitupa, M., Vontilainen, E., Hersio, K., Korhonen, T., and Siitonen, O., 1981, Improved diabetic control and hypocholesterolemic effect induced by long-term dietary supplementation with guar gum in type 2 (insulin-independent) diabetes, Diabetologia 21: 29–33.

    CAS  Google Scholar 

  • Asplund, J. M., Orskov, E. R., Hovell, F. D., and Macleod, N. A., 1985, The effect of intragastric infusion of glucose, lipids or acetate on fasting nitrogen excretion and blood metabolites in sheep, Br. J. Nutr 54: 189–195.

    CAS  Google Scholar 

  • Atkins, T. W., Al-Hussary, N. A. J., and Taylor, K. G., 1987, The treatment of poorly controlled noninsulin-dependent diabetic subjects with granulated guar gum, Diabetes Res. Clin. Pract 3: 153–159.

    CAS  Google Scholar 

  • Bantle, J. P., Laine, D. C., Castle, G. W., Thomas, J. W., Hoogwerf, B. J., and Goetz, F. C., 1983, Postprandial glucose and insulin responses to meals containing different carbohydrates in normal and diabetic subjects, N. Engl. J. Med 309: 7–12.

    CAS  Google Scholar 

  • Bierman, E., and Hamlin, J. I., 1961, Hyperlipidemic effect of a low fat, high carbohydrate diet in diabetes, Diabetes 10: 432–437.

    CAS  Google Scholar 

  • Blackburn, N. A., Redfern, J. S., Jaŋis, H., Holgate, A. M., Hanning, I., Scarpello, J. H. B., Johnson, I. T., and Read, N. W., 1984, The mechanism of action of guar gum in improving glucose tolerance in man, Clin. Sci 66: 329–336.

    CAS  Google Scholar 

  • Bornet, F. R. J., Costaglioloa, D., Blayo, A., Fòntvielle, A., Haardt, M. J., Letanoux, M., Tchobroutsky, G., and Slama, G., 1987, Insulinogenic and glycemic indexes of six starch-rich foods taken alone and in a mixed meal by type 2 diabetics, Am. J. Clin. Nutr 45: 588–595.

    CAS  Google Scholar 

  • Bosello, O., Ostuzzi, R., Armellini, F., Micciolo, R. M., and Ludovico, A. S., 1980, Glucose tolerance and blood lipids in bran fed patients with impaired glucose tolerance, Diabetes Care 3: 46–49.

    CAS  Google Scholar 

  • Botha, A. P. J., Steyn, A. F., Esterhuysen, A. J., and Slabbert, M., 1981, Glycosylated haemoglobin, blood glucose and serum cholesterol levels in diabetics treated with guar gum, S. Afr. Med. J 59: 333–334.

    CAS  Google Scholar 

  • Brand, J. C., Nicholson, P. L., Thorburn, A. W., and Truswell, A. S., 1985, Food processing and the glycemic index, Am. J. Clin. Nutr 42: 1192–1196.

    CAS  Google Scholar 

  • Brockman, P. R., 1982, Insulin and glucagon responses in plasma to intraportal infusions of propionate and butyrate in sheep, Comp. Biochem. Physiol 73A: 237–238.

    CAS  Google Scholar 

  • Carroll, D. G., Dykes, V., and Hodgson, W., 1981, Guar gum is not a panacea in diabetes management, N.Z. Med. J 93: 292–234.

    CAS  Google Scholar 

  • Chew, I., Brand, J. C., Thorburn. A. W., and Truswell, A. S., 1988, Application of glycemic index to mixed meals, Am. J. Clin. Nutr 47: 53–56.

    CAS  Google Scholar 

  • Cohen, M., Leong, V. W., Salmon, E., and Martin, F. I. R., 1980, The role of guar and dietary fibre in the management of diabetes mellitus, Med. J. Aust 1: 59–61.

    CAS  Google Scholar 

  • Collier, G., McLean, A., and O’Dea, K., 1984, Effect of coingestion of fat on the metabolic responses to slowly and rapidly absorbed carbohydrates, Diabetologia 26: 50–54.

    CAS  Google Scholar 

  • Collier, G. R., Wolever, T. M. S., Wong, G. S., and Josse, R. G., 1986, Prediction of glycemic response to mixed meals in non-insulin dependent diabetic subjects, Am. J. Clin. Nutr 44: 349–352.

    CAS  Google Scholar 

  • Coulston, A., Liu, G., and Reaven, G. M., 1983, Plasma glucose, insulin and lipid responses to high carbohydrate low fat diets in normal humans, Metabolism 32: 52–56.

    CAS  Google Scholar 

  • Coulston, A. M., Hollenbeck, C. B., Swislocki, A. L. M., and Reaven, G. M., 1987, Effect of source of dietary carbohydrate on plasma glucose and insulin responses to mixed meals in subjects with NIDDM, Diabetes Care 10: 395–400.

    CAS  Google Scholar 

  • Cummings, H., and Branch, W. J., 1986, Fermentation and the production of short-chain fatty acids in the human colon, in: Dietary Fiber: Basic and Clinical Aspects (G. V. Vahouny and D. Kritchevsky, eds.), Plenum Press, New York, pp. 131–149.

    Google Scholar 

  • Edwards, C. A., Blackburn, N. A., Craigen, L., Davison, P., Tomlin, J., Sugden, K., Johnson, I. T., and Read, N. W., 1987, Viscosity of food gums determined in vitro related to their hypoglycemic actions, Am. J. Clin. Nutr 46: 11–11.

    Google Scholar 

  • Ford, E. J. H., and Simmons, H. A., 1985, Gluconeogenesis from caecal propionate in the horse, Br. J. Nutr 53: 55–60.

    CAS  Google Scholar 

  • Ftiessl, S., Adrian, T. E., Bacarese-Hamilton, A. J., and Bloom, S. R., 1986, Guar in NIDD: Effect of different modes of administration on plasma glucose and insulin responses to a starch meal, Pract. Diabetes 3(5): 258–260.

    Google Scholar 

  • Fíiessl, H. S., Williams, G., Adrian, T. E., and Bloom, S. R., 1987, Guar sprinkled on food: Effect on glycaemic control, plasma lipids and gut hormones in non-insulin dependent diabetic patients, Diabetic Med 4: 463–468.

    Google Scholar 

  • Gatti, E., Catenazzo, G., Camisasca, E., Torn, A., Denegri, E., and Sirtori, D. R., 1984, Effects of guar-enriched pasta in the treatment of diabetes and hyperlipidemia, Ann. Nutr. Metab 28: 1–10.

    CAS  Google Scholar 

  • Golay, A., Coulston, A. M., Hollenbeck, C. B., Kaiser, L. L., Wursch, P., and Reaven, G. M., 1986, Comparison of metabolic effects of white beans processed into two different forms, Diabetes Care 9: 260–266.

    CAS  Google Scholar 

  • Himsworth, H. P., 1935–36, The dietetic factor determining the glucose tolerance and sensitivity to insulin of healthy men, Clin. Sci 2: 67–94.

    Google Scholar 

  • Hollenbeck, C. B., Riddle, M. C., Conner, W. E., and Leklem, J. E., 1985, The effects of subjectselected high carbohydrate, low fat diets on glycemic control in insulin dependent diabetes mellitus, Am. J. Clin. Nutr 41: 293–299.

    CAS  Google Scholar 

  • Hollenbeck, C. B., Coulston, A. M., and Reaven, G. M., 1986, To what extent does increased dietary fiber improve glucose and lipid metabolism in patients with noninsulin-dependent diabetes mellitus (NIDDM)? Am. J. Clin. Nutr 43: 16–24.

    CAS  Google Scholar 

  • Holman, R. R., Steemson, J., Darling, P., and Turner, R. C., 1987, No glycemic benefit from guar administration in NIDDM, Diabetes Care 10: 68–71.

    CAS  Google Scholar 

  • Jenkins, D. J. A., 1967, Ketone bodies and the inhibition of free-fatty acid release, Lancet 2: 338–340.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Hockaday, T. D. R., Leeds, A. R., Haworth, R., Bacon, S., Apling, E. C., and Dilawari, J., 1977, Treatment of diabetes with guar gum, Lancet 2: 779–780.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Leeds, A. R., Gassull, M. A., Dilawari, J. B., Goff, D. V., Metz, G. L., and Alberti, K. G. M. M., 1978a, Dietary fibres, fibre analogues and glucose tolerance: Importance of viscosity, Br. Med. J 1: 1392–1394.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Nineham, R., Taylor, R. H., Metz, G. L., Bacon, S., and Hockaday, T. D. R., 1978b, Guar crispbread in the diabetic diet, Br. Med. J 2: 1744–1746.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Nineham, R., Craddock, C., Craig-McFeely, P., Donaldson, K., Leigh, T., and Snook, J., 1979, Fibre and diabetes, Lancet 1: 434–435.

    Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Taylor, R. H., Reynolds, D., Nineham, R., and Hockaday, T. D. R., 1980a, Diabetic glucose control, lipids, and trace elements on long term guar, Br. Med. J 1: 1353–1354.

    Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Bacon, S., Nineham, R., Leeds, A. R., Rowden, R., Love, M., and Hockaday, T. D. R., 1980b, Diabetic diets: High carbohydrate combined with high fiber, Am. J. Clin. Nutr 33: 1729–1733.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Taylor, R. H., Barker, H., and Fielden, H., 1980c, Exceptionally low blood glucose response to dried beans: Comparison with other carbohydrate foods, Br. Med. J 2: 578–580.

    Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Nineham, R., Sarson, D. L., Bloom, S. R., Ahern, J., Alberti, K. G. M. M., and Hockaday, T. D. R., 1980d, Improved glucose tolerance four hours after taking guar with glucose, Diabetologia 19: 21–24.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Taylor, R. H., Goff, D. V., Fielden, H., Miseiwicz, J. J., Sarson, D. L., Bloom, S. R., and Alberti, K. G. M. M., 1981a, Scope and specificity of acarbose in slowing carbohydrate absorption in man, Diabetes 30: 951–954.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Taylor, R. H., Barker, H. M., Fielden, H., and Gassull, M. A., 1981b, Lack of effect of refining on the glycemic response to cereals, Diabetes Care 4: 509–513.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Taylor, R. H., Barker, H. M., Fielden, H., Baldwin, J. M., Bowling, A. C., Newman, H. C., Jenkins, A. L., and Goff, D. V., 1981c, Glycemic index of foods: A physiological basis for carbohydrate exchange, Am. J. Clin. Nutr 34: 362–366.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Taylor, R. H., Griffiths, C., Krzeminska, K., Lawrie, J. A., Bennett, C. M., Goff, D. V., Sarson, D. L., and Bloom, S. R., 1982a, Slow release carbohydrate improves second meal tolerance, Am. J. Clin. Nutr 35: 1339–1346.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Ghafari, H., Wolever, T. M. S., Taylor, R. H., Barker, H. M., Fielden, H., Jenkins, A. L., and Bowling, A. C., 1982b, Relationship between the rate of digestion of foods and postprandial glycaemia, Diabetologia 22: 450–455.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Jenkins, A. L., Lee, R., Wong, G. S., and Josse, R. G., 1983, Glycemic response to wheat products: Reduced response to pasta but no effect of fiber, Diabetes Care 6: 155–159.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Thome, M. J., Jenkins, A. L., Wong, G. S., Josse, R. G., and Csima, A., 1984, The relationship between glycemic response, digestibility, and factors influencing the dietary habits of diabetics, Am. J. Clin. Nutr 40: 1175–1191.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Kalmusky, J., Giudici, S., Giordano, C., Wong, G. S., Bird, J. H., Patten, R., Hall, M., Buckley, G. C., and Little, J. A., 1985, Low glycemic index foods in the management of hyperlipidemia, Am. J. Clin. Nutr 42: 604–617.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Jenkins, M. A., Wolever, T. M. S., Taylor, R. H., and Ghafari, H., 1986, Slow release carbohydrate: Mechanism of action of viscous fibers, J. Clin. Nutr. Gastroenterol 1: 237–241.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Cuff, D., Wolever, T. M. S., Knowland, D., Thompson, L. U., Cohen, Z., and Prokipchuk, E., 1987a, Digestibility of carbohydrate foods in an ileostomate: Relationship to dietary fiber, in vitro digestibility, and glycemic response, Am. J. Gastroenterol 82: 709–717.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Collier, G. R., Ocana, A., Rao, A. V., Buckley, G., Lam, K. Y., Meyer, A., and Thompson, L. U., 1987b, The metabolic effects of a low glycemic index diet, Am. J. Clin. Nutr 46: 968–975.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Kalmusky, J., Guidici, S., Giordano, C., Patten, R., Wong, G. S., Bird, J. N., Hall, M., Buckley, G., Csima, A., and Little, J. A., 1987c, Low-glycemic index diet in hyperlipidemia: Use of traditional starchy foods, Am. J. Clin. Nutr 46: 66–71.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., Buckley, G., Lam, K. Y., Giudici, S., Kalmusky, J., Jenkins, A. L., Patten, R., Bird, J., Wong, G. S., and Josse, R. G., 1988a, Low glycemic index starchy foods in the diabetic diet, Am. J. Clin. Nutr 48: 248–254.

    CAS  Google Scholar 

  • Jenkins, D. J. A., Wolever, T. M. S., and Jenkins, A. L., 1988b, Starchy foods and the glycemic index, Diabetes Care 11: 149–159.

    CAS  Google Scholar 

  • Johansen, K., 1981, Decreased urinary glucose excretion and plasma cholesterol level in non-insulindependent diabetic patients with guar, Diabetes Metab 7: 87–90.

    CAS  Google Scholar 

  • Karlstrom, B., Vessby, B., Asp, N.-G., Boberg, M., Gustafsson, I.-B., Lithell, H., and Werner, I., 1984, Effects of an increased content of cereal fibre in the diet of type II (non-insulin-dependent) diabetics, Diabetologia 26: 272–277.

    CAS  Google Scholar 

  • Karlstrom, B., Vessby, B., and Asp, N.-G., 1987, Effects of leguminous seeds in a mixed diet in noninsulin-dependent diabetic patients, Diabetes Res 5: 199–205.

    CAS  Google Scholar 

  • Kiehm, T. G., Anderson, J. W., and Ward, K., 1976, Beneficial effects of a high carbohydrate high fiber diet in hyperglycemic men, Am. J. Clin. Nutr 29: 895–899.

    CAS  Google Scholar 

  • Kinmonth, A.-L., Angus, R. M., Jenkins, P. A., Smith, M. A., and Baum, D., 1982, Whole foods and increased dietary fibre improve blood glucose control in diabetic children, Arch. Dis. Child 57: 187–194.

    CAS  Google Scholar 

  • Kuhl, C., Molsted-Pedersen, L., and Hornnes, P. J., 1983, Guar gum and glycemic control of pregnant insulin-dependent diabetic patients, Diabetes Care 6: 152–154.

    CAS  Google Scholar 

  • Laine, D. C., Thomas, W., Levitt, M. D., and Bantle, J. P., 1987, Comparison of predictive capabilities of diabetic exchange lists and glycemic index of foods, Diabetes Care 10: 387–394.

    CAS  Google Scholar 

  • Lindsay, A. N., Hardy, S., Jarrett, L., and Rallinson, M. L., 1984, High-carbohydrate, high-fiber diet in children with type I diabetes mellitus, Diabetes Care 7: 63–67.

    CAS  Google Scholar 

  • Liu, G. C., Coulston, A. M., and Reaven, G. M., 1983, Effect of high carbohydrate-low fat diets on plasma glucose, insulin and lipid responses in hypertriglyceridemic humans, Metabolism 32: 750–753.

    CAS  Google Scholar 

  • Mahalko, J. R., Sandstead, H. H., Johnson, L. K., Inman, L. F., Milne, D. B., Warner, R. C., and Haunz, E. A., 1984, Effect of consuming fiber from corn bran, soy hulls, or apple powder on glucose tolerance and plasma lipids in type II diabetes, Am. J. Clin. Nutr 39: 25–34.

    CAS  Google Scholar 

  • Mayne, P. D., McGill, A. R., Gormley, T. R., Tomplin, G. H., Julian, T. R., and O’Moore, R. R., 1982, The effect of apple fibre on diabetic control and plasma lipids, Ir. J. Med. Sci 151: 36–42.

    CAS  Google Scholar 

  • Miranda, P. M., and Horwitz, D. L., 1978, High fiber diets in the treatment of diabetes mellitus, Ann. Intern. Med 88: 482–486.

    CAS  Google Scholar 

  • Monnier, L. H., Blotman, M. J., Colette, C., Monnier, M. P., and Mirouze, J., 1981, Effects of dietary fibre supplementation in stable and labile insulin-independent diabetics, Diabetologia 20: 12–17.

    CAS  Google Scholar 

  • Najemnik, C., Kritz, H., Irsigler, K., Laube, H., Knick, B., Klimm, H. D., Wahl, P., Vollmar, J., and Brauning, C., 1984, Guar and its effects on metabolic control in type II diabetic subjects, Diabetes Care 7: 215–220.

    CAS  Google Scholar 

  • National Institutes of Health, 1986, Diet and Exercise in Non-Insulin-Dependent Diabetes Mellitus, National Institutes of Health Consensus Development Conference Statement, Vol. 6, No. 8, Dec 10, 1986, National Institutes of Health, Bethesda, MD.

    Google Scholar 

  • Nuttal, F. Q., Mooradian, A. D., DeMarais, R., and Parker, S., 1983, The glycemic effect of different meals approximately isocaloric and similar in protein, carbohydrate, and fat content as calculated using the ADA exchange lists, Diabetes Care 6: 432–435.

    Google Scholar 

  • Ocana, A. M., Jenkins, D. J. A., Wolever, T. M. S., Cunnane, S., Singer, W., and Bloom, S. R., 1988, “Nibbling versus gorging”: Metabolic effects of prolonging the rate of glucose absorption, Diabetes 37(Suppl. 1):109A.

    Google Scholar 

  • O’Dea, K., Snow, P., and Nestel, P., 1981, Rate of starch hydrolysis in vitro as a predictor of metabolic responses to complex carbohydrate in vivo, Am. J. Clin. Nutr 34: 1991–1993.

    Google Scholar 

  • Osilesi, O., Trout, D. L., Glover, E. E., Harper, S. M., Koh, E. T., Behall, K. M., O’Dorisio, T. M., and Tartt, J., 1985, Use of xanthan gum in dietary management of diabetes mellitus, Am. J. Clin. Nutr 42: 597–603.

    CAS  Google Scholar 

  • Paganus, A., Maenpaa, J., Akerblom, H. K., Stenman, U.-H., Knip, M., and Simell, O., 1987, Beneficial effects of palatable guar and guar plus fructose diets in diabetic children, Acta Paediatr. Scand 76: 76–81.

    CAS  Google Scholar 

  • Parillo, M., Giacco, R., Riccardi, G., Pacioni, D., and Rivellese, A., 1985, Different glycaemic responses to pasta, bread, and potatoes in diabetic patients, Diabetic Med 2: 374–377.

    CAS  Google Scholar 

  • Perrotti, N., Santoro, D., Genovese, S., Giacco, A., Rivellese, A., and Riccardi, G., 1984, Effect of digestible carbohydrates on glucose control in insulin-dependent diabetic patients, Diabetes Care 7: 354–359.

    CAS  Google Scholar 

  • Ray, T. K., Mansell, K. M., Knight, L. C., Malmud, L. S., Owen, O. E., and Boden, G., 1983, Longterm effects of dietary fiber on glucose tolerance and gastric emptying in noninsulin-dependent diabetic patients, Am. J. Clin. Nutr 37: 376–381.

    CAS  Google Scholar 

  • Reaven, G. M., 1979, Effect of variations in carbohydrate intake on plasma glucose, insulin, and triglyceride responses in normal subjects and patients with chemical diabetes, in: Treatment of Early Diabetes (R. A. Camerini-Davalos and B. A. Hanover, eds.), Plenum Press, New York, pp. 253–262.

    Google Scholar 

  • Reaven, G. M., 1980, How much carbohydrate? Diabetologia 19: 409–413.

    CAS  Google Scholar 

  • Rivellese, A., Riccardi, G., Giacco, A., Pancioni, D., Genovese, S., Mattioli, P. L., and Mancini, M., 1980, Effect of dietary fibre on glucose control and serum lipoproteins in diabetic patients, Lancet 2: 447–450.

    CAS  Google Scholar 

  • Simpson, H. C. R., Simpson, R. W., Lousley, S., Carter, R. D., Geekie, M., Hockaday, T. D. R., and Mann, J. I., 1981, A high carbohydrate leguminous fibre diet improves all aspects of diabetic control, Lancet 1: 1–5.

    CAS  Google Scholar 

  • Simpson, H. C. R., Carter, R. D., Lousley, S., and Mann, J. I., 1982, Digestible carbohydrate-an independent effect on diabetic control in type II (non-insulin-dependent) diabetic patients? Diabetologia 23: 235–239.

    CAS  Google Scholar 

  • Simpson, R. W., Mann, J. I., Eaton, J., Carter, R. D., and Hockaday, T. D. R., 1979a, High carbohydrate diets in insulin-dependent diabetes, Br. Med. J 2: 523–525.

    CAS  Google Scholar 

  • Simpson, R. W., Mann, J. I., Eaton, J., Moore, R. A., Carter, R., and Hockaday, T. D. R., 1979b, Improved glucose control in maturity onset diabetes treated with high carbohydrate-modified fat diet, Br. Med. J 1: 1752–1756.

    Google Scholar 

  • Smith, C. J., Roseman, M. S., Levitt, N. S., and Jackson, W. P. U., 1982, Guar biscuits in the diabetic diet, S. Afr. Med. J 61: 196–198.

    CAS  Google Scholar 

  • Smith, U., and Holm, G., 1982, Effect of a modified guar gum preparation on glucose and lipid levels in diabetics and healthy volunteers, Atherosclerosis 45: 1–10.

    CAS  Google Scholar 

  • Stone, D. B., and Connor, W. E., 1965, Prolonged effects of a low cholesterol, high carbohydrate diet upon the serum lipids in diabetic patients, Diabetes 12: 127–132.

    Google Scholar 

  • Tagliaferro, V., Cassader, M., Bozzo, C., Pisu, E., Bruno, A., Marena, S., Cavallo-Perin, P., Cravero, L., and Pagano, G., 1985, Moderate guar-gum addition to usual diet improves peripheral sensitivity to insulin and lipaemic profile in NIDDM, Diabetes Metab 11: 380–385.

    CAS  Google Scholar 

  • Thorburn, A. W., Brand, J. C., and Truswell, A. S., 1987, Slowly digested and absorbed carbohydrate in traditional bushfoods: A protective factor against diabetes? Am. J. Clin. Nutr 45: 98–106.

    CAS  Google Scholar 

  • Trowell, H. C., 1973, Dietary fibre, ischaemic heart disease and diabetes mellitus, Proc. Nutr. Soc 32: 151–157.

    CAS  Google Scholar 

  • Vaaler, S., Hanssen, K. F., Dahl-Jorgensen, L., Frolich, W., Aaseth, J., Odengaard, B., and Aagenaes, O., 1983, Improvement in diabetes control after bread-enrichment with wheat bran and guar gum, in: European Association for Study of Diabetes International Symposium on Diabetes and Nutrition: Crete

    Google Scholar 

  • Wolever, T. M. S., and Collier, G. R., 1987, Dietary fiber and noninsulin-dependent diabetes mellitus, Am. J. Clin. Nutr 46: 866–867.

    CAS  Google Scholar 

  • Wolever, T. M. S., and Jenkins, D. J. A., 1985, Application of the glycemic index to mixed meals, Lancet 2: 944.

    CAS  Google Scholar 

  • Wolever, T. M. S., and Jenkins, D. J. A., 1986, The use of the glycemic index in predicting the blood glucose response to mixed meals, Am. J. Clin. Nutr 43: 167–174.

    CAS  Google Scholar 

  • Wolever, T. M. S., Nuttall, F. Q., Lee, R., Wong, G. S., Josse, R. G., Csima, A., and Jenkins, D. J. A., 1985, Prediction of the relative blood glucose response of mixed meals using the white bread glycemic index, Diabetes Care 8: 418–428.

    CAS  Google Scholar 

  • Wolever, T. M. S., Cohen, Z., Thompson, L. U., Thorne, M. J., Jenkins, M. J. A., Prokipchuk, E. J., and Jenkins, D. J. A., 1986, Ileal loss of available carbohydrate in man: Comparison of a breath hydrogen method with direct measurement using a human ileostomy model, Am. J. Gastroenterol 81: 115–122.

    CAS  Google Scholar 

  • Wolever, T. M. S., Jenkins, D. J. A., Josse, R. G., Wong, G. S., and Lee, R., 1987, The glycemic index: Similarity of values derived in insulin-dependent and non-insulin-dependent diabetic patients, J. Am. Coll. Nutr 6: 296–305.

    Google Scholar 

  • Wolever, T. M. S., Jenkins, D. J. A., Collier, G. R., Lee, R., Wong, G. S., and Josse, R. G., 1988a, Metabolic responses to test meals containing different carbohydrate foods: 1. Relationship between rate of digestion and plasma insulin response, Nutr. Res 8: 573–581.

    CAS  Google Scholar 

  • Wolever, T. M. S., Jenkins, D. J. A., Ocana, A. M., Rao, A. V., and Collier, A. V., 1988b, Second meal effect: Low glycemic index foods eaten at dinner improve subsequent breakfast glycemic response, Am. J. Clin. Nutr 48: 1041–1047.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Plenum Press, New York

About this chapter

Cite this chapter

Wolever, T.M.S. (1990). Dietary fiber in the Management of Diabetes. In: Kritchevsky, D., Bonfield, C., Anderson, J.W. (eds) Dietary Fiber. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0519-4_22

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-0519-4_22

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-7846-7

  • Online ISBN: 978-1-4613-0519-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics