Subscribe to RSS
DOI: 10.1055/a-0677-6068
Dietary Intervention with Oatmeal in Patients with uncontrolled Type 2 Diabetes Mellitus – A Crossover Study
Publication History
received 24 May 2018
revised 31 July 2018
accepted 08 August 2018
Publication Date:
29 August 2018 (online)
Abstract
Background In a pilot study, we evaluated the efficacy of two days of oatmeal on insulin resistance and glucose metabolism and found a marked decrease of insulin requirements. The most important shortcoming of that study was that the interventions were not isocaloric (diabetes adapted diet: 1500 kcal/d vs. oatmeal 1100 kcal/d). To address these drawbacks we designed the OatMeal And Insulin Resistance (OMA-IR) study.
Methods The study was a randomized, open label crossover dietary intervention study with consecutive inclusion of 15 patients with uncontrolled type 2 diabetes. The intervention comprised two days of oatmeal on days 3 and 4 of a 5 days hospital stay. During the control period, patients received a diabetes mellitus adapted diet only. The primary endpoint was the daily insulin requirement and glycemic control.
Results Upon oatmeal treatment, the required insulin dose could be significantly reduced on the third and fourth day as compared to the second day of inpatient stay (82.0±30.3 and 69.9±29.9IU versus 112±36.2IU;P<0.001). During control treatment, insulin requirement did not change. There were no significant differences in the changes of mean blood glucose or fasting glucose between both treatments. HbA1c was lower four weeks after the oatmeal intervention.
Conclusion In this crossover study, two days of oatmeal intervention allowed a highly significant reduction of required daily insulin doses while maintaining adequate metabolic control as compared to a diabetes adapted diet only. The beneficial effects of the intervention might last for several weeks as shown by the lower HbA1c four weeks after the intervention.
* Contributed equally to this manuscript as junior authors.
# Contributed equally to this manuscript as senior authors.
Supplementary Material
- Supporting Information for this article is available online at https://doi.org/10.1055/a-0677-6068
- Supplementary Material
-
References
- 1 von Noorden C. Hafercuren bei schwerem diabetes mellitus. Klin Wochenschr 1903; 36: 817-821
- 2 Allen FM. Starvation diet for diabetic patients. Am J Med Sci 1915; 150: 480-450
- 3 Mazur A. Why were “starvation diets” promoted for diabetes in the pre-insulin period?. Nutr J 2011; 10: 23
- 4 Herrick JB. The oatmeal diet in the treatment of diabetes mellitus. JAMA 1908; L: 861-865
- 5 Oyen D, Chantelau EA, Berger M. Die Entwicklung der Diabetesdiät seit 1950. In: Zur Geschichte der Diabetesdiät. Berlin Heidelberg: Springer-Verlag Berlin Heidelberg New York Tokyo; 1985
- 6 Zerm R, Kröz M. Hafertage bei diabetes mellitus typ 2 und ausgeprägter Insulinresistenz. Ernährung & Medizin 2014; 29: 13-15
- 7 Beta-glucans from oats and barley related health claims. EFSA Journal 2011; 9: 2207
- 8 Hou Q, Li Y, Li L. et al. The metabolic effects of oats intake in patients with type 2 diabetes: A systematic review and meta-analysis. Nutrients 2015; 7: 10369-10387
- 9 Weickert MO, Pfeiffer AF. Metabolic effects of dietary fiber consumption and prevention of diabetes. J Nutr 2008; 138: 439-442
- 10 Lammert A, Kratzsch J, Selhorst J. et al. Clinical benefit of a short term dietary oatmeal intervention in patients with type 2 diabetes and severe insulin resistance: A pilot study. Exp Clin Endocrinol Diabetes 2008; 116: 132-134
- 11 Wellek S, Blettner M. On the proper use of the crossover design in clinical trials: Part 18 of a series on evaluation of scientific publications. Dtsch Arztebl Int 2012; 109: 276-281
- 12 R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2018. URL https://www.R-project.org/
- 13 Lim EL, Hollingsworth KG, Aribisala BS. et al. Reversal of type 2 diabetes: Normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia 2011; 54: 2506-2514
- 14 Lean ME, Leslie WS, Barnes AC. et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): An open-label, cluster-randomised trial. Lancet 2018; 391: 541-551
- 15 Tosh SM. Review of human studies investigating the post-prandial blood-glucose lowering ability of oat and barley food products. Eur J Clin Nutr 2013; 67: 310-317
- 16 Wolever TMS, Jenkins AL, Prudence K. et al. Effect of adding oat bran to instant oatmeal on glycaemic response in humans - a study to establish the minimum effective dose of oat beta-glucan. Food Funct 2018; 9: 1692-1700
- 17 Zhao L, Zhang F, Ding X. et al. Gut bacteria selectively promoted by dietary fibers alleviate type 2 diabetes. Science 2018; 359: 1151-1156
- 18 Allen RW, Schwartzman E, Baker WL et al. Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Ann Fam Med 2013
- 19 Zare R, Nadjarzadeh A, Zarshenas MM. et al. Efficacy of cinnamon in patients with type II diabetes mellitus: A randomized controlled clinical trial. Clin Nutr 2018; DOI: 10.1016/j.clnu.2018.03.003.