Bile Acids in Patients with Uncontrolled Type 2 Diabetes Mellitus - The Effect of Two Days of Oatmeal Treatment.
2020
Background Beta-glucans are effective in binding bile acids (BA) thereby
lowering cholesterol concentration. This might contribute to the beneficial
effects of the consumption of β-glucan-rich foods like oatmeal on
glucose homeostasis. Objective We measured BA serum concentrations in patients with
uncontrolled type 2 diabetes (T2DM) to investigate the effect of two days of
oatmeal treatment on BA concentration as compared to a conventional T2DM-adapted
diet. Methods The OatMeal And Insulin Resistance study was performed as a
randomized, open label crossover dietary intervention study with consecutive
inclusion of 15 patients in an inpatient clinical setting. Bile acids were
measured by high-resolution mass spectrometry. For statistical analysis, the
differences in the concentration of serum BA and laboratory parameters between
the fifth day and the third day of each inpatient stay were calculated and the
effect compared between both phases by using the Wilcoxon test. Results Whereas there was a mean decrease in total BA following oatmeal
treatment (−0.82±1.14 µmol/l), there was
no decrease following the control treatment. Glycocholic acid was lower after
oatmeal treatment but higher following control treatment
(−0.09±0.17 vs.
0.05±0.11 µmol/l). The reduction in total BA was
directly correlated with a decrease in proinsulin during the oatmeal phase.
Decreases in blood lipids or apolipoproteins were mostly greater after oatmeal
treatment, but these differences were not statistically significant. Conclusion Two days of oatmeal diet led to significant reductions in
total BA as compared to a diabetes-adapted control diet. The magnitude of BA
reduction was directly correlated with a decrease in proinsulin.
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