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Exp Clin Endocrinol Diabetes 2020; 128(09): 624-630
DOI: 10.1055/a-1069-7330
Article

Bile Acids in Patients with Uncontrolled Type 2 Diabetes Mellitus – The Effect of Two Days of Oatmeal Treatment

Graciela E. Delgado
1   Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
,
Bernhard K. Krämer
1   Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
,
Hubert Scharnagl
2   Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
,
Günther Fauler
2   Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
,
Tatjana Stojakovic
3   Clinical Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Graz, Graz, Austria
,
Winfried März
1   Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
2   Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
4   Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany
,
Marcus Edi Kleber  ‡
1   Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
,
Alexander Lammert‡
1   Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
5   Praxis für Diabetes, Stoffwechsel-und Nierenerkrankungen, Grünstadt, Germany
› Author Affiliations Funding: This work has received funding from the European Union’s Horizon 2020 research and innovation programme under the ERA-Net Cofund action N° 727565 (OCTOPUS project) and the German Ministry of Education and Research (grant number 01EA1801A).
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Abstract

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.

Key words

beta-glucans - fibres - dietary intervention

Supplementary Material



Publication History

Article published online:
02 January 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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