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More Fiber, Less Diabetes Medicine?

WebMD Health News

May 10, 2000 -- Diet can contribute to developing type 2 diabetes, but it can also help keep it under control. Diabetics who eat more high-fiber fruit, vegetables, and grains can improve their blood sugar control and may reduce their need for additional diabetic medicine, researchers report in this week's New England Journal of Medicine.

Lead author Manisha Chandalia, MD, tells WebMD that the high-fiber diet reduced blood sugar levels as much as an additional dose of diabetes drugs taken by mouth called hypoglycemic agents.

But a healthy diet doesn't have to equal boredom. Chandalia also says that this can be done by following a very tasty menu that includes lots of cantaloupe, grapefruit, oranges, papaya, raisins, lima beans, okra, sweet potatoes, winter squash, zucchini, granola, oat bran, and oatmeal. Chandalia is assistant professor of internal medicine in the VA Medical Center in Dallas.

Chandalia tested the new diet in 13 people who have type 2 diabetes. Each spent six weeks following the standard American Diabetes Association (ADA) diet that includes 24 grams of fiber per day. They then followed a high-fiber diet, which includes 50 grams of fiber per day, for another six weeks.

During the high-fiber weeks, the study subjects had major improvements in the levels of sugar in their blood. They also had improvement in their cholesterol levels.

Chandalia tells WebMD that her study shows that diet should still be the centerpiece in managing diabetes. She says that simple things can be done to increase daily fiber intake, such as "eating whole wheat instead of white bread, or eating an orange instead of drinking orange juice."

Vladimir Vuksan, PhD, who was not involved in the study, tells WebMD that paying more attention to fiber may also increase the effectiveness of other diabetic treatments. "This is a very fine, well-controlled trial that clearly demonstrates the efficacy of dietary fiber in controlling type 2 diabetes. Other studies, including our own, have shown comparable effects, and we think that fiber could be an effective [additional] therapy." Vuksan is associate director of the Risk Factor Modification Center at St. Michael's Hospital in Toronto.

One of Chandalia's colleagues involved in the study, Abihymanyu Garg, MD, tells WebMD that adopting the high-fiber diet requires some changes in thinking about meals. Garg says that some patients were initially intimidated by the large servings of fruits and vegetables that are needed to bring dietary fiber up to 50 grams per day. "They quickly got used to it, and nobody dropped out," he says. "One patient even became quite fond of papaya, although he had never eaten it before." Garg is associate program director of general clinical research at the University of Texas Southwest Medical Center in Dallas.

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