GAMZE AKBULUT, MERVE ŞEYDA KARAÇİL ERMUMCU

Tip 2 Diabetes Mellitus ve Βeta Glukan

Tip 2 diabetes mellitus (DM) en yaygın diyabet türü olup nüfus artışı, yaşlanma, sağlıksız beslenme, obezite ve sekonder yaşam biçimi nedeniyle gittikçe prevelansı artmaktadır. Yeterli ve dengeli beslenme, düzenli fiziksel aktivite ve normal ağırlığın korunması ile Tip 2 DM önlenebilir veya başlangıç yaşı ertelenebilir. Yapılan epidemiyolojik ve kısa dönemli müdahale çalışmalarında yüksek glisemik yüklü ve düşük tahıl lifi içeren besinleri tüketen bireylerde Tip 2 DM riskinin arttığı gösterilmiş, yüksek posa alımının lipit profili, açlık ve tokluk glisemik kontrollerinde iyileşme ile ilişkili olduğu vurgulanmıştır. Besinlerde doğal olarak bulunanlar diyet posası olarak, besinlere eklenen veya besinlerden izole edilenler ise işlevsel posa olarak sınıflandırılmaktadır. İşlevsel besinler alanında, β-glukan sağlığa olan ilgili potansiyel katkılarından dolayı ilgi kazanmıştır. Çözünür posa β-glukanın insulin ve glukoz düşürücü etkilerini açıklayacak çeşitli mekanizmalar öne sürülmüştür. β-glukanın miktarı ve eklendiği besinin formu glisemik kontrol üzerinde etkili olan etmenlerindendir. Yüksek viskoziteye sahip posa kaynakları (β-glukan) ile bu posa kaynaklarının eklenmiş olduğu ürünlerin tüketiminin, diyabet riskinin potansiyel olarak azaltılmasında ve diyabetik komplikasyonların iyileştirilmesinde etkili olarak, diyabet yönetiminde önemli bir rol oynayabileceği düşünülmektedir.

Type 2 Diabetes Mellitus and Βeta Glucan

Type 2 diabetes mellitus (DM) is the most common type of diabetes and its prevalence is progressively increasing due to population growth, aging, unhealthy diet, obesity and secondarily lifestyle. Type 2 DM can be prevented and its age of onset can be delayed with adequate and balanced diet, regular physical activity and normal weight maintenance. The epidemiological and short-term intervention studies has shown that consumption of foods with a high glycemic load and poor cereal fiber content is associated/correlated with an increased risk of type 2 DM. Also they emphasized that high fiber intake is associated with improvement in lipid profile, fasting and postprandial glycemic controls. Fiber is found naturally in foods as dietary fiber and added to or isolated from foods are classified as functional dietary fiber. β-glucan has gained attention for its potential contribution to the health in the field of functional foods. Various mechanisms have been suggested to explain insulin and glucose lowering effects of soluble fiber β-glucan. The amount of β-glucan and added in the form of food are factors which are effective on glycemic control. High viscous dietary fiber sources (β-glucan) and the consumption of their products which are added as β-glucan is considered to play an important role in management of diabetes by reducing as potential risk of diabetes and comprising its positive results on diabetic complications

PDF

___

1.Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD) Çalışma ve Eğitim Grubu. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu. 5. Baskı. Ankara; 2011.
2.International Diabetes Federation. International Diabetes Federation Diabetes Atlas (update).5th Edition. Belgium; 2012.
3.Türkiye Diyabet, Hipertansiyon, Obezite ve Endokrinolojik Hastalıklar Prevalans Çalışması-II (TURDEP-II Çalışması) . Erişim: http://www.istanbul. edu.tr/itf/attachments/021_turdep.2.sonuclarinin. aciklamasi.pdf Erişim tarihi: 9 Aralık 2012.
4.Chen J, Raymond K. β-glucans in the treatment of diabetes and associated cardiovascular risks. Vasc Health Risk Manag 2008;4(6):1265-1272.
5.Cloetens L, Ulmius M, Persson AJ, Akesson B, Önning G. Role of dietary β-glucans in the prevention of the metabolic sendrom. Nutr Rev 2012;70(8):444-458.
6.Anceau CC, Nazare JA, Biorklund M, Le-Coquil E, Sassolas A, Sothier M, et al. A controlled study of consumption of β-glucan-enriched soups for 2 months by type 2 diabetic free-living subjects. Br J Nutr 2010;103(3):422-428.
7.De-Mello VD, Laaksonen DE. Dietary fibers: current trends and health benefits in the metabolic syndrome and type 2 diabetes. Arq Bras Endocrinol Metab 2009;53(5):509-518.
8.Vuksan V, Rogovik LA, Jovanovski E, Jenkins A. Fiber facts: Benefits and recommendations for individuals with type 2 diabetes. Curr Diab Rep 2009;9:405-411.
9.Kim SY, Song HJ, Lee YY, Cho KH, Roh YK. Biomedical issues of dietary fiber β-glucan, J Korean Med Sci 2006; 21(5):781-789.
10.Salvado SJ, Gonzalez MAM, Bullo M, Ros E. The role of diet in the prevention of type 2 diabetes. Nutr Metab Cardiovasc Dis 2011;21:32-48.
11.American Diabetes Association. Position of the American Dietetic Association: Health Implications of Dietary Fiber. J Am Diet Assoc 2008;108:1716-1731.
12.Tominac VP, Krpan VZ, Grba S, Srecec S, Krbavcic IP, Vidovic L. Biological effects of yeast ß-glucans. Agric Conspec Sci 2010;4:149-158.
13.Stone BA. Chemistry of ß-glucans. In: Bacic A, Fincher GB, Stone BA, editors. Chemistry, Biochemistry, and Biology of (1-3)-[β]-Glucans and Related Polysaccharides. 1st ed. Amsterdam: Macmillan Publishing; 2009. p. 5-47.
14.European Food Safety Authority (EFSA). EFSA panel on dietetic products, nutrition and allergies (NDA). EFSA Journal 2011;9(6):2207.
15.U.S. Food and Drug Administration (FAO). Food labelling: health claims; oats and coronary heart disease. Final rule. Fed Regist 1997;62:3584-3601.
16.U.S. Food and Drug Administration (FAO). Food Labelling: health claims; soluble dietary fiber from certain foods and coronary heart disease. Fed Regist 2005; 70:7615076162. Available at: http:// www.fda.gov/food/labelingnutrition/labelclaims/ healthclaimsmeetingsignificantscientificagreementssa/ ucm074306.htm Accessed December 10, 2012.
17.European Food Safety Authority (EFSA). Panel on dietetic products, nutrition and allergies. Scientific opinion on dietary reference values for carbohydrates and dietary fibre. EFSA Journal 2010;8(2):1482.
18.Akbulut G, Yıldız A. Likenlere genel bir bakış: Bazı türlerinin besin ögesi içeriği. Kafkas Üniv Fen Bil Enst Derg 2010; 3(2):79-86.
19.Önning G. The use of cereal β-glucans to control diabetes and cardiovascular disease. Functional Foods. In Arnoldi A editor. Functional Foods, cardiovascular disease and diabetes. 1st. ed. Cambridge: Woodhead Publising; 2004. p. 403-405.
20.Khoury DE, Cuda C, Luhovyy BL, Anderson GH. ß-Glucan: Health benefits in obesity and metabolic syndrome. J Nutr Metab 2012;851362:1-28.
21.Nazare JA, Normand S, Triantafyllou AO, De La Perrière AB, Desage M, Laville M. Modulation of the postprandial phase by β-glucan in overweight subjects: Effects on glucose and insulin kinetics. Mol Nutr Food Res 2009;53(3):361-369.
22.Biörklund M, Rees AV, Mensink RP, Önning G. Changes in serum lipids and postprandial glucose and insulin concentrations after consumption of beverages with β-glucans from oats or barley: a randomised dose- controlled trial. Eur J Clin Nutr 2005;59(11):1272- 1281.
23.Hallfrisch J, Scholfield DJ, Behall KM. Diets containing soluble oat extracts improve glucose and insulin responses of moderately hypercholesterolemic men and women. Am J Clin Nutr 1995;61(2):379-384.
24.Jenkins AL, Jenkins DJ, Zdravkovic U, Würsch P, Vuksan V. Depression of the glycemic index by high levels of β-glucan fiber in two functional foods tested in type 2 diabetes. Eur J Clin Nutr 2002;56(7):622-628.
25.Kim H, Stote KS, Behall KM, Spears K, Vinyard B, Conway JM.Glucose and insulin responses to whole grain breakfasts varying in soluble fiber, β-glucan. Eur J Nutr 2009;48:170-175.
26.Li J, Kaneko T, Qin LQ, Wang J, Wang Y. Effects of barley intake on glucose tolerance, lipid metabolism, and bowel function in women. Nutrition 2003;19:926- 929.
27.Granfeldt Y, Nyberg L, Björck I. Muesli with 4 g oat β-glucans lowers glucose and insulin responses after a bread meal in healthy subjects. Eur J Clin Nutr 2008;62(5):600-607.
28.Tapola N, Karvonen H, Niskanen L, Mikola M, Sarkkinen E. Glycemic responses of oat bran products in type 2 diabetic patients. Nutr Metab Cardiovasc Dis 2005;15(4):255-261.
29.Lebowicz H, Darwiche G, Björgell O, Almér LO. Effect of muesli with 4 g oat β-glucan on postprandial blood glucose, gastric emptying and satiety in healthy subjects: A randomized cross over trial. J Am Coll Nutr 2008;27(4):470-475.
30.Beck EJ, Tosh SM, Batterham MJ, Tapsell LC, Huang XF. Oat β-glucan increases postprandial cholecystokinin levels, decreases insulin response and extends subjective satiety in overweight subjects. Mol Nutr Food Res 2009;53(10):1343-1351.
31.Liatis S, Tsapogas P, Chala E, Dimosthenopoulos C, Kyriakopoulos K, Kapantais E. The consumption of bread enriched with β-glucan reduces LDL-cholesterol and improves insulin resistance in patients with type 2 diabetes. Diabetes Metab 2009;35:115-120.
32.Reyna NY, Cano C, Bermúdez VJ, Medina MT, Souki AJ, Ambard M, et. al. Sweeteners and β-glucans improve metabolic and anthropometrics variables in well controlled type 2 diabetic patients. Am J Ther 2003;10(6):438-443.
33.Kabir M, Oppert JM, Vidal H, Bruzzo F, Fiquet C, Wursch P. Four-week low-glycemic index breakfast with modest amount of soluble fibers in type 2 diabetic men. Metabolism 2002;51:819-826.
34.Asif A, Munir B, Abrar M, Bashi S, Adnan M, Tabassum T. Perspective of β glucan as functional ingredient for food industry. T J Nutr Food Sci 2012;2(2):1-8.