THE EFFECT OF CONSUMING ENZYME-RESISTANT STARCH (RS4) PRODUCT AS A SNACK FOOD ON BLOOD GLUCOSE IN INDIVIDUALS DIAGNOSED WITH TYPE 2 DIABETES MELLITUS
Project no. 20732 · Status: Kapanmış · 2019
Summary
This study aims to determine the effect of bagels containing enzyme-resistant starch (RS4-Realife) given as mid-afternoon snack food on blood glucose in individuals with insulin-dependent Type 2 Diabetes Mellitus(T2DM). The research was carried out in two stages. In the first stage, bagel snacks were prepared in the laboratory using enzyme-resistant starch (RS4), and the recipes of these snack foods were standardized. In the second stage, the effect of consuming bagel snacks made from plain flour, and those made from enzyme-resistant starch on blood glucose was examined through clinical research. The study group consists of patients at the age of between 20-60 years with T2DM who use multiple insulin injections and are followed up in the Endocrinology Polyclinic of Ege University Hospital. Patients with a concomitant chronic condition(s) and pregnant women were not included in the study. The patients who came to the polyclinic were informed about the research following their interviews with the physician and dietician, and those who agreed to participate in the research was started with CGMS (Continuous Glucose Monitoring System - Start - Day 0) by the polyclinic nurse. The patients were given 3 separate packages of bagel snacks that were visually similar, each containing 15 g of carbohydrate, and they were recommended to consume the bagel snacks made from plain flour in the red package on Day 1 and to consume the bagel snacks made from enzyme-resistant flour in the blue packages on Day 2 and Day 3 as a mid-afternoon meal without consuming anything else. The patients were not informed about the ingredients of the products in the packages. On the last day (Day 4), the CGMS devices were removed by the polyclinic nurse, and the data were imported into the computer. Initially, 16 patients agreed to participate in the study, however, one of them left the study voluntarily, and another person was excluded due to a technical problem. Therefore, the study was completed with 14 participants. SPSS 25.0 software package was used in analyzing the data, and the differences in the risky anthropometric measurements and biochemical parameters by the gender were evaluated using chi-square tests, and the effects of bagel snacks made from plain flour and enzyme-resistant flour on blood glucose were evaluated using the area under the curve (AUC) and Wilcoxon signed-rank test. The correlation between blood glucose value obtained by glucose meter and glucose value obtained by CGMS was evaluated using Spearman’s rho correlation. A p-value less than 0.05 (p < 0.05) was considered statistically significant. No significant difference was found between males and females in terms of risky anthropometric measurements or risky biochemical parameters. In terms of sensorial properties, although participants stated that the taste of the bagel snacks consumed on Day 1 was different from those consumed on the following two days, no significant difference was found between the products in terms of parameters such as the taste, appearance, discomfort, etc. The preprandial blood glucose level measured in the morning, and postprandial blood glucose levels measured in the afternoon and evening using glucometer were found to have a significant and very strong positive correlation with the glucose levels measured by CGMS. While the blood glucose level was found to be 1241 unit2 for the bagel snacks made from plain flour, it was found to be 932 unit2 when enzyme-resistant flour was used, and this difference was found to be significant. To conclude, it was found that taste of the bagel snacks made from enzyme-resistant flour was different from those made from plain flour; however, this difference did not cause any discomfort, and the bagel snacks made from enzyme-resistant flour increased blood glucose significantly less and slower compared to the plain flour. Thus, patients with diabetes mellitus may be recommended to consume enzyme-resistant flour.