Fibre consumption, metabolic effects and prevention of complications in diabetic patients: epidemiological evidence

The EURODIAB Complications Study, a clinic based epidemiological project including 3250 individuals with type 1 diabetes from 31 European centres analysed the natural dietary fibre intake and possible benefits for patients with diabetes. The mean intake of natural dietary fibre in the cohort of patients with type 1 diabetes was 17.3 g/day for all centres with a centre range of 13.9-21.9 g/day. The fibre consumption was lowest in patients from Eastern European centres compared to patients from centres in Southern and North-Western Europe. The fibre density was highest in patients from Southern Europe. Total fibre intake was significantly inversely related to HbA1c levels; severe ketoacidosis risk fell significantly with higher fibre intakes. Higher intakes of total fibre were independently associated with significantly higher levels of high density lipoprotein-cholesterol in male and in female patients. Fibre intakes in men with diabetes were also inversely related to ratios of total cholesterol to high density lipoprotein-cholesterol and to levels of low density lipoprotein-cholesterol. Higher fibre intakes are also associated with decreases in plasma oestradiol and oestrone levels. A protective effect of total fibre intake against cardiovascular disease was observed in females but not in males with diabetes.