Data published in the American Journal of Clinical Nutrition indicated that multi-week supplementation with psyllium before meals was associated with reductions in fasting blood glucose levels and glycated hemoglobin (HbA1c), a marker of long-term presence of excess glucose in the blood, in people with diabetes.
While no significant blood sugar reductions were observed in people with normal blood sugar levels (euglycemic subjects), a modest effect was observed in pre-diabetics, wrote the authors.
“On the basis of 8 meta-analyses, psyllium dosed before meals significantly lowered elevated fasting blood glucose concentrations and HbA1c,” they wrote. “This effect was consistent across a variety of populations and a range of study designs. Moreover, both the aggregate and individual data meta-analyses indicate that the effect of psyllium to reduce fasting and postprandial blood glucose is commensurate to the loss of glycemic control with the greatest improvement shown in subjects who were being treated for type-2 diabetes mellitus.
“Although additional studies are needed to determine how best to incorporate psyllium into clinical practice, particularly in regards to concomitant hypoglycemic medications, these data show that psyllium would be an effective addition to a lifestyle intervention program.”
The study adds to the potential blood sugar benefits of psyllium, a soluble, gel-forming, non-fermented fiber supplement. The link between psyllium and diabetes risk is already supported by a qualified health claim from the FDA to P&G.
The agency allows for the following claim statements to be made:
Psyllium husk may reduce the risk of type 2 diabetes, although the FDA has concluded that there is very little scientific evidence for this claim.
Psyllium husk may reduce the risk of type 2 diabetes. FDA has concluded that there is very little scientific evidence for this claim.
The authors of the new AJCN paper identified 35 RCTS from the published literature database as well as from clinical records stored by P&G. The trials spanned 30 years and were performed on three continents. The data were assessed in 8 meta-analyses with the results showing significant improvements in fasting blood glucose and HbA1c levels.
“These meta-analyses strengthen the existing clinical evidence […] that psyllium dosed before meals as a dietary supplement provides an effective modality for lowering elevated [fasting blood glucose] concentrations,” wrote the authors, led by P&G’s Roger Gibb. “This effect is both significant and clinically meaningful, with an approximately 1% (10.6-mmol/mol) lowering of HbA1c, which is comparable to the effect of many drugs that are used to treat diabetes.
“Moreover, the effect seems to be dependent on blood glucose concentrations, which were minimal in persons with euglycemia and most pronounced in patients who were being treated for [type 2 diabetes mellitus].”
Source: American Journal of Clinical Nutrition
Published online ahead of print, doi: 10.3945/ajcn.115.106989
“Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus”
Authors: R.D. Gibb, et al.