This study examined the effects of dietary fiber intake on blood sugar levels in diabetic patients in Indore, India. 40 non-smoking patients with no renal or liver disorders were divided into an intervention group that consumed 30-45 grams of dietary fiber per day and a control group. Fasting and post-meal blood sugar levels were measured monthly for both groups over 2 years. The intervention group saw significant decreases in both fasting (127 mg/dL vs. 138 mg/dL) and post-meal (210 mg/dL vs. 255 mg/dL) blood sugar levels compared to initial levels, while the control group saw little change. Statistical analysis confirmed the decreases in the intervention group were significant but not in the control group.

1. INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES
Research Paper
EFFECT OF DIETARY FIBERS ON BLOOD SUGAR LEVELS IN
DIABETIC PATEINTS OF INDORE DISTRICT
Khurana N1, Dhakad N2
1.Deptt. of Biotechnology, holkar science college,Indore,INDIA
2. Add. Director of higher education ,Indore Ujjain Division, INDIA
Abstract
The sugar disease is posing an enormous health problem in the country. The International Journal of Diabetes
says that there is alarming rise in prevalence of diabetes in Developing Countries, which has gone beyond
epidemic form to a pandemic one. Diabetes mellitus type 2 – formerly non-insulin-dependent diabetes mellitus
(NIDDM) or adult-onset diabetes – is a metabolic disorder that is characterized by high blood sugar in the
context of insulin resistance and relative insulin deficiency. Dietary fiber (alternate names: roughage, bulk, dietfiber) is a complex of substances of cell walls of plants which are not digested and not absorbed in a human's
digestive tract. There are two major kind of dietary fibers Insoluble and Soluble type. Soluble and insoluble
fiber act in totally different ways. Modification in lifestyle and proper medication can delay and prevent
diabetes in high-risk groups. Eating whole grain carbohydrates and moderate exercise and avoiding excessive
weight gain could eliminate over eighty per cent of Type-2 diabetes. This study is a clinical Trial with 40 nonsmoker Patients which had no renal and liver disorder. The patients were selected through questionnaire data
collection method, by ways of various health care camps organized in the city. They were randomly divided
into 2 groups; the first group was given 30-45 grams of dietary fibers per day (intervention group). The control
group remained normal with no additional dietary supplements. All the groups were observed for a period of2
years. Fasting blood sugar level, blood sugar level 2 hrs after eating were checked every month. Mean and SD
were calculated. The significance of differences in the means of intervention group and control group were
found using t test both paired and unpaired.
KEYWORDS: NIDDM, Fasting Sugar Level, Post Prandial Sugar Levels, Dietary Fibers.
INTRODUCTION
The term diabetes is from the Greek word
diabaineine refers a tubular organ that take-in or
expels water - excessive urine discharges
disease.Diabetes is a chronic and complex
disease, caused by having too much sugar
(sugar) in the blood. This happens when there is
low or no insulin production or improper use of
insulin. Globally in 2003 it was estimated that
there were 150 million people with type 2
diabetes. According to Saikat Neogi, The
Hindustan Times, “India is the diabetes capital
of world“(New Delhi, September 03, 2007).The
sugar disease is posing an enormous health
problem in the country. The International
Journal of Diabetes says that there is alarming
rise in prevalence of diabetes in Developing
Countries, which has gone beyond epidemic
form to a pandemic one. The International
Diabetes Federation estimates that the number
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of diabetic patients in India is more than
doubled from 19 million in 1995 to 40.9 million
in 2007. It is projected to increase to 69.9
million by 2025. Currently, up to 11 per cent of
India’s urban population and 3 per cent of rural
population above the age of 15 has diabetes.
The World Health Organization estimates that
mortality from diabetes and heart disease cost
India about $210 billion every year and is
expected to increase to $335 billion in the next
ten years. Various studies have shown that the
high incidence of diabetes in India is mainly
because of sedentary lifestyle, lack of physical
activity, obesity, stress and consumption of
diets rich in fat, sugar and calories [1-7]. This
study is a clinical Trial with 40 non-smoker
Patients which had no renal and liver disorder
for a period of 2 years, to see whether change in
lifestyle particularly adapting to a diet rich in
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2. INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES
dietary fiber can lead to decrease in blood sugar
levels.
MATERIALS AND METHOD:
This study is a clinical Trial with 40 nonsmoker Patients which had no renal and liver
disorder. These were again divided into two
groups, intervention group with 30 patients and
control group with 10 patients each. The
patients were selected through questionnaire
data collection method(see annexure), by ways
of various health care camps organized in the
city, via diabetic and hypertensive care camp
organized by MA vashno group in mathlani
garden, Indore; launch party of dietary fiber
rich flour SIFER,through the reference of
various diabetologist and cardiologist etc. The
questionnaire was given to patients in order to
inquire about their present status of disease and
health and calculation of BMI. Weight was
measured while the subjects were minimally
clothed without shoes using digital scales and
recorded to the nearest 0.1 kg. Height was
measured in a standing position without shoes
using a tape meter while the shoulders were in a
normal state.
Through the help clinical
dieticians diet charts were prepared for these
patients after energy calculation. Each of these
diet charts included fiber rich products in the
range of 36-45 Gms of fiber per day. The first
group consisted 20 males and 10 females
having an average age of 47.66. While the
control group consisted of 5 males and 5
females having an average age of 44.1. The first
group was given 36-45 grams of dietary fibers
per day. The control group remained normal
with no additional dietary supplements. All the
groups were observed for a period of two long
years. Fasting blood sugar level and blood sugar
level 2 hrs after eating was checked every
month during the study . Mean values for a
period of every 3 months were calculated. The
significance of differences in the means of
intervention group and control group were
calculated using t test.
DATA AND ITS ANALYSIS:
Table 1: Effect on fasting glucose after intervention
Effect on fasting glucose after intervention
Patient fg initial as on FEB-10 (BI) M1
fg0 147
Patient fg after 3 months as on MAY-10
Patient fg after 6 months as on AUG-10
Patient fg after 9 months as on NOV-10
Patient fg after 12 months as on FEB-11
Patient fg after 15 months as on MAY-11
Patient fg after 18 months as on AUG-11
Patient fg after 21 months as on NOV-11
Patient fg after 24 months as on FEB-12
fg1
fg2
fg3
fg4
fg5
fg6
fg7
fg8
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145
143
142
138
136
133
132
127
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3. INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES
Figure 1: Bar Graph of Effect on fasting glucose after intervention
Table 2: Fasting sugar in control group
Mean fasting sugar in control group
Patient fg initial as on FEB-10 (B I)
fg0 138.2
Patient fg after 3 months as on MAY-10
fg1 136.4
Patient fg after 6 months as on AUG-10
fg2 135.7
Patient fg after 9 months as on NOV-10
fg3 134.9
Patient fg after 12 months as on FEB-11
fg4 135.1
Patient fg after 15 months as on MAY-11
fg5 135.6
Patient fg after 18 months as on AUG-11
fg6 136.7
Patient fg after 21 months as on NOV-11
fg7 138.7
Patient fg after 24 months as on FEB-12
fg8 138.8
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4. INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES
Figure 2: Bar Graph of fasting sugar in control group
Table 3: Effect on post Prandial sugar after intervention
Effect on post Prandial sugar after intervention
Initial ppg as on feb-10 (bi) m1
ppg0
Patient ppg after 3 months as on may-10
ppg1
Patient ppg after 6 months as on aug-10
ppg2
Patient ppg after 9 months as on nov-10
ppg3
Patient ppg after 12 months as on feb-11
ppg4
Patient ppg after 15 months as on may-11
ppg5
Patient ppg after 18 months as on aug-11
ppg6
Patient ppg after 21 months as on nov-11
ppg7
Patient ppg after 24 months as on feb-12
ppg8
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255
248
244
239
233
228
221
217
210
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5. INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES
Figure 3: Bar Graph of Effect on post Prandial sugar after intervention
Table 4: Effect on values post Prandial sugar in control
Mean values post Prandial sugar in control
Patient PPG initial as on FEB-10 (BI)
Patient PPG after 3 months as on MAY-10
Patient PPG after 6 months as on AUG-10
Patient PPG after 9 months as on NOV-10
Patient PPG after 12 months as on FEB-11
Patient PPG after 15 months as on MAY-11
Patient PPG after 18 months as on AUG-11
Patient PPG after 21 months as on NOV-11
Patient PPG after 24 months as on FEB-12
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ppg0
ppg1
ppg2
ppg3
ppg4
ppg5
ppg6
ppg7
ppg8
249.2
247.1
246.3
248.7
248.1
246.1
248.3
247.0
247.4
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6. INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES
Figure 4: Bar Graph of effect on values post Prandial sugar in control
RESULT AND DISCUSSION
As we can see from the above data that there
is a big difference between the mean values of
fasting sugar and post Prandial sugar levels in
intervention group (group given additional
dietary fiber). Therefore in order to confirm
that the difference is significant a paired t test
was applied. For the above values the
calculated standard error for fasting sugar was
1.4 and the calculated value of paired t test
was found to be 13.6.similarly for post
Prandial values the calculated SE was 3.5 and
t value is 12.5.
H0= there is no significant difference between
the mean of after supplementation and before
supplementation in the intervention group.
Hα= there is significant difference between the
mean of after supplementation and before
supplementation in the intervention group.
The table value for t at 5% level of
significance and d.f=29 is 0 .68 AND
therefore the null hypothesis was rejected. So
there exists a significant difference between
the mean values of fasting and prandial sugar
values in the intervention group. Similarly to
determine the decrease in sugar levels in case
of intervention groups was because of change
in diet i.e. introduction of dietary fibers an
unpaired t test was applied.
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H0= there is no significant difference between
the mean’s of intervention and control groups.
Hα= there is a significant difference between
the mean‘s of intervention and control groups.
The value of t for fasting sugar for unpaired
test came out to be 86.3 with SE=3.4(n1=30
and n2=10).while for ppg the value t was
202.6 and SE=34.3 (n1=30 and n2=10). Again
rejecting H0 .Therefore Dietary fibers are
highly effective in lowering sugar values in
diabetic patients.
REFERENCES:
[1] Chen, Hsiao-Ling, et al. "Konjac
supplement
alleviated
hypercholesterolemia
and
hyperglycemia in type 2 diabetic
subjects—a randomized double-blind
trial." Journal of the American College
of Nutrition 22.1 (2003): 36-42.
[2] CHO, SUSAN S., and NELSON
ALMEIDA.
"JIN-HEE
PARK,
ALBERT W. LEE, STEPHANIE
NISHI." Dietary Fiber and Health
(2012): 293.
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7. INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES
[3] Dr. Bernstein's “Diabetes Solution.”
Chap. 10: Diet Guidelines: Basic
Treatment for All Diabetics.
[4] Jenkins, David JA, et al. "Effect of
wheat bran on glycemic control and
risk factors for cardiovascular disease
in type 2 diabetes." Diabetes Care 25.9
(2002): 1522-1528.
[5] FP ANTIA AND PHILLIP , BOOK
ON
CLINICAL
NUTRITION.CHAPTER 34 PAGES
175-177.
[6] Riccardi, Gabriele, and Angela A.
Rivellese. "Effects of dietary fiber and
carbohydrate
on
glucose
and
lipoprotein metabolism in diabetic
patients." Diabetes Care 14.12 (1991):
1115-1125.
[7] Healthy Indian Cooking for Diabetes
Azmina Govindji (Author), Sanjeev
Kapoor (Author)
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