Dietary fiber in treatment of diabetes: mith or reality?

Diabetes is a plurimetabolic disease characterized mainly by glucose metabolism abnormalities responsible of development of acute and long- term complications in diabetic patients. Long-term complications are quickly increasing, explaining the higher mortality for cardiovascular events observed in diabetic patients in respect to general population. It is well known that a poor blood glucose control is an important risk factor for the development of cardiovascular complications and dietary fiber, particularly the soluble type, play an important role on the control of plasma glucose concentrations and other risk factors associated to diabetes. Several and convincing evidences prove that: 1) dietary fiber in diabetic patients decreases postprandial plasma glucose, insulin and triglyceride concentrations and has a clinically relevant hypocholesterolemic effect; 2) it is possible to increase dietary fiber by consuming exclusively natural foods and to have a satisfactory compliance in free living diabetic patients also in the long term since side effects are minimal; 3) the beneficial metabolic effects of dietary fiber in both type 1 and type 2 diabetic patients are clinically relevant and long-lasting as showed by lower plasma glycosylated hemoglobin levels, reduced rate of hypoglycemias and improved cardiovascular profile.