in patients with metabolic disorders 3month Progress Report until December 2 2021 Anna Evelin Juhász About the lecturer Anna Evelin Juhász PhD Student Department ID: 917975
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Slide1
Application of dietary fibre in patients with metabolic disorders
3-month Progress Reportuntil December 2, 2021
Anna Evelin Juhász
Slide2About the lecturer
Anna Evelin JuhászPhD Student
Department:
Doctoral
School
of Health Sciences, Semmelweis UniversitySupervisor:Réka Hermánné Juhász (University associate professor, The Department of Dietetics and Nutrition Sciences, Semmelweis University)Scientific methodology supervisor:Brigitta TeutschStatistician: Alex VáradiVision: Normalise the metabolic disorders of the patients by using dietary fibre instead of a drug Mission: To draw the attention of physicians to the results of studies regarding the dietary management of polycystic ovary syndromeContact: juhaszannaevelin@gmail.com
Slide3OVERVIEWPROJECT LIST
Effects of dietary
fibr
e
supplementation on glycemic
control and lipid profile in patients with type 2 diabetes
:a systematic review and network meta-analysis Project started: September 20212. Effectiveness of dietary fibre and inositol on the ovarian function and metabolic balance in women with Polycystic ovary syndrome (PCOS): protocol of a randomised controlled trial Project started: October 2021
Slide4Effects of dietary fiber supplementation on glycemic control and lipid profile in patients with type 2 diabetes
Project started:September 2021Planned
submission
date
:
May 2022Systematic review and network meta-analysisCo-investigator
:
Dorina
Greff
1
Slide5Background
Type 2 diabetes 6.28% of the world’s population
(M. Abdul
Basith
Khan et al. 2019,
Epidemiology of Type 2 Diabetes, Journal of Epidemiology and Global Health)Lifestyle management -> medical nutrition therapy (MNT) (Powers MA, et al. 2015, Diabetes self management education and support in type 2 diabetes, Diabetes Care)Dietary fibre
c
ould
d
e
crease
(
30%
)
the
fasting
glucose level in 1 month (Chen C. et al, 2016, Therapeutic effects of soluble dietary fiber consumption on type 2 diabetes mellitus. Experimental and therapeutic medicine )Using dietary fibre is a gap in the Guidelines on Diabetes
AIM:
to investigate the effects of dietary fiber
supplementation on glycemic control and lipid profiles in patients with type 2 diabetes
Slide6QuestionClinical
question: Does dietary fibre intake decrease the HbA1C compared to another type dietary fibre/no dietary fibre intake?P
p
atients
with type 2 diabetes
I v. C
soluble (B-glucan, Galactomannan, Glucomannan, Inulin, Tora fibre, Fucoidan), non-soluble dietary fibre (Cellulose) and no fibreO glycaemic factors (HbA1C, fasting glucose level, postprandial blood glucose, insulin level, HOMA-IR) lipid factors (Total cholesterol, LDL cholesterol, HDL cholesterol, Triacylglycerols
)
Clinical
i
mplication
:
To
prevent
long
term complications in T2DMHypothesis: Soluble dietary fibre intake can significantly normalise glucose and lipid levels in patients with T2DM.
Slide7Systematic searchDatabases
: Medline (601), Embase (428), Central
(
576
)
Date
of search: October 20, 2021Searchkey: type 2 diabetes AND dietary fibre AND random*(type 2 diabetes OR type 2 diabetes mellitus OR type II diabetes OR non insulin dependent diabetes OR non insulin dependent diabetes mellitus OR NIDDM) AND (“soluble dietary fibre” OR “soluble
dietary
fiber
” OR
inulin
OR
polycarbofil
OR
psyllium OR “resistant starch” OR “
resistant
maltodextrin” OR “wheat dextrin” OR xylooligosaccharide OR XOS OR roughage OR “beta glucan” OR “b-glucan” OR “β-glucan” OR “guar gum” OR guaran OR “gellan gum” OR alginate OR alginic OR algin OR “maize-based soluble fibre” OR “maize-based soluble fiber” OR galactomannan OR galactomannans OR konjac OR plantain OR “soluble corn fiber” OR “soluble maize fiber” OR arabinoxylan OR arabinoxylans OR “acacia gum” OR fructooligosaccharide OR FOS OR oligofructose OR galactooligosaccharide OR GOS OR glucomannan OR mannan OR “gum Arabic” OR pectin OR pectins OR laminarin OR laminarins OR polydextrose OR polyglycoplex OR “mixed-linkage glucans” OR pullulan
OR “plant gum” OR “plant gums” OR gum OR
gums
OR “
plant
mucilage
” OR
mucilage
OR “
fermentable fiber” OR prebiotic OR “prebiotic fiber”) AND random*
Slide8Flowchart of selection
Cohen’s Kappa: 0.8
2
Cohen’s Kappa:
0.81
Data
extraction
Slide9Effectiveness of dietary fibre and inositol on the ovarian function and metabolic balance in women with Polycystic ovary syndrome (PCOS)
Project started:October 2021Planned submission date:July 2022
P
rotocol
of a
randomised
controlled trial2
Slide10BackgroundPolycystic ovary syndrome (PCOS) is one of the most
common (12-24%) diseases in women of reproductive age (Eiras, M.C.,et
al. 2021, Polycystic Ovary
Syndrome: the Epigenetics Behind the Disease)
Clinical
manifestations: elevated serum androgen levels, menstrual irregularities, anovulation, insulin resistance, hyperinsulinemia (70%) and obesity (80%) (John C.M. et al 2012, All Women With PCOS Should Be Treated For Insulin Resistance, Fertil Steril)First choice of treatment: insulin sensitizers -> serious short (vomiting,diarrhea) and long-term (vitamin B12 deficiency) complications (Goldenberg N,
et
al
,
2008
,
Medical therapy in
women with polycystic ovary syndrome before and
during pregnancy and lactation)
Alternative
treatment: dietary fibre and inositol (Torres, N. et al, 2020. Dietary fiber and diabetes)( Franca F. et al, 2017,Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS))Aim:
to examine the effects of dietary fibre
and
inositol
in
the
treatment
of PCOS
Slide11QuestionClinical
question: Can dietary fibre and inositol improve metabolic disorders in PCOS?P women
with
PCOS
I
soluble dietary fibreC inositolO main: ovulation, menstrual cycle regularization additional: glycaemic factors (fasting glucose, fasting insulin, glucose/insulin ratio, HOMA- IR)Clinical and/or research
i
mplication:
Improve
ovarian
function
Hypothesis
:
soluble
dietary fibre is not inferior than inositol in the treatment of women with PCOS
Protocol drafting - eligibility criteria
Inclusion criteria:women aged between 18 and 45 years with PCOS according to the Rotterdam criteria
take only metformin
Exclusion
criteria
:pregnancy or lactationusing contraceptive medicationspatients on hormonal therapyprevious surgery to remove one or both ovariessymptoms of thyroid gland disorders and Cushing’s syndrome
Slide13Intervention
Arm A: soluble
dietary
fibre
Arm B: inositolProtocol drafting - intervention
Slide14Protocol drafting - outcomes
Primary
outcome
:
o
vulationmenstrual cycle regularization
Secondary
outcomes
:
Metabolic
parameters
(
fasting
glucose
, fasting insulin , glucose/insulin ratio, HOMA- IR)Hormonal parameters (FHS/LH ratio, dehydroepiandrosterone sulfate (DHEAS))
Slide15SPECIFIC GOALSAIMS
Effects of dietary fiber supplementation on glycemic
control and lipid profile in patients with type 2 diabetes
:
a
systematic
review and network meta-analysis Planned submission date: May 20222. Effectiveness of dietary fibre and inositol on the ovarian function and metabolic balance in women with Polycystic ovary syndrome (PCOS): protocol of a randomised controlled trial Planned submission date: July 2022
Slide16Thank
you for your attention!
“Let food be thy medicine and medicine be thy food.”
―
Hippocrates