Main Article Content

Hidayet Ağören
Emine Yıldız
Seyit Mehmet Mercanlıgil


Fiber, Bread Types, Insulin, Triglyceride, Glycemic Control


Study Aims: Supporting the formation of an adequate and balanced diet and personal healthy eating habits in individuals with diabetes and having fiber in their diets as much as their requirements is an important step in regulating blood glucose levels and preventing complications caused by diabetes. If bread, which is one of our main food sources, is made from flour with high fiber content, and therefore, its glycemic index is lower, if portion control is also provided, it provides support for better control of blood glucose in individuals with diabetes.This study was planned to determine the differences between blood glucose, triglyceride and insulin responses against bread types and to determine the effects of fiber amounts in bread on these difference. Methods: 50 people with Type 2 DM between 30-60 years of age, who do not use insulin, whose blood glucose levels are regulated and whose HBA1C levels are ≤ 7% with body mass index at most 29.9 kg / m², was selected on a voluntary basis from patients at Cyprus Famagusta State Hospital Nutrition and Dietetics policlinic. Anthropometric measurements of individuals were taken, 24-hour food consumption records and face-to-face survey method were used to determine nutritional status. Before the study, blood tests were performed to determine the biochemical blood results (total cholesterol, HDL cholesterol, LDL cholesterol, VLDL cholesterol, ALT, AST, Hb A1C). After analyzing energy, carbohydrate, protein, fat, total fiber, soluble and insoluble fiber contents of bread varieties in TUBITAK food analysis laboratories, it was determined how many grams of bread contains 50 grams of carbohydrates and given to individuals participating in the study for consumption Results: The average age of the individuals participating in the study was found to be 43.02 ± 9.86 years. 40% of individuals are men and 60% are women. When the blood results were examined, the average HbA1C value of men was 6.4 ± 0.4% and women was 6.3 ± 0.4%. According to the results of the analysis, bread with the highest fiber level (11.47 g / 100g) and the lowest carbohydrate level (37.32 g / 100 g) is diabetic bread. The distributions of the differences between blood sugar values ​​at the time of fasting and 120. minute of different bread varieties were examined. It was observed that the blood sugar value in white, whole wheat and whole grain bread increased at 120 minute, while the blood sugar value decreased in diabetic bread. Insulin difference of diabetes bread being lower than all other bread types were found statistically significant (p <0.001). The triglyceride value of diabetes bread at 120 minutes was lower than the triglyceride value of all other bread types (p <0.001) which found statistically significant. Conclusions:As a result, it shows that bread with high fiber content will contribute significantly to the daily fiber requirement, thereby contributing to the control of postprandial glucose, postprandial insulin and triglyceride levels.


Download data is not yet available.
Abstract 9 | PDF Downloads 3


1- Turkish Diabetes Program 2015-2020. Turkey Puplic Health Agency, Ankara 2014.
2- Turkish Endocrinology and Metabolism Association. Clinical practice guideline for Diagnosis, Treatment and Follow up of Diabetes Mellitus and its Complications 2019.
3- Tümer G,Çolak R. Medical Nutrition Therapy in Tip 2 Mellitus. Journal of Experimental and Clinical Medicine, 2012; 29:12-15.
4- Graham A. Hitman. Tip 2 Diabetes, Prediction and Prevention 1999;7-28
5- Franz JM, A. Powers A.M, Leontos C, et al. The Evidence for Medical Nutrition Therapy for Type 1 and Type 2 Diabetes in Adults. JAmDietAssoc. 2010;110:1852-1889.
6- Nutrition Recommendations and Interventions for Diabetes. A position statement of the American Diabetes Association. Diabetes Care, 2008; 31(1).
7- Diabetes Care. Standarts of Medical care in diabetes 2018; 41:14-37
8- Lifestyle Management: Standarts of Medical Care in Diabetes 2018;41:38-50
9- Rozen LA, Silva LB, Andersson UK, et al. Endosperm and Wholegrain Ryebreads are Characterized by Low Post-prandial Insulin Response and a Beneficial Blood Glucose Profile. Nutrition Journal 2009, 8:42
10- Fujii H., Wase M., Ohkuma T., et al. Impact of Dietary Fiber Intake on Glycemic Control, Cardiovascular Risk Factors and Chronic Kidney Disease in Japanese Patients with Type 2 Diabetes Mellitus: the Fukuoka Diabetes Registry. Nutrition Journal 2013, 12:159
11- Samur G, Mercanlıgil SM. Nutrition and Dietary Fiber. Puplication of the Ministry of Health. No: 727. February 2008
12- Fardet A, Leenhard F, ScalbertA,et al. Parameters Controlling The Glycaemic Response To Breads. Nutrition Research Rewievs.2006.
13- Breen C, Ryan MF, Corrigan M, et al. Glycemic, Insulinemic, and Appetite Responses of Patients With Type 2 Diabetes to Commonly Consumed Breads. The Diabetes Educator,2013.
14- Rakıcıoğlu N, Acar Tek N, Ayaz A et al. Food and Food Photo Catalog, Sizes and Quantities. 4th edition. Ata Printing Office, Ankara, 2014
15- Turkish Food Codex Communiqué on Bread and Bread Types (Communiqué No: 2012/2) Date of Official Journal :04.01.2012 No of Official Journal: 28163
16- Tarçın Ü. Ö. Physiophatology of Diabetes Mellitus. Clinics of Turkey J Nutr Diet Special Topics 2017;3 (3): 130-4
17- Alphan M.E.T. Medical Nutrition Therapy in Type 2 Diabetes. Clinics of Turkey J Nutr Diet Special Topics 2017;3 (3): 173-81.
18- Jiang J, Qiu H, Zhao G, et al. Dietary Fiber Intake is Associated with HbA1C Level among Prevalent Patients with Type 2 Diabetes in Pudong New Area of Shanghai, China. Plos One 2012, 7(10)
19- Abuteir AS, Naser IA, Hamed AT. Soluble Fibers From Psyllium Improve Glycemic Response and Body Weight Among Diabetes Type 2 Patients (randomized control trial). Nutr J. 2016; 15(1): 86
20- Sierra M, Garcia JJ, Fernandez R, et al. Effects of Ispaghula Husk And Guar Gum On Postprandial Glucose And İnsulin Concentrations İn Healthy Subjects. European Journal of Clinical Nutrition. 2001; 55:235-243.
21- Bayraktar M. Oral hypoglycemics. Medical Journal of Turkey. 2001;8(1):35-44.
22- Montonen J, Knekt P, Järvinen R, et al. Wholegrain and Fiber Intake And The Incidence Of Type 2 Diabetes. Am J Clin Nutr. 2003; 77:622-629.
23- Seki T, Nagase R, Horimitsu M, et al. Insoluble Fiber Is A Major Constituent Responsible For Lowering The Post-Prandial Blood Glucose Concentration In The Pre-Germinated Brown Rice. Biol Pharm Bull. 2005;28(8):1539- 1541
24- Chandalia M, Garg A, Lutjohann Dve et al. Beneficial Effects of High Fiber Dietary Fiber Intake in Patients with Type 2 Diabetes Mellitus. The New England Journal of Medicine. 2000: 1392-1398
25- Giacco R, Costabile G, Della P. G, et al. A Whole Grain Cereal Based Diet Lowers Postprandial Plasma Insulin and Trigliserid Levels in Individuals with Metabolic Syndrome. Nutrition, Metabolism and Cardiovascular Diseases (2014)24, 837-844
26- Hannon B, Thompson VS, Edwards CG, et al. Dietary Fiber Is Independently Related to Blood Triglycerides Among Adults with Overweight and Obesity. Curr Dev Nutr 2018;3:nzy094.
27- Reynolds A.N, Akerman A.P, Mann J. Dietary Fiber and Whole Grains in Diabetes Management: Systematic Review and Metaanalyses. PlosMed 17(3): 2020
28- Li L, Pan M, Pan S, et al. Effects of Insoluble and Soluble Fibers Isolated from Barley on Blood Glucose, Serum Lipids, Liver Function and Caecal Short-Chain Fatty Acids in Type 2 Diabetic and Normal Rats. Foodand Chemical Toxicology 135 (2020)
29- Avhan N. Determination of Nutritional Status of Patients with Type 2 Diabetes Mellitus Applying to Diabetes Center. Master Thesis (2015), IBÜ
30- Köseoğlu Ö. Tip 2 The Effect of Nutrition Education on Diabetes Status and Eating Habits in Diabetic Individuals.Master Thesis (2015), YYÜ