Results Compliance with the diets was excellent.
During the sixth week of the high-fiber diet, as compared
with the sixth week of the ADA diet, mean daily
preprandial plasma glucose concentrations were 13
mg per deciliter (0.7 mmol per liter) lower (95 percent
confidence interval, 1 to 24 mg per deciliter [0.1
to 1.3 mmol per liter]; P=0.04) and mean daily urinary
glucose excretion was 1.3 g lower (median difference,
0.23 g; 95 percent confidence interval, 0.03
to 1.83; P=0.008). The high-fiber diet also lowered the
area under the curve for 24-hour plasma glucose and
insulin concentrations, which were measured every
two hours, by 10 percent (P=0.02) and 12 percent
(P=0.05), respectively. The high-fiber diet reduced
plasma total cholesterol concentrations by 6.7 percent
(P=0.02), triglyceride concentrations by 10.2
percent (P=0.02), and very-low-density lipoprotein
cholesterol concentrations by 12.5 percent (P=0.01).
Conclusions A high intake of dietary fiber, particularly
of the soluble type, above the level recommended
by the ADA, improves glycemic control, decreases
hyperinsulinemia, and lowers plasma lipid concentrations
in patients with type 2 diabetes. (N Engl J