White common bean extract remodels the gut microbiota and ameliorates type 2 diabetes and its complications: A randomized double-blinded placebo-controlled trial.

Feng Hu, Feng Zhang, Yanxin Jia, Jianfen Gao, Yu Deng, Minhong Jiang, Aijuan Tang, Jin Zhang, Su Sun, Ying Han, Hong Zou, Yufei Feng, Jian Wang, Min Cao, Xiaoying Ding, Meihua Dong, Yanping Xia, Ju Yang, Jiai Yan, Dan Li, Yin Guan, Fang He, Hong Cao, Qinyue Wang, Jie Zhu, Yuwei Feng, Wei Zhao

Journal: Frontiers in endocrinology 2022;13():999715

PMID: 36303868

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Plain Language Summary

Patients with type 2 diabetes (T2D) have a higher risk of macrovascular complications. Intensive glycaemic control reduces microvascular complications and exerts a modest improved effect on macrovascular outcomes. The main aim of this study was to explore the effects of white common bean extract (WCBE) on glucose metabolism and diabetic complications in patients with T2D. This study was a randomised double-blind placebo-controlled trial which enrolled ninety-six patients with T2D aged between 35 and 75 years. Participants were randomly assigned in a 1:2 ratio to the control group and WCBE group. Results showed that WCBE alleviated glucose metabolism dysbiosis and diabetic complication indices. In fact, after 2 months of an intense intervention with a WCBE treatment and in the following two-month maintenance period, the improvements to glycaemic metabolism were preserved. Furthermore, there was notable improvement of the structure of the gut microbiota, especially the enrichment of short-chain fatty acid-producing bacteria and inhibition of opportunistic pathogens. Authors conclude that WCBE may be considered as a novel prebiotic antidiabetic agent for the regulation of glucose metabolism and gut microbiota homeostasis and may slightly ameliorate diabetic complications in patients with T2D.

Abstract

OBJECTIVE

Excessive carbohydrate intake is a high risk factor for increased morbidity of type 2 diabetes (T2D). A novel regimen for the dietary care of diabetes that consists of a highly active α-amylase inhibitor derived from white common bean extract (WCBE) and sufficient carbohydrates intake was applied to attenuate T2D and its complications. Furthermore, the role of gut microbiota in this remission was also investigated.

METHODS

We conducted a 4-month randomized double-blinded placebo-controlled trial. During the intense intervention period, ninety subjects were randomly assigned to the control group (Group C) and WCBE group (Group W). Subjects in Group C were supplemented with 1.5 g of maltodextrin as a placebo. Subjects in Group W took 1.5 g of WCBE half an hour before a meal. Fifty-five participants continued the maintenance intervention receiving the previous dietary intervention whereas less frequent follow-up. The variation in biochemical, vasculopathy and neuropathy indicators and the structure of the fecal microbiota during the intervention was analyzed.

RESULT

Glucose metabolism and diabetic complications showed superior remission in Group W with a 0.721 ± 0.742% decline of glycosylated hemoglobin after 4 months. The proportion of patients with diabetic peripheral neuropathy (Toronto Clinical Scoring System, TCSS ≥ 6) was significantly lower in Group W than in Group C. Both the left and right sural sensory nerve conduction velocity (SNCV-left sural and SNCV-right sural) slightly decreased in Group C and slightly increased in Group W. Additionally, the abundances of , and were higher in Group W, and the abundances of , , and Enterobacteriaceae_unclassified were lower than those in Group C at month 2. At the end of month 4, remained more abundant in Group W.

CONCLUSION

To our knowledge, this is the first report of improvement to diabetes complications by using a dietary supplement in such a short-term period. The enrichment of SCFA-producing bacteria might be responsible for the attenuation of T2D and its complications.

CLINICAL TRIAL REGISTRATION NUMBER

http://www.chictr.org.cn/edit.aspx?pid=23309&htm=4, identifier ChiCTR-IOR-17013656.

Address: Department of Nutrition, Affiliated Hospital of Jiangnan University, Wuxi, China.; Clinical Evaluation Center for Functional Food, Affiliated Hospital of Jiangnan University, Wuxi, China.; Wuxi School of Medicine Jiangnan University, Wuxi, China.; Department of Infection Control, Affiliated Hospital of Jiangnan University, Wuxi, China.; Department of Endocrinology, Affiliated Hospital of Jiangnan University, Wuxi, China.; State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, China.; School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, China.; Yinglongqiao Community Health Service Center, Health Commision of Liangxi District, Wuxi, China.; Department of Health Promotion, Wuxi Center for Disease Control and Prevention, Wuxi, China.; Department of Functional Examination, Affiliated Hospital of Jiangnan University, Wuxi, China.; Special Ward, Affiliated Hospital of Jiangnan University, Wuxi, China.; Department of Urology, Affiliated Hospital of Jiangnan University, Wuxi, China.; Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.; Mashan Community Healthcare Center, Health Commision of Binhu District, Wuxi, China.; Guangrui and Tongjiang Community Healthcare Center, Health Commision of Liangxi District, Wuxi, China.; Beidajie Community Healthcare Center, Health Commision of Liangxi District, Wuxi, China.; Yangming Community Healthcare Center, Health Commision of Liangxi District, Wuxi, Jiangsu, China.; Shanbei Community Healthcare Center, Health Commision of Liangxi District, Wuxi, China.

DOI: 10.3389/fendo.2022.999715