RELATION OF FIBER INTAKE TO HBA(1C) AND THE PREVALENCE OF SEVERE KETOACIDOSIS AND SEVERE HYPOGLYCEMIA

The effect of dietary fibre intake on glycaemic control is still contr oversial. This study analysed the intake of natural dietary fibre in p atients with Type I diabetes mellitus enrolled in the EURODIAB IDDM Co mplications Study to determine any associations with HbA(1c) levels an d with the prevalence of severe ketoacidosis or severe hypoglycaemia. Dietary intake was assessed by a 3-day dietary record. The relation be tween intake of fibre (total, soluble and insoluble) and HbA(1c) was e xamined in 2065 people with Type I diabetes. Associations with severe ketoacidosis (requiring admission to hospital) and severe hypoglycaemi a (requiring the help of another person) were analysed in 2687 people with Type I diabetes. Total fibre intake (g/day) was inversely related to HbA(1c) (p = 0.02), independently of carbohydrate intake, total en ergy intake and other factors regarding lifestyle and diabetes managem ent. Severe ketoacidosis risk fell significantly with higher fibre int ake (p = 0.002), with an adjusted odds ratio of 0.48 (95% confidence i nterval 0.27 to 0.84) in the highest quartile (greater than or equal t o 23.0 g fibre/day) compared with the lowest quartile (less than or eq ual to 13.7 g fibre/day). The occurence of severe hypoglycaemia was no t related to fibre intake. Beneficial effects of fibre on HbA(1c) and the risk of severe ketoacidosis were particularly pronounced in patien ts from southern European centres. This study shows that higher fibre intake is independently related to a reduction in HbA(1c) levels in Eu ropean people with Type I diabetes. Furthermore, increased fibre intak e may reduce the risk of severe ketoacidosis. These beneficial effects were already observed for fibre intake within the range commonly cons umed by people with Type I diabetes.