The effects of dietary supplementation with Gum arabic on blood pressure and renal function in subjects with Type 2 diabetes mellitus
General Material Designation
[Thesis]
First Statement of Responsibility
Glover, David A.
.PUBLICATION, DISTRIBUTION, ETC
Name of Publisher, Distributor, etc.
Cardiff University
Date of Publication, Distribution, etc.
2012
DISSERTATION (THESIS) NOTE
Dissertation or thesis details and type of degree
Thesis (M.D.)
Text preceding or following the note
2012
SUMMARY OR ABSTRACT
Text of Note
Type 2 diabetes mellitus is associated with a significant increased morbidity and mortality resulting from microvascular and macrovascular complications, in particular diabetic nephropathy and cardiovascular disease. Treatment of these conditions has involved improving diabetic control, reducing blood pressure and addressing other cardiovascular risk factors. Dietary fibre has wide reaching health benefits, including improvement of diabetic control and blood pressure, potentially by alterations in colonic bacterial populations that result in changes in serum short chain fatty acids. An open labelled study with a washout period was undertaken to examine the potential effects of Gum arabic on blood pressure and renal function. A daily supplement of gum arabic (25g), a soluble dietary fibre, was administered for a period of 12 weeks. An initial pilot study was conducted in healthy subjects (n=10) and subjects with overt nephropathy (n=14). A follow on study investigated subjects with incipient nephropathy (n=23) in more detail. Measurements of renal function, including isotope GFR and ERPF, blood pressure and vascular stiffness (follow on only), and short chain fatty acids were measured. A significant drop in GFR was seen in the healthy individuals with no associated change in filtration fraction, which could convey some renal protective effect. No changes were seen in the diabetic subjects. Significant drops in blood pressure were seen each of the individual groups. Results of pulse wave analysis and central blood pressure measurements suggest this is not as a result of changes in vascular stiffness. Significant changes in short chain fatty acid production were seen, in particular an increase in acetate (p=0.033) in the incipient nephropaths and butyrate (p=0.03) in the healthy subjects. This study suggests that Gum arabic has beneficial effects on blood pressure but no immediate beneficial effects on renal function in either diabetic cohort.