Dietary fibre intake and glucose metabolism in post-pancreatitis diabetes mellitus

Abstract

Dietary fibre, a complex carbohydrate mainly derived from plant cell walls, have been associated with a reduced risk of type 2 diabetes mellitus, pancreatic diseases, and other chronic diseases where glucose homeostasis is impaired. However, little is known about the effect of dietary fibre intake among individuals who developed new-onset diabetes after acute pancreatitis. The primary aim of this thesis was to investigate the associations between habitual dietary fibre intake and fasting plasma glucose and glycated haemoglobin in individuals after an attack of acute pancreatitis. The secondary aim was to investigate whether common food sources of dietary fibre (fruit, vegetables, cereals, and nuts) were associated with fasting plasma glucose and glycated haemoglobin. A total of 108 individuals following an episode of acute pancreatitis were studied in a cross-sectional fashion. Habitual dietary fibre intake was determined using the EPIC-Norfolk food frequency questionnaire. Multivariable regression analyses were conducted, adjusting for covariates (age, sex, BMI, energy intake, use of anti-diabetic medications, aetiology of acute pancreatitis, recurrence of acute pancreatitis, and the presence of pancreatic necrosis). The results of this thesis demonstrated that increased intake of habitual total dietary fibre, including insoluble and soluble fibre, was significantly inversely associated with fasting plasma glucose in individuals with new-onset diabetes after acute pancreatitis. Also, increased intake of common sources of dietary fibre, specifically vegetables and nuts, was significantly inversely associated with a reduction in fasting plasma glucose. Further, increased intake of nuts was significantly inversely associated with glycated haemoglobin in the same group. In conclusion, this thesis represents the first investigation into the role of dietary fibre intake in a post-pancreatitis setting. Intake of dietary fibre, specifically vegetables and nuts, may benefit individuals after an attack of acute pancreatitis to prevent developing new-onset diabetes after acute pancreatitis. This thesis paves the way for future research on the use of dietary fibre in diseases of the exocrine pancreas and their sequelae.