Inulin Might Exceed Incretin Based Drugs in the Treatment of Type 2 Diabetes Mellitus

Mina Wassef Girgiss^1*, Wassef Girgiss Nicola², Aly Mohamed Ezz El-Arab³, Dawoud Fakhry Habib⁴, Nadia Mohamed Ahmed⁵ and Eman Refaat Youness⁶

¹Lecturer of Internal Medicine, Endocrinology, Diabetology and Metabolism-Medical Department, Medical Division, National Research Centre (NRC), Cairo, Egypt.

²Professor of Internal Medicine, endocrinology and metabolism-Department of Internal Medicine, Medical Division, National Research Centre (NRC), Cairo, Egypt.

³Professor of Nutrition-Department of Nutrition and Food Science,  National Research Centre (NRC), Cairo, Egypt.

⁴Professor of Biochemistry-Medical Biochemistry Department, Medical Division, National Research Centre (NRC), Cairo, Egypt.

⁵Professor of Biochemistry-Medical Biochemistry Department, Medical division, National Research Centre (NRC), Cairo-Egypt.

⁶Assisstant Professor of Biochemistry-Medical Biochemistry Department, Medical division, National Research Centre (NRC), Cairo-Egypt.

Corresponding Author E-mail: mwgnicola@hotmail.com

Abstract: Glucagon hormone being catabolic and hyperglycemic, it acts in an opposite manner to insulin and adds to insulin resistance. The oligosaccharide inulin fructans is indigestible in the small bowel. When it reaches the large intestine, it encourages beneficial microbacteria strains. These latter produce certain peptides which when absorbed they reach the endlocrine L-cells of the small gut. These peptides stimulate L-cells to release glucagon like peptide 1 (GLP-1) which suppresses glucagon and stimulates insulin secretion in a glucose dependant manner. Our aim is  to find how inulin suppresses glucagon and to what extent this improves insulin resistance. Fasting serum glucagon and homeostasis model assessment for insulin resistance (HOMA-IR) were estimated in 28 type 2 diabetic female patients before and after twenty one days of daily inulin intake. Fasting serum glucagon and HOMA-IR decreased significantly after the inulin intake period. In conclusion inulin stimulates the release of GLP-1. This acts in a glucose dependant manner thus simulating the novel incretin based drugs in reducing insulin resistance. However, owing to inulin other actions on insulin resistance, it might exceed these novel drugs.

Keywords: Glucagon; Inulin; Incretin Based Drugs, Type 2 Diabetes Mellitus

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