臺灣博碩士論文加值系統

本研究之目的為探討富含難消化性麥芽糊精(resistant maltodextrin, RMD)熟飯對第2型糖尿病大鼠醣類及脂質代謝的影響。三十二隻雄性Wistar大鼠以streptozotocin及nicotinamide誘發成第2型糖尿病大鼠後，隨機分成RC (rice control)、33% RMD rice、67% RMD rice及100% RMD rice組。四組實驗飼料皆由AIN-93M調整，RC組由無添加難消化性麥芽糊精熟飯之澱粉完全取代玉米澱粉，33% RMD rice、67% RMD rice及100% RMD rice組則分別以33%、67%及100%富含難消化性麥芽糊精熟飯之澱粉取代玉米澱粉，共餵養四週。餵食不同實驗飼料四週後，100% RMD rice組之禁食血漿葡萄糖及胰島素濃度，顯著較RC組低 (P＜0.05)。67% RMD rice 及100% RMD rice組之胰島素抗性程度顯著低於RC組 (P＜0.05)。100% RMD rice組之禁食血漿三酸甘油酯及總膽固醇濃度的降低量顯著高於RC組 (P＜0.05)。67% RMD rice 及100% RMD rice組之肝臟三酸甘油酯濃度顯著較RC組及33% RMD rice組低 (P＜0.05)。100% RMD rice組之肝臟膽固醇濃度顯著較其餘3組低 (P＜0.05)。33% RMD rice、67% RMD rice 及100% RMD rice組之糞便膽酸濃度顯著較RC組高 (P＜0.05)。隨每日難消化性麥芽糊精攝取量(0－2.7 g/d)的增加，第2型糖尿病大鼠之禁食血漿葡萄糖、胰島素、三酸甘油酯及總膽固醇濃度、胰島素抗性程度、肝臟三酸甘油酯及膽固醇濃度顯著隨之降低 (P＜0.05)。本研究結果顯示富含難消化性麥芽糊精熟飯可使第2型糖尿病大鼠之禁食血漿葡萄糖、胰島素、三酸甘油酯及總膽固醇濃度、胰島素抗性程度、肝臟三酸甘油酯及膽固醇濃度顯著降低，且降低之效果顯著與每日難消化性麥芽糊精攝取量呈正相關。

The purpose of this study was to examine the effects of resistant maltodextrin (RMD)-enriched boiled rice on carbohydrate and lipid metabolism in type 2 diabetic rats. Thirty-two male Wistar rats with streptozotocin/nicotinamide-induced type 2 diabetes were randomly divided into RC (rice control), 33% RMD rice, 67% RMD rice and 100% RMD rice groups. Four diets were modified from AIN-93M, and the starch of RC diet was totally from boiled rice without RMD, and the starch of 33% RMD rice, 67% RMD rice and 100% RMD rice diets were 33%, 67% and 100% from RMD-enriched boiled rice. Four groups were fed each diet for 4 weeks. The fasting plasma glucose and insulin levels in the rats fed the 100% RMD rice diet were significantly lower than that of RC group (P＜0.05). The levels of insulin resistance in the rats fed the 67% RMD rice and 100% RMD rice diets were significantly lower than that of RC group (P＜0.05). The levels of attenuation of fasting plasma triglyceride and total cholesterol in the rats fed the 100% RMD rice diet were significantly higher than that of RC group (P＜0.05). The hepatic triglyceride levels in the rats fed the 67% RMD rice and 100% RMD rice diets were significantly lower than that of RC and 33% RMD rice groups (P＜0.05). The hepatic cholesterol levels in the rats fed the 100% RMD rice diet were significantly lower than that of other groups (P＜0.05). The rats fed the 33% RMD rice, 67% RMD rice and 100% RMD rice diets had greater fecal bile acid excretion than the rats fed the RC diet (P＜0.05). The levels of fasting plasma glucose, insulin, triglyceride and total cholesterol, insulin resistance, hepatic triglyceride and cholesterol in the diabetic rats were negatively correlated with daily intake of resistant maltodextrin (0－2.7 g/d). These findings support the conclusion that RMD-enriched boiled rice can significantly suppress hyperglycemic and hyperlipidemic responses in type 2 diabetic rats, and the suppressive effect was positively correlated with daily intake of resistant maltodextrin.

中文摘要 I
英文摘要 III
致謝 V
目錄 VII
表目錄 IX
圖目錄 X
第一章 前言 1
第二章 文獻回顧 3
第一節 糖尿病 3
一、何謂糖尿病 3
二、糖尿病流行病學 5
第二節 第2型糖尿病 6
一、何謂第2型糖尿病 6
二、第2型糖尿病之代謝異常 8
(一) 胰島素之生理功能 8
(二) 第2型糖尿病之醣類代謝異常 10
(三) 第2型糖尿病之脂質代謝異常 10
三、第2型糖尿病之飲食治療 12
四、第2型糖尿病之動物模式 14
第三節 膳食纖維 16
一、何謂膳食纖維及功能性纖維 16
二、膳食纖維之攝取與第2型糖尿病 17
三、膳食纖維與膽酸 18
四、膳食纖維與短鏈脂肪酸 20
第四節 難消化性麥芽糊精 22
一、何謂難消化性麥芽糊精 22
二、難消化性麥芽糊精之基本特性 22
三、難消化性麥芽糊精之安全性 23
四、難消化性麥芽糊精之應用 23
五、難消化性麥芽糊精之過去相關研究 24
第三章 材料與方法 25
第一節 研究架構圖 25
第二節 實驗材料 26
一、動物品系 26
二、適應期及誘發期之大鼠飼料 26
三、實驗飼料材料 26
四、分析用試劑 27
五、儀器設備 28
第三節、實驗方法 30
一、實驗流程 30
二、實驗分組 30
三、實驗飼料配製 31
四、大鼠每日難消化性麥芽糊精攝取量之計算 32
五、飼養環境與方法 32
六、第2型糖尿病誘發 33
七、腹腔注射葡萄糖耐受試驗 33
八、樣本收集及處理 34
九、分析項目 35
十、分析方法 36
十一、統計分析 46
第四章 結果 47
第一節 體重、體重增加量、器官重及每日攝食量 47
第二節 禁食血漿葡萄糖及胰島素濃度 47
第三節 腹腔注射葡萄糖耐受試驗之血漿葡萄糖及胰島素曲線下面積 48
第四節 胰島素抗性程度 48
第五節 禁食血漿三酸甘油酯及總膽固醇濃度 49
第六節 肝臟三酸甘油酯及膽固醇濃度 49
第七節 糞便中性固醇及膽酸濃度 50
第五章 討論 51
第一節 體重、體重增加量、器官重及每日攝食量 51
第二節 血糖控制 51
第三節 胰島素抗性 53
第四節 脂質代謝 54
一、本研究結果與過去研究結果 54
二、難消化性麥芽糊精之降血脂及降肝臟脂質的機制 54
三、熟飯澱粉之降肝臟脂質的機制 56
第五節 難消化性麥芽糊精攝取量 57
一、消化性麥芽糊精攝取量之換算 57
二、纖維建議攝取量 59
第六節 難消化性麥芽糊精之攝取型式 61
第六章 結論 62
第七章 參考文獻 63

苗明三 (1997) 實驗動物和實驗動物技術。p127-132，中國人民出版社。

傅偉光 (2002) 食物膳食纖維之機能與其分析方法。食品工業34: 3-10。

賴明宏 (2002) 飲食中補充米麩或三價鉻對第二型糖尿病患或STZ誘導的糖尿病大白鼠醣類及脂質代謝之影響。臺北醫學大學藥學研究所食品化學組博士論文。

國民健康局 (2002) 臺灣地區高血壓、高血糖、高血脂盛行率調查期末報告。取自：http://www.bhp.doh.gov.tw/health91/study-2.htm。取得：2009年5月27日。

行政院衛生署 (2008) 臺灣地區十大死因統計資料，行政院衛生署編印，臺北。

American diabetes association (2003) Screening for type 2 diabetes. Diabetes Care 26: S21-S24.

Anderson JW (1995) Short chain fatty acids and lipid metabolism: human studies. In: Physiological and Clinical Aspects of Short Chain Fatty Acids (Cummings JH, Rombeau JL, Sakata T, eds.), pp. 509-523. Cambridge University Press, New York.

Anderson JW, Chen WJ (1979) Plant fiber. Carbohydrate and lipid metabolism. Am J Clin Nutr 32: 346-363.

Association of Official Analytical Chemists (1980) Official methods of Analysis, 13th ed. pp. 15; 132; 133-134; 211; 227. AOAC, Washington DC.

Banerjee M, Kanitkar M, Bhonde RR (2005) Approaches towards endogenous pancreatic regeneration. Rev Diabet Study 2: 165-176.

Basu A, Shah P, Nielsen M, Basu R, Rizza RA (2004) Effects of type 2 diabetes on the regulation of hepatic glucose metabolism. J Investig Med 52: 366-374.


Bloomgarden ZT (2004) Consequences of diabetes: cardiovascular disease. Diabetes Care 27: 1825-1831.

Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM, Brinkley LJ (2000) Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med 342: 1392-1398.

Chen CW, Cheng HH (2006) A rice bran oil diet increases LDL-receptor and HMG-CoA reductase mRNA expressions and insulin sensitivity in rats with streptozotocin/nicotinamide-induced type 2 diabetes. J Nutr 136: 1472-1476.

Cheng HH, Lai MH (2000) Fermentation of resistant rice starch produces propionate reducing serum and hepatic cholesterol in rats. J Nutr 130: 1991-1995.

Chou P, Li CL, Wu GS, Tsai ST (1998) Progression to type 2 diabetes among high-risk groups in Kin-Chen, Kinmen. Exploring the natural history of type 2 diabetes. Diabetes Care 21: 1183-1187.

D''Alessio DA, Vogel R, Prigeon R, Laschansky E, Koerker D, Eng J, Ensinck JW(1996) Elimination of the action of glucagon-like peptide 1 causes an impairment of glucose tolerance after nutrient ingestion by healthy baboons. J Clin Invest 97: 133-138.

DeFronzo RA (1988) Lilly lecture 1987. The triumvirate: beta-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes 37: 667-687.

Diabetes Control and Complications Trail Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329: 977-986.

Dikeman CL, Fahey GC (2006) Viscosity as related to dietary fiber: a review. Crit Rev Food Sci Nutr 46: 649-663.

Eastwood MA, Morris ER (1992) Physical properties of dietary fiber that influence physiological function: a model for polymers along the gastrointestinal tract. Am J Clin Nutr 55: 436-442.

Everson GT, Daggy BP, McKinley C, Story JA (1992) Effects of psyllium hydrophilic mucilloid on LDL-cholesterol and bile acid synthesis in hypercholesterolemic men. J Lipid Res 33: 1183-1192.

Fernandez ML (2001) Soluble fiber and nondigestible carbohydrate effects on plasma lipids and cardiovascular risk. Curr Opin Lipidol 12: 35-40.

Ferrannini E (1998) Insulin resistance versus insulin deficiency in non-insulin-dependent diabetes mellitus: problems and prospects. Endocr Rev 19: 477-490.

Food and Nutrition Board (2002) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Protein and Amino acids. Washington DC: National Academy of Sciences.

Franz MJ (2004) Medical nutrition therapy for diabetes mellitus and hypoglycemia of nondiabetic origin. In: Food, nutrition, & diet therapy (Mahan LK, Escott-Stump S, eds.), pp.825-829. Elsevier, USA.

Funnell MM, Donnelly MB, Anderson RM, Johnson PD, Oh MS (1992)Perceived effectiveness, cost, and availability of patient education methods and materials. Diabetes Educ 18: 139-145.

Funnell MM, Merritt JH (1993) The challenges of diabetes and older adults. Nurs Clin North Am 28: 45-60.

Gerhardt AL, Gallo NB (1998) Full-fat rice bran and oat bran similarly reduce hypercholesterolemia in humans. J Nutr 128: 865-869.

Giacco R, Parillo M, Rivellese AA, Lasorella G, Giacco A, D''Episcopo L, Riccardi G (2000) Long-term dietary treatment with increased amounts of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients. Diabetes Care 23: 1461-1466.

Ginsberg HN (1991) Lipoprotein physiology in nondiabetic and diabetic states. Relationship to atherogenesis. Diabetes Care 14: 839-855.


Ginsberg HN (1994) Lipoprotein metabolism and its relationship to atherosclerosis. Med Clin North Am 78: 1-20.

Ginsberg HN (2000) Insulin resistance and cardiovascular disease. J Clin Invest 106: 453-458.

Gordon DT, Okuma K (2002) Determination of total dietary fiber in selected foods containing resistant maltodextrin by enzymatic-gravimetric method and liquid chromatography: collaborative study. J AOAC Int 85: 435-444.

Gropper SS, Smith JL, Groff JL (2005) Advanced nutrition and human metabolism. 4th ed. pp. 80-82; 114; 253-255. Wadsworth, USA.

Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M (1998) Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 339: 229-234.

Hertzler S (2000) Glycemic index of “energy” snack bars in normal volunteers. J Am Diet Assoc 100: 97-100.

Horton JD, Cuthbert JA, Spady DK (1994) Regulation of hepatic 7 alpha-hydroxylase expression by dietary psyllium in the hamster. J Clin Invest 93: 2084-2092.

Hosker JP, Kumar S, Gordon C, Bhatnagar D, France M, Boulton AJ (1993) Diet treatment of newly presenting type 2 diabetes improves insulin secretory capacity, but has no effect on insulin sensitivity. Diabet Med 10: 509-513.

International diabetes federation (2006) Statistics at a glance. Available at: http://www.eatlas.idf.org/index2983.html. Accessed May 27, 2009.

Jenkins DJ, Kendall CW, Axelsen M, Augustin LS, Vuksan V (2000) Viscous and nonviscous fibres, nonabsorbable and low glycaemic index carbohydrates, blood lipids and coronary heart disease. Curr Opin Lipidol 11: 49-56.

Jenkins DJ, Wolever TM, Rao AV, Hegele RA, Mitchell SJ, Ransom TP, Boctor DL, Spadafora PJ, Jenkins AL, Mehling C (1993) Effect on blood lipids of very High intakes of fiber in diets low in saturated fat and cholesterol. N Engl J Med 329: 21-26.

Kahn CR (1978) Insulin resistance, insulin insensitivity, and insulin unresponsiveness: a necessary distinction. Metabolism 27: 1893-1902.

Kahn SE (2001) Clinical review 135: The importance of beta-cell failure in the development and progression of type 2 diabetes. J Clin Endocrinol Metab 86: 4047-4058.

Kannel WB, McGee DL (1979) Diabetes and cardiovascular disease. The Framingham study. JAMA 241: 2035-2038.

Karlstrom B, Vessby B, Asp NG, Boberg M, Gustafsson IB, Lithell H, Werner I (1984) Effects of an increased content of cereal fibre in the diet of Type 2 (non-insulin-dependent) diabetic patients. Diabetologia 26: 272-277.

Kendall DM, Sobel BE, Coulston AM, Peters Harmel AL, McLean BK,
Peragallo-Dittko V, Buse JB, Fonseca VA, Hill JO, Nesto RW, Sunyer FX(2003) The insulin resistance syndrome and coronary artery disease. Coron Artery Dis 14: 335-348.

Kishimoto Y, Oga H, Tagami H, Okuma K, Gordon DT (2007) Suppressive effect of resistant maltodextrin on postprandial blood triacylglycerol elevation. Eur J Nutr 46: 133-138.

Kissebah AH (1987) Low density lipoprotein metabolism in non-insulindependent diabetes mellitus. Diabetes Metab Rev 3: 619-651

Kuusisto J, Mykkanen L, Pyorala K, Laakso M (1994) NIDDM and its metabolic control predict coronary heart disease in elderly subjects. Diabetes 43: 960-967.

Liese AD, Roach AK, Sparks KC, Marquart L, D''Agostino RB, Jr., Mayer-Davis EJ(2003) Whole-grain intake and insulin sensitivity: the Insulin Resistance Atherosclerosis Study. Am J Clin Nutr 78: 965-971.

Lin T, Chou P, Tsai ST, Lee YC, Tai TY (2004) Predicting factors associated with costs of diabetic patients in Taiwan. Diabetes Res Clin Pract 63: 119-125.

Livesey G, Tagami H (2009) Interventions to lower the glycemic response to carbohydrate foods with a low-viscosity fiber (resistant maltodextrin): meta-analysis of randomized controlled trials. Am J Clin Nutr 89: 114-125.

Maczulak AE, Wolin MJ, Miller TL (1993) Amounts of viable anaerobes, methanogens, and bacterial fermentation products in feces of rats fed high-fiber or fiber-free diets. Appl Environ Microbiol 59: 657-662.

Marlett JA, Hosig KB, Vollendorf NW, Shinnick FL, Haack VS, Story JA (1994) Mechanism of serum cholesterol reduction by oat bran. Hepatology 20: 1450-1457.

Masiello P, Broca C, Gross R, Roye M, Manteghetti M, Hillaire-Buys D, Novelli M, Ribes G (1998) Experimental NIDDM: development of a new model in adult rats administered streptozotocin and nicotinamide. Diabetes 47: 224-229.

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28: 412-419.

Merkel M, Eckel RH, Goldberg IJ (2002) Lipoprotein lipase: genetics, lipid uptake, and regulation. J Lipid Res 43: 1997-2006.

Nagata J, Saito M (2006) Effects of simultaneous intakes of indigestible dextrin and diacylglycerol on lipid profiles in rats fed cholesterol diets. Nutrition 22: 395-400.

National Cholesterol Education Program (NCEP): Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) (2001). JAMA 285: 2486-2497.

Nomura M, Nakajima Y, Abe H (1992) Effects of long-term administration of indigestible dextrin as soluble dietary ber on lipid and glucose metabolism. J Jpn Soc Nutr Food Sci 45: 21-25.

Ohkuma K, Matsuda I, Katta Y, Hanno Y (1990) Pyrolysis of starch and its digestibility by enzymes-Characterization of indigestible dextrin. Denpun Kagaku 37: 107-114.

Pawlak DB, Kushner JA, Ludwig DS (2004) Effects of dietary glycaemic index on adiposity, glucose homoeostasis, and plasma lipids in animals. Lancet 364: 778-785.

Pratipanawatr W, Pratipanawatr T, Cusi K, Berria R, Adams JM, Jenkinson CP, Maezono K, DeFronzo RA, Mandarino LJ (2001) Skeletal muscle insulin resistance in normoglycemic subjects with a strong family history of type 2 diabetes is associated with decreased insulin-stimulated insulin receptor substrate-1 tyrosine phosphorylation. Diabetes 50: 2572-2578.

Qi L, Rimm E, Liu S, Rifai N, Hu FB (2005) Dietary glycemic index, glycemic load, cereal fiber, and plasma adiponectin concentration in diabetic men. Diabetes Care 28: 1022-1028.

Richmond W (1973) Preparation and properties of a cholesterol oxidase from Nocardia sp. and its application to the enzymatic assay of total cholesterol in serum. Clin Chem 19: 1350-1356.

Rendell M (2000) Dietary treatment of diabetes mellitus. N Engl J Med 342: 1440-1441.

Roediger WE (1982) Utilization of nutrients by isolated epithelial cells of the rat colon. Gastroenterology 83: 424-429.

Salmeron J, Ascherio A, Rimm EB, Colditz GA, Spiegelman D, Jenkins DJ, Stampfer MJ, Wing AL, Willett WC (1997) Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 20: 545-550.

Schnedl WJ, Ferber S, Johnson JH, Newgard CB (1994) STZ transport and cytotoxicity. Specific enhancement in GLUT2-expressing cells. Diabetes 43: 1326-1333.

Schulze MB, Liu S, Rimm EB, Manson JE, Willett WC, Hu FB (2004) Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women. Am J Clin Nutr 80: 348-356.

Simpson IA, Cushman SW, Egan JJ, Habberfield AD, Londos C, Nishimura H, Saltis J (1990) Hormonal regulation of glucose transport in rat adipose cells. Biochem Soc Trans 18: 1123-1125.

Song YJ, Sawamura M, Ikeda K, Igawa S, Yamori Y (2000) Soluble dietary fibre improves insulin sensitivity by increasing muscle GLUT-4 content in stroke-prone spontaneously hypertensive rats. Clin Exp Pharmacol Physiol 27: 41-45.

Story JA, Kritchevsky D (1976) Comparison of the binding of various bile acids and bile salts in vitro by several types of fiber. J Nutr 106: 1292-1294.

Streicher R, Kotzka J, Muller-Wieland D, Siemeister G, Munck M, Avci H, Krone W (1996) SREBP-1 mediates activation of the low density lipoprotein receptor promoter by insulin and insulin-like growth factor-I. J Biol Chem 271: 7128-7133.

Tasi ST, Wong CH, Lin RS, Chang SH (2002) A report of diabetes quality care. Annual Report of Taiwanese Association of Diabetes Educator, Taiwanese Association of Diabetes Educator, Taipei.

Tokunaga K, Matsuoka A (1999) Effects of a FOSHU (food for specifed health use) containing indigestible dextrin as functional component on glucose and fat metabolisms. J Jpn Diab Soc 42: 61-65.

Trautwein EA, Kunath-Rau A, Erbersdobler HF (1999) Increased fecal bile acid excretion and changes in the circulating bile acid pool are involved in the hypo-cholesterolemic and gallstone-preventive actions of psyllium in hamsters. J Nutr 129: 896-902.

Tripathy D, Carlsson M, Almgren P, Isomaa B, Taskinen MR, Tuomi T, Groop LC (2000) Insulin secretion and insulin sensitivity in relation to glucose tolerance: lessons from the Botnia Study. Diabetes 49: 975-980.

Turley SD, Daggy BP, Dietschy JM (1991) Cholesterol-lowering action of psyllium mucilloid in the hamster: sites and possible mechanisms of action. Metabolism 40: 1063-1073.

US Department of Health and Human Services (2005) The Report of the Dietary Guidelines Advisory Committee on Dietary Guidelines for Americans. Available at: http://www.health.gov/DietaryGuidelines/dga2005/document. Accessed May 27, 2009.

Vahouny GV, Cassidy MM (1985) Dietary fibers and absorption of nutrients. Proc Soc Exp Biol Med 180: 432-446.

Vahouny GV, Roy T, Gallo LL, Story JA, Kritchevsky D, Cassidy M (1980) Dietary fibers. III. Effects of chronic intake on cholesterol absorption and metabolism in the rat. Am J Clin Nutr 33: 2182-2191.

Vahouny GV, Tombes R, Cassidy MM, Kritchevsky D, Gallo LL (1980) Dietary fibers: V. Binding of bile salts, phospholipids and cholesterol from mixed micelles by bile acid sequestrants and dietary fibers. Lipids 15: 1012-1018.

Vauhkonen I, Niskanen L, Vanninen E, Kainulainen S, Uusitupa M, Laakso M (1998) Defects in insulin secretion and insulin action in non-insulin-dependent diabetes mellitus are inherited. Metabolic studies on offspring of diabetic
probands. J Clin Invest 101: 86-96.

van Bennekum AM, Nguyen DV, Schulthess G, Hauser H, Phillips MC (2005) Mechanisms of cholesterol-lowering effects of dietary insoluble fibres: relationships with intestinal and hepatic cholesterol parameters. Br J Nutr 94: 331-337.

Wakabayashi S, Kishimimoto Y, Nanbu S, Matsuoka A (1999) Effects of indigestible dextrin on postprandial rise in blood glucose levels in man. J Jpn Assoc Dietary Fiber Res 3: 13-19.

Wakabayashi S, Satouchi M, Nogami Y, Ohkuma K, Matsuoka A (1991) Effect of indigestible dextrin on cholesterol metabolism in rat. J Jpn Soc Nutr Food Sci 44: 471-478.

Wang JF, Zhu YH, Li DF, Wang Z, Jensen BB (2004) In vitro fermentation of various fiber and starch sources by pig fecal inocula. J Anim Sci 82: 2615- 262.

Wang Z, Gleichmann H (1998) GLUT2 in pancreatic islets: crucial target molecule in diabetes induced with multiple low doses of streptozotocin in mice. Diabetes 47: 50-56.

Wild S, Roglic G, Green A, Sicree R, King H (2004) Global prevalence of diabetes: stimates for the year 2000 and projections for 2030. Diabetes Care 27: 1047-1053.

Wolever TM, Vuksan V, Eshuis H, Spadafora P, Peterson RD, Chao ES, Storey ML, Jenkins DJ (1991) Effect of method of administration of psyllium on glycemic response and carbohydrate digestibility. J Am Coll Nutr 10: 364-371.

Yki-Jarvinen H (1997) Acute and chronic effects of hyperglycaemia on glucose metabolism: implications for the development of new therapies. Diabet Med 14 Suppl 3: S32-37.

Yusof RM, Said M (2004) Effect of high fibre fruit (Guava-psidium guajava L.) on the serum glucose level in induced diabetic mice. Asia Pac J Clin Nutr 13: S135.

Zimmet P, Alberti KG, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414: 782-787.