The acute effects of dietary pulses on postprandial glycemia in diabetes: a meta‐analysis (272.8)

Background and Aims: Elevated postprandial glucose (PPG) levels have been associated with higher incidence of cardiovascular disease and all‐cause mortality. Dietary pulses including beans, lentils and chickpeas have resulted in low and medium PPG responses, however most studies have included few subjects and their overall PPG responses, when taken in equicarbohydrate amounts either alone or in mixed meals, have not been systematically summarized and quantitated. Objective: to synthesize the evidence of the effect of dietary pulses on PPG responses in individuals with diabetes. Methods: MEDLINE, EMBASE, CINAHL and Cochrane were searched through Oct 31, 2013 for all acute human trials in individuals with type 1 and type 2 diabetes reporting data for areas under the PPG curve or glycemic indices. Data were pooled by the generic inverse variance method using random effect models and expressed as ratio of means (RoM) with 95% confidence intervals (CI). Heterogeneity was assessed by Chi2 and quantified by I2. Results: Thirty‐six trials (n=259) from 12 published papers met the inclusion criteria. Pulses significantly reduced the relative PPG by 49% compared to an equicarbohydrate white bread control (RoM: 0.51, CI 0.45‐0.57). Heterogeneity was moderate and statistically significant (I2=30%; p<0.0001), however this effect was consistent across all types of pulses and in mixed meals. Canned pulses showed a weaker effect. Conclusion: Pooled analyses suggest that dietary pulses in diabetic patients result in 50% significantly lower PPG rise compared to an equicarbohydrate white bread control. Grant Funding Source : Pulse Canada and CIHR