Treatment of severe insulin-resistance with a 2-day oat-diet in clinical routine

Introduction

The estimated prevalence of Diabetes Type 2 (T2D) in Europe is 8% with increasing tendency. Key feature of T2D is the insulin resistance (IR) which is accompanied amongst others by raised inflammation markers and increased risk for cardiovascular diseases and sleep apnoea. In Diabetes therapy, oat diet is being used since decades. Recently there has been a publication of data concerning the treatment of severe IR with oatmeal. The goal of this study is to verify feasibility within clinical routine.

Methods

Retrospective assessment of data of 30 patients (13f, 17m, age 62.1, SD 15.9) with a daily insulin dose (DID) of 134 IU (SD 48.9) and HbA1c of 10.2% (SD 2.0) having been treated with a 2-day diet of 3×3 carbohydrate units of oatmeal. Mean blood glucose (MBG) and DID was measured before and during treatment as well as on day 2 and 4 after treatment.

Results

Mean DID decreased from 134 IU to 96.3 (SD 41.48) on day 2 (Z=−4.52, p<0.001) and to 102.3 IU (SD 49.6) on day 4 (Z=−3.59, p<0.001) after treatment (29%, resp., 23% reduction). Simultaneously MBG decreased from 183.7mg/dl to 158.1 (day 2, Z=−2.25, p=0.025), respectively, to 152.3mg/dl (day 4, Z=−3.05, p=0.002, each Wilcoxon-rank-test). Responder-rate (defined as >20% reduction of DID) was 75% (day 2), respectively, 64% (day 4).

Discussion

Treatment of IR in a clinical setting remains challenging. A recently published pilot study showed in n=9 patients 4 weeks after oatmeal diet a reduction of the DID of 47%. Pathophysiological mechanisms are unknown. Interestingly, 4 weeks after treatment there was an increase in adiponectine, a protective adipokine. The present study under everyday conditions, showed a reduction of the DID of 29% (on day 2), resp., 23% (on day 4). Responder rate was at 64%. Therefore, this diet is an effective and cheap treatment option for IR. Further studies concerning response-determining factors and pathophysiology are necessary.

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