Plant-Derived Supplementary Carbohydrates, Polysaccharides and Oligosaccharides in Management of Diabetes Mellitus: A Comprehensive Review

Background and aims: Diabetes mellitus is a chronic heterogenic disease characterized by the deregulation of the metabolism of insulin and glucose. The aim of this review has been to evaluate the efficacy of medical plant-based carbohydrates, excluding monosaccharides, to manage glycemic response in clinical trials.Methods: The range of literature presented was compiled by searching electronic databases, including Scopus, PubMed and Cochrane library, from their inception through to June 2018. Only clinical-based studies were considered for this review. Dietary carbohydrates were investigated, especially those containing fiber possessing beneficial effects in the management of hyperglycemia. The most common oligosaccharides, including xylooligosaccharide, isomaltooligosaccharide, fructooligosaccharide, galactooligosaccharide, and sucrose, were able to manage glycemic and insulin metabolism in clinical trials.Results: In light of 77 selected papers, several plant-based oligosaccharides and polysaccharides have been shown to significantly improve the management of glucose and insulin metabolism in healthy and diabetic patients.Conclusions: Oligosaccharides and polysaccharides derived from plants possess promising hypoglycemic potential, similar to and even more effective than current synthetic drugs, with no deleterious side effects.Abbreviations: AMPK: AMP-activated protein kinase; AX: Arabinoxylan; CAT: Catalase; CFDA: Chinese food and drug administration; DM: Diabetes mellitus; FBS, Fasting blood glucose; FDA: United States food and drug administration; FOS: Fructooligosaccharide; G6Pase: Glucose-6- phosphatase; GCK: glucokinase; GD: Gestational diabetes; GI: Glycemic index; GL: Glycemic load; Glut4: Glucose transporter 4; GOS: Glucooligosaccharide; GPx: glutathione peroxidase; GRAS: generally regarded as safe HCF: high-carbohydrate, high fiber diet; HNF1α: Hepatic nuclear factor 1 alpha, HNF4α: Hepatic nuclear factor 4α; HNF1β: Hepatic nuclear factor 1β; II: Insulinemic index; IOS: Isomaltooligosaccharides; KGM: Konjac glucomannan; LBP: L. barbarum polysaccharide; MODY: Maturity onset diabetes of the young; PECK: phosphoenolpyruvate carboxykinase; RDS: Rapidly digestible starch; RS: Resistant starch; SBOS: Soybean oligosaccharides; SDS: Slowly digestible starch; SNP: Single nucleotide polymorphism; SOD: Superoxide dismutase; T1DM: Type 1 diabetes; T2DM: Type 2 diabetes mellitus; TBARS: Thiobarbituric acid reactive substances; XOS: Xylooligo-saccharide.