Improvement of sleep by resistant dextrin prebiotic in type 2 diabetic women coincides with attenuation of metabolic endotoxemia: involvement of gut–brain axis

Abstract BACKGROUND Resistant dextrin, as a prebiotic and functional food, may possess favorable effects in type 2 diabetes. This study was conducted to assess whether supplementation with resistant dextrin can improve sleep and quality of life in obese type 2 diabetic women. RESULTS In this randomized controlled trial, female obese type 2 diabetic patients ( n = 76) were randomly assigned into intervention group ( n = 38) and placebo group ( n = 38), and received 10 g day −1 of resistant dextrin or maltodextrin for a period of 8 weeks, respectively. Sleep quality and quality of life (QOL) were assessed by Pittsburgh Sleep Quality Index (PSQI) and SF‐36 health survey, respectively. Fasting blood samples were driven to measure serum bacterial endotoxin, fasting blood sugar, glycosylated hemoglobin (HbA1c), pro‐inflammatory/anti‐inflammatory biomarkers (IL‐18, IL‐6, IL‐10, TNF‐α), and biomarkers of hypothalamic‐pituitary‐adrenal (HPA) axis function [tryptophan (TRP), adrenocorticotropic hormone (ACTH), kynurenine (KYN), cortisol]. Supplementation with resistant dextrin improved sleep ( P < 0.001) and QOL ( P < 0.001) significantly. It also caused a significant decrease in levels of endotoxin, HbA1c, IL‐18, IL‐6, TNF‐α and a significant increase in IL‐10 levels. Significant and positive correlations were found between endotoxin ( r = 0.488, P = 0.003), IL‐6 ( r = 0.436, P = 0.008), IL‐18 ( r = 0.475, P = 0.003), cortisol ( r = 0.545, P = 0.048), KYN/TRP ( r = 0.527, P = 0.001), and PSQI scores. CONCLUSIONS It is concluded that resistant dextrin improves sleep and QOL in obese women with type 2 diabetes. Its beneficial effects may be attributed in part to modulation of glycemia, metabolic endotoxemia and subsequently a decrease in biomarkers of inflammation and HPA axis activity. © 2022 Society of Chemical Industry.