Oleh Admin Kalbe Medical pada June 13, 2017 06:30

Adakah Dampak Asupan Karboidrat dengan Sel Beta Pankreas?

Modifikasi gaya hidup, termasuk penerapan pola makan sehat, telah disarankan untuk menurunkan risiko diabetes tipe 2 sebesar 40-70%. Penelitian sebelumnya tentang hubungan asupan total mono dan disakarida dengan diabetes tipe 2 menunjukkan hasil yang bertentangan. Hasil yang bertentangan ini kemungkinan disebabkan karena adanya kriteria subyek yang terlalu bervariasi. Penelitian terbanyak adalah pada individu yang mengkonsumsi glukosa, fruktosa, dan sukrosa.

Pada beberapa penelitian yang diobservasi terdapat hubungan positif glukosa dan fruktosa dengan prediabetes dan diabetes tipe 2, sedangkan di sisi lain menunjukkan hasil yang berlawanan bahkan tidak ditemukan adanya hubungan. Terkait asupan sukrosa, beberapa penelitian menunjukkan hubungan yang terbalik dengan prediabetes atau diabetes tipe 2, sedangkan yang lainnya menunjukkan tidak terdapat hubungan yang bermakna.

Fungsi sel β pankreas dan sensitivitas insulin terkadang sudah memburuk beberapa tahun sebelum terdiagnosis diabetes tipe 2. Oleh karena itu, diperlukan intervensi yang lebih awal untuk mencegah berkembangnya proses diabetes tipe 2 dan meningkatkan pengetahuan tentang efek mono dan disakarida yang lebih detail terhadap metabolisme glukosa. Hal ini penting dilakukan penelitian terhadap faktor penentu yaitu sel β pankreas dan sensitivitas insulin. Defek pada jalur signaling insulin intraseluler menyebabkan penurunan ambilan glukosa jaringan yang tergantung pada insulin. Jika sensitivitas insulin menurun, sel β pankreas secara normal akan upregulate terhadap sekresi insulin untuk menjaga kadar glukosa darah tetap normal. Namun, ketika fungsi sel β pankreas terganggu, kadar glukosa plasma akan meningkat pada prediabetes dan diabetes.

Penelitian sebelumnya yang telah dilakukan untuk menilai efek mono dan disakarida terhadap sensitivitas insulin menunjukkan hasil yang bertentangan. Oleh karena itu, tidak diketahui dengan pasti efek pemberian mono dan disakarida pada sel β pankreas maupun pada sensitivitas insulin. Tujuan dari penelitian ini adalah untuk mengevaluasi keterkaitan secara cross-sectional pada populasi yang berdasarkan desain cohort baru terdiagnosis diabetes tipe 2. Subyek sebanyak 120 pasien dengan rerata usia 59,7 ± 8,18 tahun. Asupan glukosa, fruktosa, sukrosa dinilai melalui kuesioner frekuensi makan. Status metabolisme glukosa, sensitivitas insulin dan sel β pankreas diukur dengan tes toleransi glukosa oral. Hasil analisis regresi linear menunjukkan hubungan positif asupan glukosa dengan sensitivitas insulin (standardized beta (95% CI) 0,07 (0,05, 0,14) SD untuk asupan glukosa > 23 g vs <10 g). Asupan fruktosa dan sukrosa tidak berhubungan dengan sensitivitas insulin. Selain itu, juga tidak ditemukan adanya hubungan asupan glukosa, fruktosa, dan sukrosa terhadap fungsi sel β pankreas. (LAI)

Image: Ilustrasi
Referensi:
1. J Louise, et al. Associations of Dietary Glucose, Fructose, and Sucrose with β Cell Function, Insulin Sensitivity, and Type 2 Diabetes in the Maastricht Study. Nutrients 2017;9:380. doi:10.3390/nu9040380.
2. Laville M, Nazare JA. Diabetes, insulin resistance and sugars. Obes. Rev. 2009;10 (Suppl. S1):24–33.
3. Ahmadi-Abhari S, Luben RN, Powell N, Bhaniani A, Chowdhury R, Wareham NJ, et al. Dietary intake of carbohydrates and risk of type 2

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