Effect of high-fibre diet on haemostatic variables in diabetes

Abstract

Raised values of factor VIIc, factor VIIIc, and fibrinogen are associated with increased cardiovascular mortality. Treatment of hyperlipidaemia with a fat-modified diet causes substantial falls in plasma factors VIIc, VIIIc, and Xc, and an increase in fibrinolytic activity. Patients with diabetes have a greatly increased risk of cardiovascular morbidity and mortality; values of factors VIIc and fibrinogen are significantly higher in diabetics than in non-diabetics, especially those with retinopathy or proteinuria. We report a randomised crossover study of the effects of dietary treatment of diabetes on haemostatic function. The results show that some plasma clotting factor values can be reduced by diet alone. Since most patients had previously had a low-fibre intake, the changes can reasonably be described as decreases due to the high-fibre rather than increases due to the low-fibre content. The effects of the high-fibre diet on factors VIIc and Xc in the non-insulin-dependent group were similar to changes seen after the dietary treatment of hyperlipidaemia. In some circumstances, therefore, dietary modifications may exert clinical benefits partly through their effects on clotting factor values. There is other evidence for this possibility. The lack of any effect of high-fibre on factors VIIc and Xc in the insulin-dependent group may be due to the nature of insulin-dependent diabetes or to an effect of exogenous insulin.