The immediate and well-documented benefits of carbohydrate restriction include improved glycemic control in individuals with diabetes mellitus. Starch, a significant source of carbohydrates, is categorized as rapidly digestible, slowly digestible, or resistant starch (RS). RS, which is a non-viscous fermentable fiber, has shown promise in animal studies for antidiabetic effects by improving glucose metabolism. Although the exact mechanism by which RS affects glucose metabolism remains unclear, it is expected to positively impact glucose tolerance and insulin sensitivity. The fermentation of RS by colonic microbiota in the large bowel produces short-chain fatty acids, which exert multiple metabolic effects on glucose regulation and homeostasis. Moreover, RS may influence glucose metabolism via bile acid modulation, independent of its fermentation. Diets rich in RS could aid in blood glucose homeostasis. However, it is uncertain whether they can alter the metabolic pathology associated with glucose regulation. In essence, RS has the potential to lower postprandial glucose levels similarly to a low-glycemic index diet. Yet, its efficacy as a medical nutrition therapy for type 2 diabetes needs further investigation. To confirm the role of RS in glycemic control and to possibly recommend it as an additional dietary approach for people with type 2 diabetes mellitus, a well-designed, large-scale intervention is required.

中文翻译：

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抗性淀粉和 2 型糖尿病：临床观点

碳水化合物限制的直接且有据可查的好处包括改善糖尿病患者的血糖控制。淀粉是碳水化合物的重要来源，可分为快速消化淀粉、缓慢消化淀粉或抗性淀粉 (RS)。 RS 是一种非粘性可发酵纤维，在动物研究中显示出通过改善葡萄糖代谢具有抗糖尿病作用的前景。尽管RS影响葡萄糖代谢的确切机制尚不清楚，但预计它会对葡萄糖耐量和胰岛素敏感性产生积极影响。大肠中结肠微生物群发酵 RS 产生短链脂肪酸，对葡萄糖调节和体内平衡发挥多种代谢作用。此外，RS 可能通过胆汁酸调节影响葡萄糖代谢，与其发酵无关。富含 RS 的饮食有助于血糖稳态。然而，尚不确定它们是否可以改变与葡萄糖调节相关的代谢病理学。从本质上讲，RS 具有与低血糖指数饮食类似的降低餐后血糖水平的潜力。然而，其作为 2 型糖尿病医学营养疗法的功效还需要进一步研究。为了证实 RS 在血糖控制中的作用，并可能将其推荐为 2 型糖尿病患者的额外饮食方法，需要精心设计的大规模干预措施。