Yet a pilot study of 200, 500, or 1,000 samples may be feasible, and may uncover results that can be
replicated in the larger cohort.
Conversely, within non-diabetic populations, periods of IER (75 - 85 % ER on restricted days) do not typically affect fasting glucose levels 37, 41, 45, 48 or HbA1c 41, 48; results of which can often be
replicated by short term CER studies.62 - 65These findings are unsurprising given that frank hyperglycaemia within the T2DM diagnostic range is effectively a late - stage manifestation of IR, which along with compensatory increases insulin secretion, can precede the onset of T2DM by many years.66, 67 Findings from one
large scale prospective
cohort study, Whitehall II, reveal a sharp increase
in the trajectory towards fasting hyperglycaemia which is only detectable three years prior to diagnosis with T2DM.67 Consequently, it can be argued that changes
in circulating insulin concentrations, fasting (hepatic) insulin sensitivity and glucose uptake / clearance are more sensitive markers of deteriorating glucose control than fasting glycaemia
in non - diabetics.68 - 70
However, the point estimates suggest that prebiotic consumption, especially GOSs, might be associated with a lower risk of depression; therefore, it would be of great interest to
replicate these analyses
in a
cohort with a
larger number of incident cases of depression to increase the statistical power.