Results From Low–Glycemic Index Diets in the
Management of Diabetes
Choosing low-GI foods in place of conventional or high-GI foods has a small but clinically useful effect on medium-term glycemic control in patients with diabetes.
The use of diets with low glycemic index (GI) in the management of diabetes is controversial, with contrasting recommendations around the world. In this study they performed a meta-analysis of randomized controlled trials to determine whether low-GI diets, compared with conventional or high-GI diets, improved overall glycemic control in individuals with diabetes, as assessed by reduced HbA1c or fructosamine levels.
Literature searches identified 14 studies, comprising 356 subjects, that met strict inclusion criteria. All were randomized crossover or parallel experimental design of 12 days’ to 12 months’ duration (mean 10 weeks) with modification of at least two meals per day. Only 10 studies documented differences in postprandial glycemia on the two types of diet.
The results showed that, Low-GI diets reduced HbA1c by 0.43% points (CI 0.72–0.13) over and above that produced by high-GI diets. Taking both HbA1c and fructosamine data together and adjusting for baseline differences, glycated proteins were reduced 7.4% (8.8–6.0) more on the low-GI diet than on the high-GI diet. This result was stable and changed little if the data were unadjusted for baseline levels or excluded studies of short duration. Systematically taking out each study from the meta-analysis did not change the CIs.
From the results it was concluded that, choosing low-GI foods in place of conventional or high-GI foods has a small but clinically useful effect on medium-term glycemic control in patients with diabetes. The incremental benefit is similar to that offered by pharmacological agents that also target postprandial hyperglycemia.
Source: Diabetes In Control Dot Com: Diabetes Care 26:2261-2267, 2003.
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