Article

Glycemic index and glycemic load in relation to glucose intolerance among Greenland's Inuit population.

Steno Diabetes Center, Gentofte, Denmark.
Diabetes research and clinical practice (Impact Factor: 2.74). 05/2012; 97(2):298-305. DOI: 10.1016/j.diabres.2012.05.005
Source: PubMed

ABSTRACT Intake of carbohydrates which elicit a large glycemic response is hypothesized to increase the risk of diabetes. However, studies assessing the relationship between glycemic index (GI) and glycemic load (GL) and diabetes are inconsistent. Only few studies have studied the relationship between GI and GL and markers of glucose metabolism, mostly in western populations.
To determine the relationship between GI and GL and indices of glucose metabolism and prevalence of diabetes in Greenland's Inuit population.
The Inuit Health in Transition Study is a geographically representative cross-sectional study among aged ≥18years. Diet was assessed using a 67-item food frequency questionnaire. Logistic and linear regression was used to assess the association between GI and GL and diabetes, impaired fasting glucose, impaired glucose tolerance, HbA(1c), fasting plasma glucose, 2h plasma glucose, HOMA2-IR and HOMA2-%β.
No association was found between GI and GL and diabetes. GL was significantly inversely associated with IFG (OR: 0.91 (0.84-0.98)). While GI was positively associated with FPG, GL was positively associated with both HOMA2-IR and HOMA2-%β and inversely associated with IFG.
These findings do not support a link between dietary GI or GL and risk of type 2 diabetes among Greenland's Inuit population.

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    ABSTRACT: Background/Objectives:The aim was to investigate the associations of glycemic index (GI), glycemic load (GL), carbohydrate and fiber intakes with hyperglycemia in type 2 diabetic patients.Subjects/Methods:In a cross-sectional study of 640 type 2 diabetic patients aged 28-75 years, usual dietary intakes were assessed by validated food frequency questionnaire. We used published international and Iranian tables of GI based on the white bread. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI).Results:High-GL diet was associated with higher risk of hyperglycemia in type 2 diabetic patients after controlling for potential confounders. In multivariable model, OR (95% CI) for the highest vs the lowest quartile of GL was 2.58 (1.08-6.15) for elevated fasting serum glucose (FSG) (>130 mg/dl) (Ptrend=0.02) and was 3.05 (1.33-7.03) for elevated HbA1c (>8.6%) (Ptrend=0.008). After additional adjusting for dietary fiber and protein intakes, the relation of GL with elevated FSG and HbA1c was stable. GI was not significantly associated with either elevated FSG or HbA1c. In multivariable model, OR (95% CI) for the highest vs lowest quartile of the substitution of dietary carbohydrate for fat intake was 2.32 (1.37-3.92) for elevated HbA1c (Ptrend=0.001). Higher intake of dietary fiber was associated with lower risk of elevated FSG (highest vs lowest quartile: OR, 0.53; 95% CI: 0.28-0.99; Ptrend=0.04), but not with lower risk of elevated HbA1c.Conclusions:GL and carbohydrate intake were positively associated with the risk of hyperglycemia in type 2 diabetic patients; but the benefit in pursuing a low-GI diet without considering carbohydrate and energy intakes in these patients should be further investigated.European Journal of Clinical Nutrition advance online publication, 19 February 2014; doi:10.1038/ejcn.2013.288.
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