Dietary Glycemic Index and Glycemic Load Are Associated with Metabolic Control in Type 2 Diabetes: The CAPRI Experience

Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy.
Metabolic syndrome and related disorders (Impact Factor: 1.98). 02/2010; 8(3):255-61. DOI: 10.1089/met.2009.0096
Source: PubMed


The role of low-glycemic-index diets in the treatment of diabetes mellitus remains unclear. The aim of the present study was to evaluate the association between the dietary glycemic index (GI) and glycemic load (GL) with metabolic control in type 2 diabetic patients.
We conducted a cross-sectional analysis in 901 outpatients with type 2 diabetes attending diabetes clinics located in the area of the Campania County, South Italy, who provided complete home blood glucose profiles and centralized glycosylated hemoglobin A1c (HbA1c). Dietary information was obtained using semiquantitative food-frequency questionnaires. HbA1c was assessed in the centralized laboratory while blood glucose profiles were assessed at home.
After adjustment for age, body mass index (BMI), waist circumference, waist-to-hip ratio, smoking, alcohol consumption, physical activity, medication use, prevalence of metabolic syndrome, hypertension, energy and fiber intake, dietary GI and GL were positively associated with HbA1c in a dose-dependent fashion (P for trend, 0.007 for GI and 0.02 for GL). Diabetic patients with the highest GI and GL had the highest HbA1c levels (difference 1%, P = 0.001). The difference in 1-h postmeal glucose levels at home between the highest and the lowest quintile of GI was 37 (15) [mean and standard deviation (SD)] mg/dL (P = 0.001).
Diets low in GI and GL are associated with lower HbA1c and postmeal glucose levels in the everyday life of type 2 diabetic patients.

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    • "Fasting and postprandial blood glucose remained below 100 mg/dL among all participants throughout the entire study, which is similar to findings reported in previous studies (Bellisle et al., 2007; Esposito et al., 2010; Perälä et al., 2011). This may be due to the predominance of low-GI foods (fiber-rich whole grains), despite the ingestion of foods with a medium to high GI. "
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    • "Author's personal copy type 2 diabetes (Esposito et al., 2010). It is possible that an increase in GLP-1 contributes to these metabolic improvements, as low-GI carbohydrates exhibit a lower absorption rate and, therefore, have the potential to give rise to interaction of nutrients with more distal regions of the small intestine. "
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