The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Low-glycemic index foods improve long-term glycemic control in NIDDM. The use of low glycaemic index foods improves metabolic control of diabetic patients over five weeks. Long-term dietary treatment with increased amounts of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients. A flexible, low-glycemic index mexican-style diet in overweight and obese subjects with type 2 diabetes improves metabolic parameters during a 6-week treatment period. Diets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM. Effect of long-term intake of Asian food with different glycemic indices on diabetic control and protein conservation in type 2 diabetic patients. Beneficial effect of low-glycemic index diet in overweight NIDDM subjects. Dietary advice based on the glycaemic index improves dietary profile and metabolic control in type 2 diabetic patients. Improved plasma glucose control, whole-body glucose utilization, and lipid profile on a low-glycemic index diet in type 2 diabetic men: a randomized controlled trial.
To determine the long-term effect of low glycemic index dietary advice on metabolic control and quality of life in children with type 1 diabetes.
                Children with type 1 diabetes (n = 104) were recruited to a prospective, stratified, randomized, parallel study to examine the effects of a measured carbohydrate exchange (CHOx) diet versus a more flexible low-glycemic index (GI) dietary regimen on HbA(1c) levels, incidence of hypo- and hyperglycemia, insulin dose, dietary intake, and measures of quality of life over 12 months.
                At 12 months, children in the low-GI group had significantly better HbA(1c) levels than those in the CHOx group (8.05 +/- 0.95 vs. 8.61 +/- 1.37%, P = 0.05). Rates of excessive hyperglycemia (>15 episodes per month) were significantly lower in the low-GI group (35 vs. 66%, P = 0.006). There were no differences in insulin dose, hypoglycemic episodes, or dietary composition. The low-GI dietary regimen was associated with better quality of life for both children and parents.
                Flexible dietary instruction based on the food pyramid with an emphasis of low-GI foods improves HbA(1c) levels without increasing the risk of hypoglycemia and enhances the quality of life in children with diabetes. To compare high- and low-glycemic index (GI) diets in the treatment of non-insulin-dependent diabetes mellitus (NIDDM).
                Sixteen subjects with well-controlled NIDDM and normal lipid profile, 10 of whom continued oral hypoglycemic medication, participated in the study. A diet that emphasized low-GI foods (e.g., porridge, pasta) was compared with a high-GI diet (e.g., processed cereals, potatoes). The GI of the low-GI diet was 15% lower than the high-GI diet (77 +/- 3 vs. 91 +/- 1) but otherwise similar in macronutrient composition and fiber, as determined by a 4-day weighed record. The diets were instituted under instruction from a dietitian who visited subjects at home on a weekly basis. Body weight was maintained within 1-2 kg.
                Glycemic control was improved on the low-GI diet compared with the high-GI diet (statistically significant findings, P less than 0.05). Mean glycosylated hemoglobin at the end of the low-GI diet was 11% lower (7.0 +/- 0.3%) than at the end of the high-GI diet (7.9 +/- 0.5%), and the 8-h plasma glucose profile was lower (area under the curve above fasting 128 +/- 23 vs. 148 +/- 22 mmol.h-1.L-1, respectively). Mean fasting plasma glucose, total cholesterol triglycerides, and lipoproteins did not show important differences.
                A low-GI diet gives a modest improvement in long-term glycemic control but not plasma lipids in normolipidemic well-controlled subjects with NIDDM. The aim of the present study was to determine whether any benefit might occur from lowering the glycaemic index of diet in the medium term in diabetic patients. Eighteen well-controlled diabetic patients (12 Type 1 and 6 Type 2 non-insulin-treated), were assigned to either a high mean glycaemic index or low mean glycaemic index diet for 5 weeks each in a random order using a cross-over design. The two diets were equivalent in terms of nutrient content and total and soluble fibre content. The glycaemic indices were 64 +/- 2 (mean +/- SD) % and 38 +/- 5% for the two diets. The high glycaemic index diet was enriched in bread and potato and the low glycaemic index diet in pasta, rice, and legumes. At the end of the study periods, the following variables were improved on the low compared to the high glycaemic index diet: fructosamine (3.9 +/- 0.9 vs 3.4 +/- 0.4 mmol l-1, p less than 0.05); fasting blood glucose (10.8 +/- 2.8 vs 9.6 +/- 2.7 mmol l-1, p less than 0.02); 2-h postprandial blood glucose (11.6 +/- 2.9 vs 10.3 +/- 2.5 mmol l-1, p less than 0.02); mean daily blood glucose (12.0 +/- 2.5 vs 10.4 +/- 2.7 mmol l-1, p less than 0.02); serum triglycerides (1.5 +/- 0.9 vs 1.2 +/- 0.6 mmol l-1, p less than 0.05). No significant differences were found in body weight, HbA1C, insulin binding to erythrocytes, insulin and drug requirements, and other circulating lipids (cholesterol, HDL-cholesterol, phospholipids, Apolipoprotein A1, Apolipoprotein B). Thus the inclusion of low glycaemic index foods in the diet of diabetic patients may be an additional measure which slightly but favourably influences carbohydrate and lipid metabolism, requires only small changes in nutritional habits and has no known deleterious effects. To evaluate in type 1 diabetic patients 1) the long-term feasibility of a high-fiber (HF) diet composed exclusively of natural foodstuffs and 2) the efficacy of this diet in relation to blood glucose control and incidence of hypoglycemic episodes.
                The study was randomized with parallel groups. Participants were part of a larger multicenter study on the effects of acarbose on glucose control in diabetes. A total of 63 type 1 diabetic patients, age 28 +/- 9 years, BMI 24 +/- 0.6 kg/m2, after a 4-week run-in period on their habitual diet, were randomized to either an HF (n = 32) or a low-fiber (LF) diet (n = 31) for 24 weeks. The two diets, composed exclusively of natural foodstuffs, were weight-maintaining and, aside from their fiber content, were similar for all nutrients. At the end of the run-in period and the dietary treatment, fasting blood samples for the measurement of plasma cholesterol, HDL cholesterol, triglyceride, and HbA(1c) were collected. A daily glycemic profile was performed on a day in which the participants had consumed a standard menu representative of their treatment diet (HF or LF).
                Of the 63 study subjects, 29 in the HF group (91%) and 25 in the LF group (81%) completed the study Compared with the LF diet, the HF diet after 24 weeks decreased both mean daily blood glucose concentrations (P < 0.05) and number of hypoglycemic events (P < 0.01). When compliance to diet was taken into account, 83% of the subjects on the HF diet and 88% on the LF diet were compliant. In this subgroup, compared with the LF diet, the HF diet significantly reduced mean daily blood glucose concentrations (P < 0.001), HbA(1c) (P < 0.05), and number of hypoglycemic events (P < 0.01).
                In type 1 diabetic patients, an HF diet is feasible in the long term and, compared with an LF diet, improves glycemic control and reduces the number of hypoglycemic events. The aim of this study was to compare the effects of a flexible lower- and higher-glycemic index (GI) Mexican-style diet on biochemical data and BMI during a 6-week treatment period.
                This study was a randomized, crossover design of two 6-week periods with a 6-week washout period between treatments. Subjects with type 2 diabetes (n = 36) with a BMI >25 kg/m(2) were selected. Fourteen subjects completed the study with eligible dietary records. Dietary instruction was provided on flexible diets with both a high and low GI. Fasting venous blood samples were taken at the start and finish of each dietary period, and biochemical data were analyzed. Multi- and univariate one-factor repeated-measures ANOVA were used to compare biochemical data.
                Glycemic load and GI were lower during the low-GI diet, and dietary fiber was lower during the high-GI diet. The participants in the low-GI period consumed significantly fewer carbohydrates, such as white-wheat bread, white long-grain rice, potatoes, high-GI fruits, and carrots, and more carbohydrates, such as pinto beans, whole-meal wheat bread, and low-GI fruits than did participants in the high-GI period. There were no differences in the amount of carbohydrates consumed, such as corn tortillas and dairy products. At the end of the study periods, A1c was improved on the low- compared with the high-GI diet (P < 0.008).
                We conclude that a low-GI diet, containing Mexican-style foods, may help to improve the metabolic control in type 2 obese diabetic subjects during a 6-week period. To examine the relative effects of high and low glycemic index (GI) carbohydrates, and monounsaturated fats on blood glucose and lipid metabolism in NIDDM subjects.
                Fourteen male and seven female variably controlled NIDDM subjects recruited by advertisement.
                Free living outpatients.
                A repeated measures, within-subject design was used such that each subject consumed three diets: (a) a high-GI diet (53% CHO -21% fat, 63 GI units (glucose= 100)); (b) a low-GI diet (51% CHO -23% fat, 43 GI units); and (c) a high-mono high-GI diet (42% CHO -35% fat, 59 GI units) in random order and cross-over fashion for four weeks. Approximately 45% energy was provided as key foods which differed in published GI values and specifically excluded legumes. Dietary fibre intake was > 30 g/d on each diet. At the end of each dietary intervention, we measured fasting plasma lipids, glucose, insulin, total glycated plasma protein, fructosamine, LDL and HDL particle size as well as 24 h urinary excretion of glucose and C-peptide.
                HDL-cholesterol was higher on the low-GI and high-mono high-GI diets compared to the high-GI diet (P < 0.05 for overall diet effect). There were no other significant differences in metabolic control between diets, even when adjusted for BMI, glucose control or gender. Body weight and saturated fat intake remained stable between dietary interventions.
                High-mono high-GI and high-CHO, low-GI diets are superior to high-CHO, high-GI diets with respect to HDL metabolism but no effect was noted on glucose metabolism in variably controlled NIDDM subjects. The study was carried out in 10 females with type 2 diabetes aged 32-60 yrs. All of them were receiving weight-maintaining diets composed of 12 per cent protein, 30 per cent fat and 58 per cent carbohydrate. The only difference among all study-diets was the types of complex carbohydrate used. High-glycemic diet (HG) or low glycemic diet (LG) consisted mainly of glutinous rice or mungbean noodles and the intermediate-glycemic diet (DM) was solely white rice. After the metabolic evaluation of the baseline diet (BL), each subject was placed on DM and followed randomly by HG and LG or vice versa for 4 weeks each. The diurnal plasma glucose levels tended to be lowest after LG. The integrated plasma glucose levels among all diets were not different. The integrated insulin levels after DM and LG did not differ but they were lower than HG and BL. Long-term ingestion of all test-diets spilt less urinary glucose than BL, the lowest was LG. HbA1 levels and nitrogen balance after all diets were better than BL, the best was LG. It was concluded that in addition to strict dietary control, ingestion of mungbean noodles (a low glycemic diet) without increasing fiber intake, can improve diabetic control and protein conservation in type 2 diabetes. To determine whether low-glycemic index (GI) diets have clinical utility in overweight patients with non-insulin-dependent diabetes mellitus (NIDDM).
                Six patients with NIDDM were studied on both high- and low-GI diets of 6-wk duration with metabolic diets with a randomized crossover design. Both diets were of similar composition (57% carbohydrate, 23% fat, and 34 g/day dietary fiber), but the low-GI diet had a GI of 58 compared with 86 for the high-GI diet.
                Small and similar amounts of weight were lost on both diets: 2.5 kg on high-GI diet and 1.8 kg on low-GI diet. On the low-GI diet, the mean level of serum fructosamine, as an index of overall blood glucose control, was lower than on the high-GI diet by 8% (P less than 0.05), and total serum cholesterol was lower by 7% (P less than 0.01).
                In overweight patients with NIDDM, reducing diet GI improves overall blood glucose and lipid control. The effect of dietary education incorporating information about the glycaemic index of carbohydrate was tested against standard dietary advice in a randomized controlled study in 51 newly diagnosed patients with Type 2 diabetes treated as out-patients with diet only over a 12-week study period. Outcome was assessed by dietary analysis of 3-day diet diaries, fasting blood glucose, fructosamine, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. Dietary analysis indicated that the group who received low glycaemic advice not only had a significantly lower calculated mean diet glycaemic index intake (77 +/- 1.1 (SEM) vs 82 +/- 1%, p < 0.01) but also had a lower fat intake (25 +/- 1 vs 32 +/- 2% of total energy day-1, p < 0.001), a higher carbohydrate intake (49 +/- 2% vs 44 +/- 1% of total energy day-1, p < 0.05) and non-starch polysaccharide intake (21 +/- 1.5 vs 14 +/- 1 g, p < 0.01). There was a significantly greater within-group fall in fructosamine (3.8 +/- 0.2 to 3.2 +/- 0.2 mmol-1 vs 3.6 +/- 0.2 to 3.6 +/- 0.3 mmol-1, p < 0.05) and cholesterol (6.1 +/- 0.3 to 5.4 +/- 0.3 mmol-1 vs. 5.6 +/- 0.2 to 5.3 +/- 0.1 mmol-1, p < 0.05) in the low glycaemic index group.(ABSTRACT TRUNCATED AT 250 WORDS) To determine whether a chronic low-glycemic index (LGI) diet, compared with a high-glycemic index (HGI) diet, has beneficial effects on plasma glucose control, lipid metabolism, total fat mass, and insulin resistance in type 2 diabetic patients.
                Twelve type 2 diabetic men were randomly allocated to two periods of 4 weeks of an LGI or HGI carbohydrate diet separated by a 4-week washout interval, in a crossover design.
                The LGI diet induced lower postprandial plasma glucose and insulin profiles and areas under the curve than after the HGI diet. At the end of the two dietary periods, the 7-day dietary records demonstrated equal daily total energy and macronutrient intake. Body weight and total fat mass were comparable. Four-week LGI versus HGI diet induced improvement of fasting plasma glucose (P < 0.01, Delta changes during LGI vs. HGI), HbA(1c) (P < 0.01), and whole-body glucose utilization measured by the euglycemic-hyperinsulinemic clamp (P < 0.05). LGI diet induced a decrease in fasting plasma total and LDL cholesterol (Delta changes LGI vs. HGI, P < 0.01), free fatty acids (P < 0.01), apolipoprotein B, and plasminogen activator inhibitor 1 activity.
                Only 4 weeks of an LGI diet was able to improve glycemic control, glucose utilization, some lipid profiles, and the capacity for fibrinolysis in type 2 diabetes. Even if changes in glycemic control were modest during the 4-week period, the use of an LGI diet in a longer-term manner might play an important role in the treatment and prevention of diabetes and related disorders.
A low-GI diet can improve glycaemic control in diabetes without compromising hypoglycaemic events.