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The use of low-glycaemic index diets in diabetes control

  • D. E. Thomas (a1) and E. J. Elliott (a1) (a2) (a3)


The aim of diabetes management is to normalise blood glucose levels since improved blood glucose control is associated with fewer complications. Food affects blood glucose levels; however, there is no universal approach to the optimal diabetic diet and there is controversy about the usefulness of the low-glycaemic index (GI) diet. To assess the effects of low-GI diets on glycaemic control in diabetes, we conducted electronic searches of the Cochrane Library, MEDLINE, EMBASE and CINAHL. We assessed randomised controlled trials (RCT) with interventions >4 weeks that compared a low-GI diet with a higher-GI diet for type 1 or type 2 diabetes. Twelve RCT (n 612) were identified. There was a significant decrease in glycated Hb (HbA1c) with low-GI diet than with the control diet, indicating improved glycaemic control (seven trials, n 457, weighted mean difference (WMD) − 0·4 % HbA1c, 95 % CI − 0·7, − 0·20, P = 0·001). In four studies reporting the results for glycaemic control as fructosamine, three of which were 6 weeks or less in duration, pooled data showed a decrease in fructosamine (WMD − 0·23 mmol/l, 95 % CI − 0·47, 0·00, P = 0·05), n 141, with low-GI diet than with high-GI diet. Glycosylated albumin levels decreased significantly with low-GI diet, but not with high-GI diet, in one study that reported this outcome. Lowering the GI of the diet may contribute to improved glycaemic control in diabetes.

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Corresponding author

*Corresponding author: Dr Diana Thomas, fax +61 2 9845 3082, email


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1 World Health Organization (2009) . Ref type: electronic citation.
2 Silink, M (2002) Childhood diabetes: a global perspective. Horm Res 57, Suppl. 1, 15.
3 Stratton, IM, Adler, AI, Neil, AW, et al. (2000) Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321, 405412.
4 American Diabetes Association (2008) Nutrition recommendations and interventions for diabetes. Diabetes Care 31, S61S78.
5 Jenkins, DJ, Wolever, TM, Taylor, RH, et al. (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 34, 362366.
6 Crapo, PA, Reaven, G & Olefsky, J (1977) Postprandial plasma-glucose and -insulin responses to different complex carbohydrates. Diabetes 26, 11781183.
7 Nield, L, Moore, HJ & Hooper, L, et al. (2007) Dietary advice for treatment of type 2 diabetes mellitus in adults. The Cochrane Database of Systematic Reviews 2007, issue 3, CD004097.
8 Brand-Miller, JC, Hayne, S, Petocz, P, et al. (2003) Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care 26, 22612267.
9 Anderson, JW, Randles, KM, Kendall, CW, et al. (2004) Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence. J Am Coll Nutr 23, 517.
10 Kelly, S, Frost, G & Whittaker, V, et al. (2004) Low glycaemic index diets for coronary heart disease. The Cochrane Database of Systematic Reviews 2004, CD004467.
11 Livesey, G, Taylor, R, Hulshof, T, et al. (2008) Glycemic response and health a systematic review and meta-analysis: relations between dietary glycemic properties and health outcomes. Am J Clin Nutr 87, 258S268S.
12 Opperman, AM, Venter, CS, Oosthuizen, W, et al. (2004) Meta-analysis of the health effects of using the glycaemic index in meal-planning. Br J Nutr 92, 367381.
13 Thomas, D & Elliott, EJ (2009) Low glycaemic index, or low glycaemic load, diets for diabetes mellitus. The Cochrane Database of Systematic Reviews 2009, issue 1, CD006296.
14 Goldstein, DE, Little, RR, Lorenz, RA, et al. (2004) Tests of glycemia in diabetes. Diabetes Care 27, S91S93.
15 Winocour, P, Bhatnagar, D, Kalsi, P, et al. (1988) Relative clinical usefulness of glycosylated serum albumin and fructosamine during short-term changes in glycemic control in IDDM. Diabetes Care 12, 665672.
16 Moher, D, Cook, DJ, Eastwood, S, et al. (1999) Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of reporting of meta-analyses. Lancet 354, 18961900.
17 Jadad, AR, Moore, RA, Carroll, D, et al. (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17, 112.
18 Schulz, KF, Chalmers, I, Hayes, RJ, et al. (1995) Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 273, 408412.
19 Higgins, JPT & Thompson, SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21, 15391558.
20 Cooper, H & Hedges, LV (1994) The Handbook of Research Synthesis, 2nd ed. New York: Russell Sage Foundation.
21 Tang, JL & Liu, JL (2000) Misleading funnel plot for detection of bias in meta analysis. J Clin Epidemiol 53, 477484.
22 Brand, JC, Colagiuri, S, Crossman, S, et al. (1991) Low-glycemic index foods improve long-term glycemic control in NIDDM. Diabetes Care 14, 95101.
23 Collier, GR, Giudici, S, Kalmusky, J, et al. (1988) Low glycemic index starchy foods improve glucose control and lower serum cholesterol in diabetic children. Diabetes Nutr Metab 1, 1119.
24 Fontvieille, AM, Rizkalla, SW, Penfornis, A, et al. (1992) The use of low glycaemic index foods improves metabolic control of diabetic patients over five weeks. Diabet Med 9, 444450.
25 Frost, G, Wilding, J & Beecham, J (1994) Dietary advice based on the glycaemic index improves dietary profile and metabolic control in type 2 diabetic patients. Diabet Med 11, 397401.
26 Giacco, R, Parillo, M, Rivellese, AA, et al. (2000) 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. Diabetes Care 23, 14611466.
27 Gilbertson, HR, Brand-Miller, JC, Thorburn, AW, et al. (2001) The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Diabetes Care 24, 11371143.
28 Jimenez-Cruz, A, Bacardi-Gascon, M, Turnbull, WH, et al. (2003) 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. Diabetes Care 26, 19671970.
29 Luscombe, ND, Noakes, M & Clifton, PM (1999) Diets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM. Eur J Clin Nutr 53, 473478.
30 Komindr, S, Ingsriswang, S, Lerdvuthisopon, N, et al. (2001) Effect of long-term intake of Asian food with different glycemic indices on diabetic control and protein conservation in type 2 diabetic patients. J Med Assoc Thai 84, 8597.
31 Rizkalla, SW, Taghrid, L, Laromiguiere, M, et al. (2004) 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. Diabetes Care 27, 18661872.
32 Wolever, TM, Jenkins, DJ, Vuksan, V, et al. (1992) Beneficial effect of low-glycemic index diet in overweight NIDDM subjects. Diabetes Care 15, 562564.
33 Jenkins, D, Kendall, CW & McKeown-Eyssen, G (2008) Effect of a low-glycemic index or a high-cereal fiber diet on type 2 diabetes: a randomized trial. JAMA 300, 27422753.
34 Holman, RR, Cull, CA & Turner, RC (1999) A randomized double-blind trial of acarbose in type 2 diabetes shows improved glycemic control over 3 years (U.K. Prospective Diabetes Study 44). Diabetes Care 22, 960964.
35 Anonymous (1995) United Kingdom Prospective Diabetes Study Group, UKPDS 13: relative efficacy of randomly allocated diet, sulphonylurea, insulin or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. BMJ 310, 8388.
36 U.S. Department of Health and Human Services, Guidance for industry: diabetes mellitus: developing drugs and therapeutic biologics for treatment and prevention. . Ref Type: electronic citation.
37 Ma, Y, Olendzki, BC, Merriam, PA, et al. (2008) A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes. Nutrition 24, 4556.
38 Thomas, D & Elliott, EJ (2007) Low glycaemic index, or low glycaemic load, diets for obesity. The Cochrane Database of Systematic Reviews 2007, issue 3, CD005105.
39 Wolever, TM, Gibbs, AL, Mehling, C, et al. (2008) The Canadian trial of carbohydrates in diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am J Clin Nutr 87, 114125.



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