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Item
#15
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. Diabetes Care
26:2261-2267, 2003
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