Low Glycemic Index Diet Helpful in Men With Type 2 Diabetes
Issue 220 Item 5

The use of an LGI diet in a longer-term manner plays an important role in the treatment and prevention of diabetes and related disorders. A low glycemic index (LGI) diet improves glycemic control, some lipid profiles, and fibrinolysis in men with type 2 diabetes, according to the results of a randomized trial.

"There is growing recognition that the postprandial glycemic and insulinemic responses to different foods may vary despite equal amounts of total absorbable carbohydrates," write Salwa W. Rizkalla, MD, PhD, from Hôtel-Dieu Hospital in Paris, France, and colleagues. "Although focusing on the total amount of carbohydrate intake is important for diabetic patients, using LGI carbohydrates could lead to additional benefits without increasing the fat content of the diet and consequently increasing plasma free fatty acids (FFAs), with all their deleterious consequences."

In a crossover design, 12 men with type 2 diabetes were randomized to two periods of four weeks of an LGI or high glycemic index (HGI) carbohydrate diet separated by a four-week washout interval.
After both dietary periods, the seven-day dietary records demonstrated equal daily total energy and macronutrient intake, and body weight and total fat mass were comparable. Compared with the HGI diet, the LGI diet induced lower postprandial plasma glucose and insulin profiles and areas under the curve, with improvements in fasting plasma glucose (P < .01), hemoglobin A1c (HbA1c) (P < .01), and whole-body glucose utilization measured by the euglycemic-hyperinsulinemic clamp (P < .05). The LGI diet was also associated with a decrease in fasting plasma total and low-density lipoprotein (LDL) cholesterol (P < .01), FFAs (P < .01), apolipoprotein B, and plasminogen activator inhibitor 1 activity.

"Only four 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," the authors write. "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.

In Conclusion: Although carbohydrates will be included in any diet for a patient with diabetes, the glycemic index can separate foods based on their effects on long-term glycemic control. Carbohydrates such as pasta, lentils, chickpeas, and pumpernickel have a low glycemic index while wholemeal bread, French baguettes, potatoes, and rice have a higher glycemic index. And an LGI diet for patients with diabetes may improve glycemic control and LDL cholesterol levels compared with an HGI diet comparable in energy. Diabetes Care. 2004;27:1866-1872