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A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes.

ABSTRACT: We compared the effects of a low glycemic index (GI) diet with the American Diabetes Association (ADA) diet on glycosylated hemoglobin (HbA1c) among individuals with type 2 diabetes.Forty individuals with poorly controlled type 2 diabetes were randomized to a low-GI or an ADA diet. The intervention, consisting of eight educational sessions (monthly for the first 6 mo and then at months 8 and 10), focused on a low-GI or an ADA diet. Data on demographics, diet, physical activity, psychosocial factors, and diabetes medication use were assessed at baseline and 6 and 12 mo. Generalized linear mixed models were used to compare the two groups on HbA1c, diabetic medication use, blood lipids, weight, diet, and physical activity.Participants (53% female, mean age 53.5 y) were predominantly white with a mean body mass index of 35.8 kg/m(2). Although both interventions achieved similar reductions in mean HbA1c at 6 mo and 12 mo, the low-GI diet group was less likely to add or increase dosage of diabetic medications (odds ratio 0.26, P = 0.01). Improvements in high-density lipoprotein cholesterol, triacylglycerols, and weight loss were similar between groups.Compared with the ADA diet, the low-GI diet achieved equivalent control of HbA1c using less diabetic medication. Despite its limited size, this trial suggests that a low-GI diet is a viable alternative to the ADA diet. Findings should be evaluated in a larger randomized controlled trial.

SUBMITTER: Ma Y

PROVIDER: S-EPMC2330083 | biostudies-literature | 2008 Jan

REPOSITORIES: biostudies-literature

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A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes.

Ma Yunsheng Y Olendzki Barbara C BC Merriam Philip A PA Chiriboga David E DE Culver Annie L AL Li Wenjun W Hébert James R JR Ockene Ira S IS Griffith Jennifer A JA Pagoto Sherry L SL

Nutrition (Burbank, Los Angeles County, Calif.) 20080101 1

<h4>Objective</h4>We compared the effects of a low glycemic index (GI) diet with the American Diabetes Association (ADA) diet on glycosylated hemoglobin (HbA1c) among individuals with type 2 diabetes.<h4>Methods</h4>Forty individuals with poorly controlled type 2 diabetes were randomized to a low-GI or an ADA diet. The intervention, consisting of eight educational sessions (monthly for the first 6 mo and then at months 8 and 10), focused on a low-GI or an ADA diet. Data on demographics, diet, ph ...[more]

PMID: 18070658

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Project description:BackgroundThe dietary glycemic index (GI) has been introduced as a novel index to elucidate the potential of foods to increase postprandial glucose. According to the limited available data about the association of GI with cardio-metabolic risk factors such as lipid profile, blood glucose markers, and blood pressure in developing countries, the current study was conducted to investigate this association in apparently obese individuals.Method and materialThree hundred forty-seven obese adults were recruited in the present cross-sectional study. A validated 147-food item semi-quantitative food frequency questionnaire (FFQ) was used to evaluate the usual dietary intake of study participants. Dietary GI was calculated using the international GI database. Fatty acid desaturase (FADs)2 gene variants were determined according to polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). ANOVA was used to compare study variables across different tertile of GI.ResultsWe found significant differences in terms of anthropometric parameters [weight (P = 0.038), waist circumference (WC) (P = 0.023), weight to hip ratio (WHR) (P = 0.007), and fat-free mass (FFM) (P < 0.001)] between different tertiles of GI. Similarly, energy and macronutrient intakes had a significant difference across dietary GI, and subjects with a higher dietary intake of energy and macronutrients (carbohydrate, protein, and total fat) were assigned to the third tertile of dietary GI (P < 0.001). While there was no significant difference in terms of cardio-metabolic risk factors in different dietary GI tertiles. Moreover, the total GI score was non-significantly higher in the TT genotype of FADS2 gene polymorphism compared with other genotypes. While no significant difference was observed between FADS2 genotype frequencies in different GI tertiles.ConclusionCalculated dietary GI was associated with several cardio-metabolic risk factors in obese individuals. However, further prospective studies and clinical trials are needed to confirm our findings.

Project description:Abstract Objectives Low-glycemic index (GI) and load (GL) dietary patterns are recommended for diabetes management by clinical practice guidelines globally. To inform the update of the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we conducted a systematic review and meta-analysis on the effect of low-GI/GL dietary patterns on glycemic control and other established cardiometabolic risk factors in type 1 and 2 diabetes. Methods MEDLINE, EMBASE, and the Cochrane Library were searched through November 2020. We included randomized controlled trials ≥3-weeks investigating the effect of low-GI/GL diets in diabetes. The primary outcome was HbA1c. Two independent reviewers extracted data and assessed risk of bias. GRADE (grading of recommendations assessment, development, and evaluation) assessed the certainty of the evidence. (ClinicalTrials.gov identifier, NCT04045938) Results We identified 30 trial comparisons in 1,672 participants with type 1 and 2 diabetes who were predominantly middle-aged, overweight or obese with moderately controlled type 2 diabetes treated by antihyperglycemic agents and/or insulin. Low-GI/GL dietary patterns significantly reduced HbA1c compared with higher-GI/GL control diets (mean difference −0.32% [95% confidence interval −0.48, −0.16%], P < 0.001; substantial heterogeneity, I2 = 74%, P < 0.001). There were also significant reductions in several secondary outcomes: fasting glucose, LDL-C, non-HDL-C, body weight, BMI, and CRP (P < 0.05), but not insulin or blood pressure. The certainty of evidence was moderate for the reduction in HbA1c and most secondary outcomes. Conclusions Our synthesis indicates that low-GI/GL dietary patterns improve established targets of glycemic control, blood lipids, adiposity and inflammation beyond concurrent therapy with antihyperglycemic agents and/or insulin in moderately controlled type 1 and type 2 diabetes. The available evidence provides a good indication of the likely benefit in this population with moderate likelihood that more research will alter our conclusions. Funding Sources Diabetes and Nutrition Study Group of the EASD, CIHR.

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A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes.

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A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes.

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