Tuesday, 8 February 2011
The Glycemic Index not the most effective nutrition therapy intervention.
Based on the above reviews, the ADA position is that there is not strong supporting evidence for the use of a low-GI diet as a primary nutrition therapy strategy. The meta-analysis by Brand-Miller et al. provides support for this recommendation. They report that implementing a low-GI diet will have a small effect on overall glycemic control in diabetes; low-GI diets reduce overall HbA1c by 0.43% units compared with high-GI diets (representing a 7.4% reduction in HbA1c/fructosamine). In patients with type 1 diabetes, HbA1c was reduced by ~0.4% units and in subjects with type 2 diabetes by ~0.2% units. This latter result is surprising, as one would expect a greater response in subjects with type 2 diabetes who, because of loss of first-phase insulin response, might be expected to benefit more from a low-GI diet than subjects with type 1 diabetes in whom mealtime insulin can be adjusted to control postprandial glycemic responses.