DM: Glycemic Index (2014)

DM: Glycemic Index (2014)

• Intervention
  In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of glycemic index on glycemia, insulin and CVD risk factors (lipids and blood pressure)?

  • Conclusion

    Studies regarding the relationship of glycemic index (GI), independent of weight loss, reported no significant effect on A1C in adults with type 2 diabetes, however the differences in GI between interventions were small. Research regarding the relationship of glycemic index on fasting blood glucose reports mixed results.

    No studies were identified in adults with type 1 diabetes. Additional long-term studies are needed regarding the relationship of glycemic index on glycemia in adults with diabetes.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of glycemic index, independent of weight loss, on glycemia (A1C and glucose)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Cheong SH, McCargar LJ, Paty BW, Tudor-Locke C, Bell RC. The First Step First Bite Program: guidance to increase physical activity and daily intake of low-glycemic index foods. J Am Diet Assoc. 2009; 109 (8): 1,411-1,416.
      • Holub I, Gostner A, Hessdorfer S, Theis S, Bender G, Willinger B, Schauber J, Melcher R, Allolio B, Scheppach W. Improved metabolic control after 12-week dietary intervention with low glycaemic isomalt in patients with type 2 diabetes mellitus. Horm Metab Res 2009;41(12):886-92.
      • Turner-McGrievy GM, Jenkins DJ, Barnard ND, Cohen J, Gloede L, Green AA. Decreases in dietary glycemic index are related to weight loss among individuals following therapeutic diets for type 2 diabetes. J Nutr 2011;141(8):1469-74.
      • Wolever TM, Gibbs AL, Mehling C, Chiasson JL, Connelly PW, Josse RG, Leiter LA, Maheux P, Rabasa-Lhoret R, Rodger NW, Ryan EA. 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. 2008; 87 (1): 114-125.
  • Search Plan and Results: DM: Glycemic Index 2012
     
  In adults with type 1 and type 2 diabetes, what is the relationship of glycemic index, independent of weight loss, on CVD risk factors (lipids and/or blood pressure)?

  • Conclusion

    Studies regarding the relationship of glycemic index, independent of weight loss, on CVD risk factors reported no significant effect on LDL-cholesterol levels or blood pressure in adults with type 2 diabetes. However, research regarding glycemic index and total cholesterol, HDL-cholesterol and triglycerides reports mixed results.
    
    Subjects did not have or were not described as having any disorders of lipid metabolism or hypertension, and none of the studies reported on adults with type 1 diabetes. Additional long-term studies are needed to ascertain the relationship of glycemic index, independent of weight loss, on lipid profile in adults with diabetes, especially those with disorders of lipid metabolism and hypertension.
     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of glycemic index, independent of weight loss, on CVD risk factors (lipids or blood pressure)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Cheong SH, McCargar LJ, Paty BW, Tudor-Locke C, Bell RC. The First Step First Bite Program: guidance to increase physical activity and daily intake of low-glycemic index foods. J Am Diet Assoc. 2009; 109 (8): 1,411-1,416.
      • Holub I, Gostner A, Hessdorfer S, Theis S, Bender G, Willinger B, Schauber J, Melcher R, Allolio B, Scheppach W. Improved metabolic control after 12-week dietary intervention with low glycaemic isomalt in patients with type 2 diabetes mellitus. Horm Metab Res 2009;41(12):886-92.
      • Wolever TM, Gibbs AL, Mehling C, Chiasson JL, Connelly PW, Josse RG, Leiter LA, Maheux P, Rabasa-Lhoret R, Rodger NW, Ryan EA. 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. 2008; 87 (1): 114-125.
  • Search Plan and Results: DM: Glycemic Index 2012
     
  In adults with type 1 and type 2 diabetes, what is the relationship of glycemic index, independent of weight loss, on insulin levels (exogenous/endogenous)?

  • Conclusion
    Two studies report mixed results regarding the relationship of glycemic index, independent of weight loss, on endogenous insulin levels in adults with type 2 diabetes.
    
    No studies were identified in subjects with type 1 diabetes or that reported on exogenous insulin levels. Additional long-term studies are needed regarding the relationship of glycemic index, independent of weight loss, on insulin levels in adults with diabetes.
    
    
    
     

     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of glycemic index, independent of weight loss, on insulin levels (exogenous or endogenous)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Holub I, Gostner A, Hessdorfer S, Theis S, Bender G, Willinger B, Schauber J, Melcher R, Allolio B, Scheppach W. Improved metabolic control after 12-week dietary intervention with low glycaemic isomalt in patients with type 2 diabetes mellitus. Horm Metab Res 2009;41(12):886-92.
      • Wolever TM, Gibbs AL, Mehling C, Chiasson JL, Connelly PW, Josse RG, Leiter LA, Maheux P, Rabasa-Lhoret R, Rodger NW, Ryan EA. 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. 2008; 87 (1): 114-125.
  • Search Plan and Results: DM: Glycemic Index 2012