DM: Carbohydrates (2001)
-
Basic Research
Nutrition Practice Guidelines for Type 1 and 2 Diabetes: Carbohydrates (2001)
-
Conclusion
Foods containing carbohydrates from whole grains, fruits, vegetables and low fat milk should be included in a healthy diet. The total amount of carbohydrate consumed at meals and snacks influences the postmeal glucose response to a greater extent than other macronutrients. There is a direct relationship between the amount of carbohydrate in a meal, postmeal blood glucose response and premeal rapid- or short- acting insulin requirements to maintain desirable blood glucose goals. Individuals receiving intensive insulin therapy can adjust the premeal insulin dose based on the amount of carbohydrate at meals to maintain blood glucose goals. The type and amount of carbohydrate in diets of individuals with type 2 diabetes needs to be individualized based on the lipid profile and type of diabetes medications. Some studies have shown short-term improvements in glycemic control by incorporating high-fiber, low glycemic index foods in meals and /or snacks. (2001)
-
Grade: I
- 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: Type 1 and 2 Diabetes: Carbohydrates (2001)
- Detail
- Quality Rating Summary
For a summary of the Quality Rating results, click here.
- Worksheets
- American Diabetes Association. Position Statement. Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications. Diabetes Care 2002; 25(suppl 1): S50-60.
- Arnold L, Mann J, Ball M. Metabolic effects of alterations in meal frequency in type 2 diabetes. Diabetes Care 1997;20:1651-1654.
- Benini L, Castellani G, Brighenti F, Heaton KW, Brentegani MT, Casiraghi MC, Sembenini C, Pellegrini N, Fioretta A, Minniti G, Porrini M, Testolin G, Vantini I. Gastric emptying of a solid meal is accelerated by the removal of dietary fibre naturally present in food. Gut. 1995;36:825-830.
- Collier GR, Wolever TMS, Wong GS, Josse RG. Prediction of glycemic response to mixed meals in non-insulin dependent diabetic subjects. Am J Clin Nutr. 1986; 44:349-352.
- Gannon MC, Nuttall FQ, Westphal SA, Fang S, Ercan-Fang N. Acute metabolic response to high-carbohydrate, high-starch meals compared with moderate-carbohydrate, low-starch meals in subjects with type 2 diabetes. Diabetes Care. 1998;1619-1626.
- Garg A, Bantle JP, Henry RR, Coulston AM, Griver KA, Raatz SK, Brinkley L, Chen Y-D I, Grundy SM, Huet BA, Reaven GM. Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus. JAMA. 1994;271:1421-1428.
- Giacco R, Parillo M, Rivellese AA, Lasorella G, Giacco A, D'Episcopo L, Riccardi G. Long-term dietary treatment with increased amounts of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients. Diabetes Care. 2000;23:1461-1466.
- Gilbertson HR, Brand-Miller JC, Thorburn AW, Evans S, Chondros P, Werther GA. The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Diabetes Care. 2001;24:1137-1143.
- Guevin N, Jacques H, Nadeau A, Galibois I. Postprandial glucose, insulin, and lipid responses to four meals containing unpurified dietary fiber in non-insulin-dependent diabetes mellitus (NIDDM), hypertriglyceridemic subjects. J Am College Nutr. 1996;15:389-396.
- Hollenbeck CB, Coulston AM, Reaven GM. To what extent does increased dietary fiber improve glucose and lipid metabolism in patients with noninsulin-dependent diabetes mellitus (NIDDM)? Am J Clin Nutr. 1986;43:16-24.
- Jarvi AE, Karlstrom BE, Granfeldt YE, Bjorck IE, Asp NGL, Vessby BOH. Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low glycemic index diet in type 2 diabetic patients. Diabetes Care. 1999; 22: 10-18.
- Parillo M, Giacco R, Ciardullo AV, Rivellese AA, Riccardi G. Does a high-carbohydrate diet have different effects in NIDDM patients treated with diet alone or hypoglycemic drugs. Diabetes Care. 1996;19:498-500.
- Rabasa-Lhoret R, Garon J, Langelier H, Poisson D, Chiasson J-L. Effects of meal carbohydrate content on insulin requirements in type 1 diabetic patients treated intensively with the basal-bolus (ultralente-regular) insulin regimen. Diabetes Care. 1999;22:667-673.
- Wolever TMS, Jenkins DJA, Jenkins AL, Josse RG. The glycemic index: methodology and clinical implications. Am J Clin Nutr. 1991;54:846-854.
- Wolever TMS, Hamad S, Chiasson JL, Josse RG, Leiter LA, Rodger NW, Ross SA, Ryan EA. Day-to-day consistency in amount and source of carbohydrate intake associated with improved glucose control in type 1 diabetes. J Amer Coll Nutr. 1999;18:242-247.
- Wolever TMS, Nguyen PM, Chiasson JL, Hunt JA, Josse RG, Palmason C, Rodger NW, Ross SA, Ryan EA, Tan MH. Determinants of diet glycemic index calculated retrospectively from diet records of 342 individuals with non-insulin-dependent diabetes mellitus. Am J Clin Nutr. 1994;59:1265-1269.
- Detail
-
Conclusion