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Low glycaemic index, or low glycaemic load, diets for diabetes mellitus.
Cochrane Database Syst Rev 2009; (1):CD006296CD

Abstract

BACKGROUND

The aim of diabetes management is to normalise blood glucose levels, since improved blood glucose control is associated with reduction in development, and progression, of complications. Nutritional factors affect blood glucose levels, however there is currently no universal approach to the optimal dietary treatment for diabetes. There is controversy about how useful the glycaemic index (GI) is in diabetic meal planning. Improved glycaemic control through diet could minimise medications, lessen risk of diabetic complications, improve quality of life and increase life expectancy.

OBJECTIVES

To assess the effects of low glycaemic index, or low glycaemic load, diets on glycaemic control in people with diabetes.

SEARCH STRATEGY

We performed electronic searches of The Cochrane Library, MEDLINE, EMBASE and CINAHL with no language restriction.

SELECTION CRITERIA

We assessed randomised controlled trials of four weeks or longer that compared a low glycaemic index, or low glycaemic load, diet with a higher glycaemic index, or load, or other diet for people with either type 1 or 2 diabetes mellitus, whose diabetes was not already optimally controlled.

DATA COLLECTION AND ANALYSIS

Two reviewers independently extracted data on study population, intervention and outcomes for each included study, using standardised data extraction forms.

MAIN RESULTS

Eleven relevant randomised controlled trials involving 402 participants were identified. There was a significant decrease in the glycated haemoglobin A1c (HbA1c) parallel group of trials, the weighted mean difference (WMD) was -0.5% with a 95% confidence interval (CI) of - 0.9 to -0.1, P = 0.02; and in the cross-over group of trials the WMD was -0.5% with a 95% CI of -1.0 to -0.1, P = 0.03. Episodes of hypoglycaemia were significantly fewer with low compared to high GI diet in one trial (difference of -0.8 episodes per patient per month, P < 0.01), and proportion of participants reporting more than 15 hyperglycaemic episodes per month was lower for low-GI diet compared to measured carbohydrate exchange diet in another study (35% versus 66%, P = 0.006). No study reported on mortality, morbidity or costs.

AUTHORS' CONCLUSIONS

A low-GI diet can improve glycaemic control in diabetes without compromising hypoglycaemic events.

Authors+Show Affiliations

Centre for Evidence Based Paediatrics Gastroenterology and Nutrition (CEBPGAN), Children's Hospital at Westmead, University of Sydney, Locked Bag 4001, Westmead , Australia, NSW 2145. dianat@chw.edu.auNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

19160276

Citation

Thomas, Diana, and Elizabeth J. Elliott. "Low Glycaemic Index, or Low Glycaemic Load, Diets for Diabetes Mellitus." The Cochrane Database of Systematic Reviews, 2009, p. CD006296.
Thomas D, Elliott EJ. Low glycaemic index, or low glycaemic load, diets for diabetes mellitus. Cochrane Database Syst Rev. 2009.
Thomas, D., & Elliott, E. J. (2009). Low glycaemic index, or low glycaemic load, diets for diabetes mellitus. The Cochrane Database of Systematic Reviews, (1), p. CD006296. doi:10.1002/14651858.CD006296.pub2.
Thomas D, Elliott EJ. Low Glycaemic Index, or Low Glycaemic Load, Diets for Diabetes Mellitus. Cochrane Database Syst Rev. 2009 Jan 21;(1)CD006296. PubMed PMID: 19160276.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low glycaemic index, or low glycaemic load, diets for diabetes mellitus. AU - Thomas,Diana, AU - Elliott,Elizabeth J, Y1 - 2009/01/21/ PY - 2009/1/23/entrez PY - 2009/1/23/pubmed PY - 2009/3/20/medline SP - CD006296 EP - CD006296 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 1 N2 - BACKGROUND: The aim of diabetes management is to normalise blood glucose levels, since improved blood glucose control is associated with reduction in development, and progression, of complications. Nutritional factors affect blood glucose levels, however there is currently no universal approach to the optimal dietary treatment for diabetes. There is controversy about how useful the glycaemic index (GI) is in diabetic meal planning. Improved glycaemic control through diet could minimise medications, lessen risk of diabetic complications, improve quality of life and increase life expectancy. OBJECTIVES: To assess the effects of low glycaemic index, or low glycaemic load, diets on glycaemic control in people with diabetes. SEARCH STRATEGY: We performed electronic searches of The Cochrane Library, MEDLINE, EMBASE and CINAHL with no language restriction. SELECTION CRITERIA: We assessed randomised controlled trials of four weeks or longer that compared a low glycaemic index, or low glycaemic load, diet with a higher glycaemic index, or load, or other diet for people with either type 1 or 2 diabetes mellitus, whose diabetes was not already optimally controlled. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data on study population, intervention and outcomes for each included study, using standardised data extraction forms. MAIN RESULTS: Eleven relevant randomised controlled trials involving 402 participants were identified. There was a significant decrease in the glycated haemoglobin A1c (HbA1c) parallel group of trials, the weighted mean difference (WMD) was -0.5% with a 95% confidence interval (CI) of - 0.9 to -0.1, P = 0.02; and in the cross-over group of trials the WMD was -0.5% with a 95% CI of -1.0 to -0.1, P = 0.03. Episodes of hypoglycaemia were significantly fewer with low compared to high GI diet in one trial (difference of -0.8 episodes per patient per month, P < 0.01), and proportion of participants reporting more than 15 hyperglycaemic episodes per month was lower for low-GI diet compared to measured carbohydrate exchange diet in another study (35% versus 66%, P = 0.006). No study reported on mortality, morbidity or costs. AUTHORS' CONCLUSIONS: A low-GI diet can improve glycaemic control in diabetes without compromising hypoglycaemic events. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/19160276/Low_glycaemic_index_or_low_glycaemic_load_diets_for_diabetes_mellitus_ L2 - https://doi.org/10.1002/14651858.CD006296.pub2 DB - PRIME DP - Unbound Medicine ER -