The use of low-glycaemic index diets in diabetes control.Br J Nutr 2010; 104(6):797-802BJ
The aim of diabetes management is to normalise blood glucose levels since improved blood glucose control is associated with fewer complications. Food affects blood glucose levels; however, there is no universal approach to the optimal diabetic diet and there is controversy about the usefulness of the low-glycaemic index (GI) diet. To assess the effects of low-GI diets on glycaemic control in diabetes, we conducted electronic searches of the Cochrane Library, MEDLINE, EMBASE and CINAHL. We assessed randomised controlled trials (RCT) with interventions >4 weeks that compared a low-GI diet with a higher-GI diet for type 1 or type 2 diabetes. Twelve RCT (n 612) were identified. There was a significant decrease in glycated Hb (HbA1c) with low-GI diet than with the control diet, indicating improved glycaemic control (seven trials, n 457, weighted mean difference (WMD) - 0.4 % HbA1c, 95% CI - 0.7, - 0.20, P = 0.001). In four studies reporting the results for glycaemic control as fructosamine, three of which were 6 weeks or less in duration, pooled data showed a decrease in fructosamine (WMD - 0.23 mmol/l, 95% CI - 0.47, 0.00, P = 0.05), n 141, with low-GI diet than with high-GI diet. Glycosylated albumin levels decreased significantly with low-GI diet, but not with high-GI diet, in one study that reported this outcome. Lowering the GI of the diet may contribute to improved glycaemic control in diabetes.