The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes.
OBJECTIVE
To determine the long-term effect of low glycemic index dietary advice on metabolic control and quality of life in children with type 1 diabetes.


METHODS
Children with type 1 diabetes (n = 104) were recruited to a prospective, stratified, randomized, parallel study to examine the effects of a measured carbohydrate exchange (CHOx) diet versus a more flexible low-glycemic index (GI) dietary regimen on HbA(1c) levels, incidence of hypo- and hyperglycemia, insulin dose, dietary intake, and measures of quality of life over 12 months.


RESULTS
At 12 months, children in the low-GI group had significantly better HbA(1c) levels than those in the CHOx group (8.05 +/- 0.95 vs. 8.61 +/- 1.37%, P = 0.05). Rates of excessive hyperglycemia (>15 episodes per month) were significantly lower in the low-GI group (35 vs. 66%, P = 0.006). There were no differences in insulin dose, hypoglycemic episodes, or dietary composition. The low-GI dietary regimen was associated with better quality of life for both children and parents.


CONCLUSIONS
Flexible dietary instruction based on the food pyramid with an emphasis of low-GI foods improves HbA(1c) levels without increasing the risk of hypoglycemia and enhances the quality of life in children with diabetes.
Gilbertson
H R
HR
Department of Nutrition and Food Services, Royal Children's Hospital, Melbourne, Australia. gilberth@cryptic.rch.unimelb.edu.au
Brand-Miller
J C
JC
Thorburn
A W
AW
Evans
S
S
Chondros
P
P
Werther
G A
GA
D001315:Australia; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000178:diet therapy* / Q000534:rehabilitation; D003927:Diet, Diabetic; D004040:Dietary Carbohydrates / Q000145:classification*; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D007003:Hypoglycemia / Q000453:epidemiology; D015994:Incidence; D008297:Male; D009790:Occupations; D010290:Parents / Q000193:education; D010353:Patient Education as Topic; D011446:Prospective Studies; D011788:Quality of Life; D012107:Research Design; D012959:Socioeconomic Factors; D013997:Time Factors
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D006442:Glycated Hemoglobin