A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes.
OBJECTIVE
We compared the effects of a low glycemic index (GI) diet with the American Diabetes Association (ADA) diet on glycosylated hemoglobin (HbA1c) among individuals with type 2 diabetes.


METHODS
Forty individuals with poorly controlled type 2 diabetes were randomized to a low-GI or an ADA diet. The intervention, consisting of eight educational sessions (monthly for the first 6 mo and then at months 8 and 10), focused on a low-GI or an ADA diet. Data on demographics, diet, physical activity, psychosocial factors, and diabetes medication use were assessed at baseline and 6 and 12 mo. Generalized linear mixed models were used to compare the two groups on HbA1c, diabetic medication use, blood lipids, weight, diet, and physical activity.


RESULTS
Participants (53% female, mean age 53.5 y) were predominantly white with a mean body mass index of 35.8 kg/m(2). Although both interventions achieved similar reductions in mean HbA1c at 6 mo and 12 mo, the low-GI diet group was less likely to add or increase dosage of diabetic medications (odds ratio 0.26, P = 0.01). Improvements in high-density lipoprotein cholesterol, triacylglycerols, and weight loss were similar between groups.


CONCLUSIONS
Compared with the ADA diet, the low-GI diet achieved equivalent control of HbA1c using less diabetic medication. Despite its limited size, this trial suggests that a low-GI diet is a viable alternative to the ADA diet. Findings should be evaluated in a larger randomized controlled trial.
Ma
Yunsheng
Y
Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. yunsheng.ma@umassmed.edu
Olendzki
Barbara C
BC
Merriam
Philip A
PA
Chiriboga
David E
DE
Culver
Annie L
AL
Li
Wenjun
W
Hébert
James R
JR
Ockene
Ira S
IS
Griffith
Jennifer A
JA
Pagoto
Sherry L
SL
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000178:diet therapy*; D003927:Diet, Diabetic; D015444:Exercise / Q000502:physiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D016014:Linear Models; D008075:Lipoproteins, HDL / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D052756:Nutritional Sciences / Q000193:education; D016017:Odds Ratio; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008075:Lipoproteins, HDL; D014280:Triglycerides