A randomized behavioural trial targeting glycaemic index improves dietary, weight and metabolic outcomes in patients with type 2 diabetes.
OBJECTIVE
Glycaemic index (GI) reflects the postprandial glucose response of carbohydrate-containing foods. A diet with lower GI may improve glycaemic control in people with diabetes. The purpose of the present study was to evaluate the change in outcomes following a behavioural intervention which promoted lower-GI foods among adults with diabetes.


METHODS
A pre-test-post-test control group design was used with participants randomly assigned to an immediate (experimental) or delayed (control) treatment group. The intervention included a 9-week, group-based intervention about carbohydrate and the glycaemic index. Dietary, anthropometric and metabolic measures were obtained pre/post-intervention in both groups and at 18-week follow-up for the immediate group.


METHODS
The study was conducted in a rural community in the north-eastern USA.


METHODS
Adults having type 2 diabetes mellitus for > or =1 year, aged 40-70 years and not requiring insulin therapy (n 109) were recruited.


RESULTS
Following the intervention, mean dietary GI (P < 0.001), percentage of energy from total fat (P < 0.01) and total dietary fibre (P < 0.01) improved in the immediate compared with the delayed group. Mean BMI (P < 0.0001), fasting plasma glucose (P = 0.03), postprandial glucose (P = 0.02), fructosamine (P = 0.02) and insulin sensitivity factor (P = 0.04) also improved in the immediate group compared with the delayed group. Mean waist circumference among males (P < 0.01) and body weight among males and females (P < 0.01) were significantly different between treatment groups.


CONCLUSIONS
Educating clients about carbohydrate and the glycaemic index can improve dietary intake and health outcomes among adults with type 2 diabetes.
Gutschall
Melissa Davis
MD
Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA.
Miller
Carla K
CK
Mitchell
Diane C
DC
Lawrence
Frank R
FR
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy*; D004032:Diet / Q000592:standards*; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D019270:Fructosamine / Q000097:blood; D038321:Glycemic Index; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012737:Sex Factors; D016896:Treatment Outcome; D014481:United States; D055105:Waist Circumference
D001786:Blood Glucose; D004041:Dietary Fats; D004043:Dietary Fiber; D019270:Fructosamine