title: The effect of a low-glycemic diet vs a standard diet on blood glucose levels and macronutrient intake in children with type 1 diabetes.
abstract: A low-glycemic index (GI) diet may lower postprandial hyperglycemia and decrease the risk for postabsorptive hypoglycemia in people with type 1 diabetes. However, insufficient evidence exists on the efficacy of a low-GI diet to support practice recommendations. The goal of this study was to examine the blood glucose response to and the macronutrient composition of low-GI meals vs usual meals consumed ad libitum at home in children with type 1 diabetes. A within-subject, crossover design was employed. Twenty-three participants were recruited between June and August 2006. Participants wore a continuous blood glucose monitoring system and completed diet diaries on 2 days. On 1 day, participants consumed their usual meal; on another day, participants consumed low-GI meals ad libidum. Order of the 2 days was counterbalanced. The mean GI was 34+/-6 for the low-GI day and 57+/-6 for the usual meal day (P<0.0001). During the low-GI day, mean daytime blood glucose values (125+/-28 mg/dL [6.9+/-1.5 nmol/L] vs 185+/-58 mg/dL [10.3+/-3.2 nmol/L], P<0.001), blood glucose area above 180 mg/dL (4,486+/-6,138 vs 26,707+/-25,038, P<0.006), and high blood glucose index (5.1+/-5.1 vs 13.6+/-7.6, P<0.001) were lower compared to the usual mean day. During the low-GI day, subjects consumed more fiber (24.5+/-12.3 g vs 14.5+/-6.1 g, P<0.007) and less fat (45.7+/-12.2 g vs 76.8+/-32.4 g, P<0.005); however, there were no differences in energy, carbohydrate, or protein intake. In this pilot study, a low-GI diet was associated with improved diet quality and a reduction in hyperglycemia.
authors.affiliation: Division of Epidemiology, Statistics and Prevention Research, NICHD, NIH, DHHS, Bethesda, MD 20892-7510, USA. rovneral@mail.nih.gov
authors.forename: Alisha J
authors.initials: AJ
authors.lastname: Rovner
authors.forename: Tonja R
authors.initials: TR
authors.lastname: Nansel
authors.forename: Lauren
authors.initials: L
authors.lastname: Gellar
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D002648:Child; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000178:diet therapy*; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000145:classification / Q000378:metabolism; D004041:Dietary Fats / Q000008:administration & dosage / Q000378:metabolism; D004043:Dietary Fiber / Q000008:administration & dosage / Q000378:metabolism; D004044:Dietary Proteins / Q000008:administration & dosage / Q000378:metabolism; D002149:Energy Intake; D005260:Female; D005502:Food / Q000145:classification; D006442:Glycated Hemoglobin / Q000032:analysis; D038321:Glycemic Index; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000517:prevention & control*; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010865:Pilot Projects; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D006442:Glycated Hemoglobin; D007328:Insulin