Dietary glycemic index and glycemic load are associated with metabolic control in type 2 diabetes: The CAPRI experience.
BACKGROUND
The role of low-glycemic-index diets in the treatment of diabetes mellitus remains unclear. The aim of the present study was to evaluate the association between the dietary glycemic index (GI) and glycemic load (GL) with metabolic control in type 2 diabetic patients.


METHODS
We conducted a cross-sectional analysis in 901 outpatients with type 2 diabetes attending diabetes clinics located in the area of the Campania County, South Italy, who provided complete home blood glucose profiles and centralized glycosylated hemoglobin A1c (HbA1c). Dietary information was obtained using semiquantitative food-frequency questionnaires. HbA1c was assessed in the centralized laboratory while blood glucose profiles were assessed at home.


RESULTS
After adjustment for age, body mass index (BMI), waist circumference, waist-to-hip ratio, smoking, alcohol consumption, physical activity, medication use, prevalence of metabolic syndrome, hypertension, energy and fiber intake, dietary GI and GL were positively associated with HbA1c in a dose-dependent fashion (P for trend, 0.007 for GI and 0.02 for GL). Diabetic patients with the highest GI and GL had the highest HbA1c levels (difference 1%, P = 0.001). The difference in 1-h postmeal glucose levels at home between the highest and the lowest quintile of GI was 37 (15) [mean and standard deviation (SD)] mg/dL (P = 0.001).


CONCLUSIONS
Diets low in GI and GL are associated with lower HbA1c and postmeal glucose levels in the everyday life of type 2 diabetic patients.
Esposito
Katherine
K
Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy. katherine.esposito@unina2.it
Maiorino
Maria Ida
MI
Di Palo
Carmen
C
Giugliano
Dario
D
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000188:drug therapy / Q000378:metabolism; D015930:Diet Records; D005247:Feeding Behavior; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007558:Italy; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D019518:Postprandial Period; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human