Document Detail


Low glycaemic index, or low glycaemic load, diets for diabetes mellitus.
MedLine Citation:
PMID:  19160276     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of diabetes management is to normalise blood glucose levels, since improved blood glucose control is associated with reduction in development, and progression, of complications. Nutritional factors affect blood glucose levels, however there is currently no universal approach to the optimal dietary treatment for diabetes. There is controversy about how useful the glycaemic index (GI) is in diabetic meal planning. Improved glycaemic control through diet could minimise medications, lessen risk of diabetic complications, improve quality of life and increase life expectancy. OBJECTIVES: To assess the effects of low glycaemic index, or low glycaemic load, diets on glycaemic control in people with diabetes. SEARCH STRATEGY: We performed electronic searches of The Cochrane Library, MEDLINE, EMBASE and CINAHL with no language restriction. SELECTION CRITERIA: We assessed randomised controlled trials of four weeks or longer that compared a low glycaemic index, or low glycaemic load, diet with a higher glycaemic index, or load, or other diet for people with either type 1 or 2 diabetes mellitus, whose diabetes was not already optimally controlled. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data on study population, intervention and outcomes for each included study, using standardised data extraction forms. MAIN RESULTS: Eleven relevant randomised controlled trials involving 402 participants were identified. There was a significant decrease in the glycated haemoglobin A1c (HbA1c) parallel group of trials, the weighted mean difference (WMD) was -0.5% with a 95% confidence interval (CI) of - 0.9 to -0.1, P = 0.02; and in the cross-over group of trials the WMD was -0.5% with a 95% CI of -1.0 to -0.1, P = 0.03. Episodes of hypoglycaemia were significantly fewer with low compared to high GI diet in one trial (difference of -0.8 episodes per patient per month, P < 0.01), and proportion of participants reporting more than 15 hyperglycaemic episodes per month was lower for low-GI diet compared to measured carbohydrate exchange diet in another study (35% versus 66%, P = 0.006). No study reported on mortality, morbidity or costs. AUTHORS' CONCLUSIONS: A low-GI diet can improve glycaemic control in diabetes without compromising hypoglycaemic events.
Authors:
Diana Thomas; Elizabeth J Elliott
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2009-01-21
Journal Detail:
Title:  Cochrane database of systematic reviews (Online)     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2009  
Date Detail:
Created Date:  2009-01-22     Completed Date:  2009-03-19     Revised Date:  2009-08-04    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD006296     Citation Subset:  IM    
Affiliation:
Centre for Evidence Based Paediatrics Gastroenterology and Nutrition (CEBPGAN), Children's Hospital at Westmead, University of Sydney, Locked Bag 4001, Westmead , Australia, NSW 2145. dianat@chw.edu.au
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MeSH Terms
Descriptor/Qualifier:
Diabetes Mellitus, Type 1 / blood,  diet therapy*
Diabetes Mellitus, Type 2 / blood,  diet therapy*
Diabetic Diet
Glycemic Index*
Hemoglobin A, Glycosylated / metabolism*
Humans
Hypoglycemia / prevention & control
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Hemoglobin A, Glycosylated
Comments/Corrections
Comment In:
Evid Based Med. 2009 Aug;14(4):106   [PMID:  19648422 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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