A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes
Division of Preventive and Behavioral Medicine
Adult; Aged; Blood Glucose; Body Mass Index; Diabetes Mellitus, Type 2; *Diabetic Diet; Exercise; Female; *Glycemic Index; Hemoglobin A, Glycosylated; Humans; Hypoglycemic Agents; Linear Models; Lipoproteins, HDL; Longitudinal Studies; Male; Middle Aged; Nutritional Sciences; Odds Ratio; Treatment Outcome; Triglycerides; Weight Loss
Community Health and Preventive Medicine | Dietetics and Clinical Nutrition | Endocrine System Diseases | Life Sciences | Medicine and Health Sciences
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.
CONCLUSION: 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.
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Citation: Nutrition. 2008 Jan;24(1):45-56. Link to article on publisher's site