GSBS Dissertations and Theses
Publication Date
2011-03-30
Document Type
Doctoral Dissertation
Academic Program
Clinical and Population Health Research
Department
Quantitative Health Sciences
First Thesis Advisor
Dr. Lori Pbert
Keywords
Diabetes Mellitus, Type 2, Hispanic Americans, Glycemic Index, Blood Glucose, Lipoproteins, Anthropometry
Abstract
Background The incidence of type 2 diabetes has increased dramatically, particularly among Latinos. While several studies suggest the beneficial effect of lowering glycemic index and glycemic load in patients with type 2 diabetes, no data exists regarding this issue in the Latino population. The purpose of this study was to determine the effect of lowering glycemic index and glycemic load on diabetes control, lipid profiles and anthropometrics among Latinos with type 2 diabetes.
Methods Subjects participated in a 12 month randomized clinical trial. The intervention targeted diabetes knowledge, attitudes and behavioral capabilities related to diabetes self management with content including nutrition and physical activity. The nutrition protocol emphasized reduction in glycemic index, fat, salt and portion size and increase in fiber. The control group was given usual care. Measurements included Hba1c, fasting glucose, total cholesterol (TC), low density lipoproteins (LDL) and high density lipoproteins (HDL), HDL:LDL ratio, TC:HDL ratio, waist circumference and BMI and were collected at baseline, 4 and 12-months.
Results Two hundred fifty two Latino adults with type 2 diabetes participated in the study. Baseline mean HbA1C was 8.98% (SD=1.87), BMI was 34.76 kg/cm (SD=6.94), age was 56 (SD=11.18) years and 76% were female. Reduction in glycemic index was positively associated with a reduction in logHbA1c (p=0.006), HDL:LDL ratio (p=0.037) and waist circumference (p=0.003) overtime, but not with fasting glucose, TC, LDL and HDL, TC:HDL ratio, body weight or BMI. No significant associations were found between glycemic load and any measures.
Conclusion Results suggest that lowering glycemic index may have a positive effect on some markers of diabetes control, lipid profiles and anthropometrics among Latinos with type 2 diabetes, but not others. While statistically significant reductions in GI and GL were noted, the actual reduction was small. Thus, greater reduction in GI and GL may be needed for clinical significance and greater effect on metabolic outcomes. Future research should target populations with higher baseline GI and GL.
Repository Citation
Gellar, LA. The Effect of Glycemic Index and Glycemic Load on Glucose Control, Lipid Profiles and Anthropometrics Among Low-Income Latinos With Type 2 Diabetes: A Dissertation. (2011). University of Massachusetts Medical School. GSBS Dissertations and Theses. Paper 522. DOI: 10.13028/zytb-hn96. https://escholarship.umassmed.edu/gsbs_diss/522
DOI
10.13028/zytb-hn96
DOI Link
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Amino Acids, Peptides, and Proteins Commons, Carbohydrates Commons, Community Health and Preventive Medicine Commons, Diagnosis Commons, Endocrine System Diseases Commons, Endocrinology, Diabetes, and Metabolism Commons, Environmental Public Health Commons, Epidemiology Commons, Health Services Research Commons, Investigative Techniques Commons, Lipids Commons, Nutritional and Metabolic Diseases Commons, Race and Ethnicity Commons