A randomized clinical trial comparing low–glycemic index versus ADA dietary education among individuals with type 2 diabetes

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 24; no. 1; pp. 45 - 56
• Main Authors: Ma, Yunsheng, M.D., Ph.D, Olendzki, Barbara C., R.D., M.P.H, Merriam, Philip A., M.S.P.H, Chiriboga, David E., M.D., M.P.H, Culver, Annie L., B.Pharm, Li, Wenjun, Ph.D, Hébert, James R., M.S.P.H., Sc.D, Ockene, Ira S., M.D, Griffith, Jennifer A., M.S, Pagoto, Sherry L., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2008; Elsevier; Elsevier Limited
• Subjects: Adult; adults; Aged; Biological and medical sciences; blood glucose; Blood Glucose - metabolism; Blood pressure; Body Mass Index; Carbohydrates; Cardiovascular disease; Clinical trials; Colleges & universities; Diabetes; Diabetes mellitus, type 2; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diet therapy; Diet; Diet, Diabetic; drug therapy; Education; Exercise - physiology; Feeding. Feeding behavior; Female; Food; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Glucose; Glycated Hemoglobin A - analysis; Glycemic Index; glycosylated hemoglobin; Heart attacks; high density lipoprotein; Humans; Hypoglycemic Agents - therapeutic use; Linear Models; Lipids; Lipoproteins, HDL - blood; Longitudinal Studies; Male; men; Middle Aged; noninsulin-dependent diabetes mellitus; nutrition education; nutrition information; Nutrition research; nutritional intervention; Nutritional Sciences - education; Odds Ratio; patient education; patients; physical activity; Physicians; psychosocial factors; Randomized clinical trial; sociodemographic characteristics; Treatment Outcome; triacylglycerols; Triglycerides - blood; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight Loss; women; Carbohydrates; Glycemic index; Randomized clinical trial; Diabetes mellitus, type 2; Endocrinopathy; Type 2 diabetes; Human; type 2; Randomized clinical trial; Metabolic diseases; Vertebrata; Mammalia; Glycemic index; Carbohydrates; Diabetes mellitus; Education; Low; Clinical trial; Carbohydrate; Comparative study
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2007.10.008

Abstract 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/m2 . 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.