New Insight into Diabetes Management: From Glycemic Index to Dietary Insulin Index

Background: Despite efforts to control hyperglycemia, diabetes management is still challenging. This may be due to focusing on reducing hyperglycemia and neglecting the importance of hyperinsulinemia; while insulin resistance and resultant hyperinsulinemia preceded diabetes onset and may contribute to disease pathogenesis. Objective: The present narrative review attempts to provide a new insight into the management of diabetes by exploring different aspects of glycemic index and dietary insulin index. Results: The current data available on this topic is limited and heterogeneous. Conventional diet therapy for diabetes management is based on reducing postprandial glycemia through carbohydrate counting, choosing foods with low-glycemic index and low-glycemic load. Since these indicators are only reliant on the carbohydrate content of foods and do not consider the effects of protein and fat on the stimulation of insulin secretion, they cannot provide a comprehensive approach to determine the insulin requirements. Conclusion: Selecting foods based on carbohydrate counting, glycemic index or glycemic load are common guides to control glycemia in diabetic patients, but neglect the insulin response, thus leading to failure in diabetes management. Therefore, paying attention to insulinemic response along with glycemic response seems to be more effective in managing diabetes.

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We-P14:388 Effects of foods and diets varying in glycemic index and glycemic load on postprandial glucose and insulin response and measures of oxidative stress

Atherosclerosis Supplements ◽

10.1016/s1567-5688(06)81741-1 ◽

2006 ◽

Vol 7 (3) ◽

pp. 432

Author(s):

L. Augustin ◽

C.W. Kendall ◽

A. Josse ◽

S. Salvatore ◽

F. Brighenti ◽

...

Keyword(s):

Oxidative Stress ◽

Glycemic Index ◽

Glycemic Load ◽

Insulin Response ◽

Postprandial Glucose

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Glycemic Index of Selected Foods in Jamaica

Pharmacovigilance and Pharmacoepidemiology ◽

10.33805/2638-8235.110 ◽

2019 ◽

pp. 13-16

Author(s):

Ryan Francis ◽

Perceval S Bahado-Singh ◽

Andrew O Wheatley ◽

Ann Marie Smith ◽

Helen N Asemota

Keyword(s):

Glycemic Index ◽

Glycemic Load ◽

Psidium Guajava ◽

Serum Glucose ◽

Dietary Advice ◽

Diabetic Patients ◽

Citrullus Vulgaris ◽

Glucose Levels ◽

Significant Difference ◽

Low Glycemic Index

Background: Fruits, vegetables and legumes for their complex carbohydrates, dietary fiber and micronutrients, should form an essential part of every diet. In order to give good dietary advice to diabetic patients, it is necessary to know the glycemic index of foods commonly consumed locally. The objective of this study was to determine the Glycemic Index (GI) and Glycemic Load (GL) of commonly available and consumed Guava (Psidium guajava), Watermelon (Citrullus vulgaris), Gungo (Cajanus cajan), Papaya (Carica papaya) and tomato (Solanum lycopersicum) in Jamaica. Methods: Ten (10) healthy Jamaican subjects (5 males, 5 females) with mean age 30 ± 2 years and mean BMI 25 ± 1 kg/m2 were recruited to the study. Using a non-blind, crossover design trial, the subjects consumed 50 (or 25) grams of available carbohydrate portions of glucose (standard food) and test foods after an overnight fast and their serum glucose levels were determined at 0, 15, 30, 45, 60, 90 and 120 minutes after the consumption of each test food. Glucose was tested on three separate occasions, and the test foods once. The GI value was calculated geometrically by expressing the Incremental Area Under the Blood Glucose Curve (IAUC) for the test foods as a percentage of each subject's average IAUC for the standard food. Results: The results indicated that the IAUC for Watermelon (95 ± 11) was significantly higher (p<0.05) than that of Tomato (37 ± 12), and Gungo (58 ± 13). The differences in IAUC of Watermelon (95 ± 11), Guava (83 ± 27) and Papaya (80 ± 7) were not statistically significant. Similarly, there was no significant difference in GI among the samples studied. Conclusion: Tomato, Gungo, Papaya Watermelon and Guava were shown to have low glycemic index and glycemic load values.

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The Impact of Dietary Glycemic Index and Glycemic Load on Postprandial Lipid Kinetics, Dyslipidemia and Cardiovascular Risk

Nutrients ◽

10.3390/nu12082204 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2204 ◽

Cited By ~ 1

Author(s):

Vaia Lambadiari ◽

Emmanouil Korakas ◽

Vasilios Tsimihodimos

Keyword(s):

Cardiovascular Disease ◽

Glycemic Index ◽

De Novo ◽

Glycemic Load ◽

Insulin Response ◽

De Novo Lipogenesis ◽

Atherogenic Dyslipidemia ◽

Postprandial Lipid Metabolism ◽

Postprandial Lipid ◽

The Impact

Many recent studies have acknowledged postprandial hypetriglyceridemia as a distinct risk factor for cardiovascular disease. This dysmetabolic state is the result of the hepatic overproduction of very low-density lipoproteins (VLDLs) and intestinal secretion of chylomicrons (CMs), which leads to highly atherogenic particles and endothelial inflammation. Postprandial lipid metabolism does not only depend on consumed fat but also on the other classes of nutrients that a meal contains. Various mechanisms through which carbohydrates exacerbate lipidemia have been identified, especially for fructose, which stimulates de novo lipogenesis. Glycemic index and glycemic load, despite their intrinsic limitations, have been used as markers of the postprandial glucose and insulin response, and their association with metabolic health and cardiovascular events has been extensively studied with contradictory results. This review aims to discuss the importance and pathogenesis of postprandial hypertriglyceridemia and its association with cardiovascular disease. Then, we describe the mechanisms through which carbohydrates influence lipidemia and, through a brief presentation of the available clinical studies on glycemic index/glycemic load, we discuss the association of these indices with atherogenic dyslipidemia and address possible concerns and implications for everyday practice.

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Glycemic index values of traditional Kenyan foods: the missing link in the effectiveness of dietary approach in the prevention and management of diabetes mellitus in Kenya

African Health Sciences ◽

10.4314/ahs.v21i2.29 ◽

2021 ◽

Vol 21 (2) ◽

pp. 710-718

Author(s):

Rebecca Ebere ◽

Jasper Imungi ◽

Violet Kimani

Keyword(s):

Diabetes Mellitus ◽

Glycemic Index ◽

Literature Search ◽

Diabetes Management ◽

Glycemic Load ◽

Food Choices ◽

Dietary Management ◽

Glycemic Response ◽

Healthy Individuals ◽

Inclusion Criteria

Background: Glycemic index (GI) measures postprandial blood sugar after consumption of carbohydrate-rich foodstuff. Kenya is yet to fully embrace this concept in prevention and management of diabetes mellitus. Objective: To review and tabulate GIs of locally consumed foods in order to improve dietary management of diabetes mellitus. Methodology: A literature search was conducted using Google scholar and PubMed databases which identified 7 articles on glycemic index values of Kenyan foods published between 2002 and 2020. Two articles failed to meet the inclusion criteria and five proceeded for review. Key search words used included GI, glycemic load and glycemic response combined with Kenya. The data was reported depending on whether the testing involved healthy individuals or patients suffering from diabetes mellitus. Results: Nine individual foods and 7 mixed meals were identified. Low GI foods included beans and whole maize ugali consumed alongside cowpea leaves. High GI foods included whole maize ugali eaten with beef, boiled rice, boiled cassava and cassava-sorghum ugali eaten with silver fish. Conclusion: Proper meal mixing is important in diabetes management. Cowpea leaves and beans possess GI lowering po- tential. This information can be used to improve guidance on food choices for diabetes patients. Keywords: Glycemic index; glycemic load and glycemic response; Kenya.

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A Randomized Trial About Glycemic Index and Glycemic Load Improves Outcomes Among Adults With Type 2 Diabetes

Health Education & Behavior ◽

10.1177/1090198108317598 ◽

2008 ◽

Vol 36 (3) ◽

pp. 615-626 ◽

Cited By ~ 7

Author(s):

Carla K. Miller ◽

Melissa Gutschall

Keyword(s):

Type 2 Diabetes ◽

Dietary Intake ◽

Glycemic Index ◽

Self Efficacy ◽

Diabetes Management ◽

Glycemic Load ◽

Self Regulation ◽

Glucose Monitoring ◽

Outcome Expectations

Glycemic index (GI) represents the postprandial glucose response of carbohydrate foods, and glycemic load (GL) represents the quantity and quality of carbohydrate consumed. A diet lower in GI and GL may improve diabetes management. A 9-week intervention regarding GI and GL was evaluated among adults in the age range of 40-70 years who had had type 2 diabetes ≥1 year ( n = 103). Randomized pre—post test design with immediate and delayed treatment groups was employed. Dietary intake, knowledge, outcome expectations, self-efficacy, and empowerment regarding GI and GL and glucose monitoring were assessed. Four components were identified for outcome expectations using principal components analysis (dietary barrier, glycemic control, family support, and glucose monitoring), and two components were identified for self-efficacy (GI and self-regulation). Significant improvements in GI, knowledge, empowerment, self-efficacy, and outcome expectations (all p < .05) were observed except for glucose monitoring expectations. Only self-regulation efficacy significantly declined ( p < .05) at the follow-up assessment in the immediate group. Nutrition education regarding GI and GL can improve dietary intake, knowledge, outcome and efficacy expectations, and empowerment for diabetes management.

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Understanding Basic Carbohydrate Counting, Glycemic Index, and Glycemic Load for Improved Glycemic Control in Hispanic Patients With Type 2 Diabetes Mellitus

Hispanic Health Care International ◽

10.1891/1540-4153.12.3.138 ◽

2014 ◽

Vol 12 (3) ◽

pp. 138-145 ◽

Cited By ~ 3

Author(s):

Lidia Guadalupe Compeán Ortiz ◽

Diane C. Berry ◽

Octelina Castillo Ruiz ◽

Eunice Reséndiz González ◽

Paulina Aguilera Pérez ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Glycemic Index ◽

Glycemic Load ◽

Carbohydrate Counting ◽

Hispanic Patients

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Glycemic Index and Load of Selected Ethiopian Foods: An Experimental Study

Journal of Diabetes Research ◽

10.1155/2019/8564879 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Nebiyu Dereje ◽

Gadise Bekele ◽

Yemisrach Nigatu ◽

Yoseph Worku ◽

Roger P. Holland

Keyword(s):

Experimental Study ◽

Glycemic Index ◽

Glycemic Load ◽

Postprandial Glucose ◽

Wheat Bread ◽

Diabetic Patients ◽

White Wheat ◽

Significant Difference ◽

Meal Planning ◽

Low Glycemic Index

Background. Determining the glycemic index and load of foods has significant impact on meal planning for diabetes. However, there is no data on the glycemic index (GI) and glycemic load (GL) of Ethiopian foods. Therefore, the aim of this study was to analyze the glycemic index and glycemic load of Teff Injera, Corn Injera, and White Wheat Bread. Methods. Experimental study design was conducted among selected healthy adults. Teff Injera, Corn Injera, and White Wheat Bread were selected as test foods for the study, and glucose was used as the reference food. The postprandial glucose concentrations in the blood were recorded at 0, 15, 30, 45, 90, and 120 minutes. The relative glycemic index of each food was calculated, and the presence of statistical difference in glycemic index among the three foods was analyzed. Results. The mean age of the participants was 23 years (±1.6 years). The glycemic indexes of Teff Injera, White Wheat Bread, and Corn Injera were 36 (low), 46 (low), and 97 (high), respectively, and the glycemic loads were 7 (low), 14 (moderate), and 22 (high), respectively. There was a significant difference in glycemic index and load among the three food items (p<0.001). Teff Injera had a much lower glycemic index and load compared with Corn Injera (p<0.001) and White Wheat Bread (p=0.03). Conclusions. Teff Injera and White Wheat Bread have low glycemic index and are recommended to be consumed by diabetic patients, whereas Corn Injera has high glycemic index and is not recommended for diabetic patients. Therefore, Teff Injera should be considered globally in the dietary modification programs for diabetes.

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Prescribing trends of antidiabetic drugs in diabetic and hypertensive diabetic patients in an urban tertiary care hospital of Bangladesh

Research in Pharmacy and Health Sciences ◽

10.32463/rphs.2017.v03i03.16 ◽

2017 ◽

Vol 3 (3) ◽

pp. 338-343

Author(s):

Mohammad Didar Khan ◽

Md. Ibrahim ◽

Md. Mizanur Rahman Moghal ◽

Dipti debnath ◽

Asma Kabir ◽

...

Keyword(s):

Urban Areas ◽

Tertiary Care ◽

Diabetic Patients ◽

Care Hospital ◽

Age Group ◽

Microsoft Excel ◽

Patient Profile ◽

Prescribing Trends ◽

Medical University ◽

Insight Into

Objective: The present epidemiological study was conducted with the objectives of providing an insight into the current use of antidiabetic medications to diabetics and hypertensive diabetics in urban areas and determining how the patient factors influence the prescribing of antidiabetic medications. Methodology: Data of patients of past two years were collected from Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh. The details were entered in the structured patient profile form. Data were statistically analyzed using the Microsoft Excel 2007 software. Result: A total of 958 patient’s data were collected and analyzed of which 632 (65.97 %) were males and 326 (34.03 %) were females. These patients were further categorized based on their age. 330 patients (34.45 %) belonged to the age group 20 – 44 years, 504 (52.61 %) to the age group 45 – 65 years and 124 (12.94 %) to the age group 65 – 80 years. 684 (71.4%) patients out of the 958 patients studied were suffering from coexisting hypertension. Co-existing hypertension was found to be more prevalent in the age group 45 – 65 years (67.69%) and was found more in females (84.04%). Conclusion: Metformin was the oral hypoglycemic which was the highest prescribed. In hypertensive diabetics Metformin and Pioglitazone were most frequently prescribed drugs. Biguanides and Insulin were the most commonly prescribed antidiabetics. A combination of two or more drugs of different classes was prescribed to hypertensive diabetics. It is necessary to have an improved understanding of the etiology and pathophysiology of diabetes to focus on research efforts appropriately.

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