Skip to comments.Diabetes control better with low-glycemic diet
Posted on 12/16/2008 6:22:00 PM PST by neverdem
NEW YORK (Reuters Health) For people who have type 2 diabetes, a low-glycemic index diet is significantly better than a high-fiber diet for keeping blood glucose levels down, researchers report
Glycemic index, or GI, refers to how rapidly a food causes blood sugar to rise. High-GI foods, like white bread and potatoes, tend to spur a quick surge in blood sugar, while low-GI foods, such as lentils, soybeans, yogurt and many high-fiber grains, produce a more gradual increase in blood sugar.
The current study in this week's Journal of the American Medical Association involved 210 individuals with type 2 diabetes treated with anti-diabetes medications who were randomly allocated to go on to either a low-GI diet or a high-fiber diet for 6 months. The main outcome measured was the change in (hemoglobin)A1C in the blood, which reflects glucose levels over the long term.
(Hemoglobin)A1C fell 0.50 percent on the low-GI diet compared with only 0.18 percent on the high-fiber diet, Dr. David J. A. Jenkins, from the University of Toronto, and co-researchers report.
Furthermore, levels of HDL ("good") cholesterol levels rose with the low-GI diet but they fell with the high-fiber diet...
(Excerpt) Read more at news.yahoo.com ...
General dietary advice conformed to the National Cholesterol Education Program Adult Treatment Panel III26 and the American Diabetes Association27 guidelines to reduce saturated fat and cholesterol intakes. Most of the participants were overweight (179/210 [85.2%], with body mass index [BMI, calculated as weight in kilograms divided by height in meters squared] of 25) or obese (113/210 [53.8%], BMI 30) and wished to lose weight. They were informed that this was not a weight-loss study but appropriate advice was given on portion size and fat intake to help them meet their body weight objectives. Participants were also provided with a checklist with either lowglycemic index or highcereal fiber food options from different categories (breakfast cereals, breads, vegetables, fruit) as approximately 15-g carbohydrate servings. The number of carbohydrate servings prescribed covered 42% to 43% of total dietary calories.
In the lowglycemic index diet, the following foods were emphasized: lowglycemic index breads (including pumpernickel, rye pita, and quinoa and flaxseed) and breakfast cereals (including Red River Cereal [hot cereal made of bulgur and flax], large flake oatmeal, oat bran, and Bran Buds [ready-to-eat cereal made of wheat bran and psyllium fiber]), pasta, parboiled rice, beans, peas, lentils, and nuts (Table 1). In the highcereal fiber diet, participants were advised to take the "brown" option (whole grain breads; whole grain breakfast cereals; brown rice; potatoes with skins; and whole wheat bread, crackers, and breakfast cereals) (Table 1). Six servings were prescribed for a 1500-kcal diet, 8 servings for a 2000-kcal diet, and 10 servings for a 2500-kcal diet. Detailed advice was also given to avoid starchy foods not directly recommended as part of the treatment, including those foods advised in the alternative treatment.
In both diets, participants were specifically advised to avoid foods such as pancakes, muffins, donuts, white buns, bagels, rolls, cookies, cakes, popcorn, french fries, and chips. Three servings of fruit and 5 servings of vegetables were encouraged on both treatments. In the lowglycemic index diet, temperate fruit was the focus, including apples, pears, oranges, peaches, cherries, and berries; and in the highcereal fiber diet, tropical fruit, such as bananas, mangos, guavas, grapes, raisins, watermelon, and cantaloupe, were emphasized. Participants were also advised against eating fruit recommended in the alternative treatment.
Checklists were completed by participants on a daily basis throughout the study and 7-day diet records were completed before each visit. Participants were instructed on how to record using food models as examples of portion size and were asked to give actual weights or to express the amounts in terms of common measures, including cups, teaspoons, and dessert spoons. Adherence was assessed from the 7-day diet records. The daily checklists were of value in alerting the dietitian to problems with adherence to the diet plan over the month before center attendance. The overall goal was to achieve a 10% to 20% reduction in glycemic index on the lowglycemic index diet while keeping dietary fiber similar between treatments.
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I got a question for those who are familiar with Diabetes... is Stevia ok for those with Diabetes? I don’t have it but I use it for sweetening my dishes instead of using refined sugars or artificial sweeteners...
If you get overwhelmed with urges go to a nearby doughnut factory and stand down-wind. You'll get over it.
Eventually things you never thought of as sweet will taste sweet and you will find your world filled with sweetness, and all without sugar or fruit or candy or sugar beats or.... lots of stuff.
Doing this is kind of like quitting cigarettes cold turkey 25 or 30 times.
“If you get overwhelmed with urges go to a nearby doughnut factory and stand down-wind. You’ll get over it.”
LOL.... I am a retired LEO, there is no way I could subject myself to such torture.
I hear it both ways... but I’m a little suspicious of the sugar and artificial sugar industry... they have most to lose...
Please put me on the ping list as I have recently been diagnosed with diabetes.
I use Stevia with (almost) no problems. It is VERY VERY SWEET. It also has a very slight “off” taste, but that is not a big deal. To give you an idea of the sweetness, with the liquid extract 1 drop = 1 teaspoon sugar.
As a type 2 diabetic, stevia has no effect on my blood glucose levels at all.
Your mileage may vary
batteries not included
Just a bit embarassed here. Having been in FR for as long or longer than most I still don’t have a clue what being on a ping list means. Asked once and got a meaningless answer.
Can I try one more time? What does being on a ping list mean?
Oh, and I’d like to be on your diabetes ping list if it doesn’t mean that my machine won’t explode or some such. I was diagnosed 3/06. Had my A1G (or whatever) tested yesterday and it was 6.3. Thought it was high but they said fine.
When I stay on my diet, my blood sugar is very good. My basic diet is Eggs and oatmeal in the morning (no milk or sugar, just cranberries), Meat and salad plus fruit for lunch, and meat and salad and veggies for dinner. When I am on this, my wake up BL is at 90-110 every morning and it rarely goes above 160 after eating. If I go off the diet, well, it’s not pretty. I’ve lost 15 pounds in the last 4 months on this diet.
I use Glipicide and Metforman.
A ping list is where you will be notified whenever something of this nature comes up.
A1c of 6.3 is good. Mine was 7.3 when last tested.
I’ve been using Splenda for some time. I wonder what the difference in Stevia and Splenda might be. I’ve heard that Splenda had some thing in it that wasn’t too good for us. I border on sweets addiction.
I think my blood sugar may get low at times and my body is telling me I need sugar. Is that possible?
I guess I should get on the list, also. I was just diagnosed with type II last month. A1C was 9.5%. I have a lot to learn.
What’s supposed to be wrong with Splenda? I just started using it in coffee instead of sugar.
It's a list of screen names of FReepers who are interested in various topics. See my homepage. Theres's a bunch. Some are for states, others for various categories. I'll add you to the diabetes list.
I was hoping someone could tell me.
That was all I was told by a friend. She couldn’t remember where she got the info or just what the info was. I’m still looking.
Probably something the sugar people (or Stevia people) put out. Who knows?
I’m not diabetic but I like to follow the diabetic diet.
How could one go wrong in that?
P.S. I’ve been using Splenda for a very long time and have no problems so I wouldn’t worry.
Look up symptoms of hypoglycemia, i.e. low blood glucose. You'll remember it better.
EXERCISE is very important. You can lower your test results drastically
and you may be able to be a controlled diabetic, if you’re not already... no insulin but still do the tests.
Walk every day at least 30-45 min. Stair-stepper, recumbent bike, swimming.
The brisker the better if you can. Talk to your doctor about exercise. It is very important.
Along with a strict diet. Diabetic diets don’t have to be bad.
Good luck and Good reading!
"Low glycemic" and "low carb" diets share the same conclusion in that it is CARBS, not FAT, that contribute to obesity and diabetes.
Enjoy bacon and eggs for breakfast. Skip the white toast, jelly, corn flakes, skim milk, and orange juice. High fiber cereals (like oatmeal) and breads are only O.K. once you have got your weight and blood sugars under control.
I also use Splenda, mostly for cooking. I use it in baking because the sugar (or substitute) is needed for texture as well as flavor.
Splenda, if I remember correctly, is sugar that is chemically altered so it is still sweet, but is not digested. Stevia is a herb, not a sugar.
Type II since June 2005 (but I felt “off” since since March 2005), originally tested @ 10.6 A1c, went immediately on the GI diet and so far that’s been it - no meds, blood sugar has so far been below 7.0 A1c.
Now the docs never told me to go on the GI diet - they simply said loss some weight and we’ll test you in a few weeks.
My father had died in March (just when I started to feel sluggish) after being Type II for 30+ years (fourth generation Type II (Scots-Irish)for me). My mother gave me a book called “The GI Diet” by Rick Gallop. And then I started walking - a LOT! 1-2 miles nightly and then about 10 miles each weekend up in the hills.
If you can get a copy of the book it will tell you what foods to eat and what foods not to eat. It is similiar to the South Beach diet.
The doc was amazed on my return - I really think they wanted to me on something!
The only way to tell is to test. I am a type 2 and I test at least 5 times a day.
Fasting - just before breakfast
2 hours after breakfast
2 hours after dinner
My goals are fasting and before meals 80 - 120. 2 hours after a meal under 140. I record my meals and how they test out. If a 2 hour test is over 180, that meal is avoided. If a 2 hour test is between 140 and 180, I modify the meal and try it again at a later date. Under 140, it is a keeper.
Using those test goals my last 3 A1c tests came back at 6.1. Not bad, my A1c target is 6.0. My Dr. is happy as long as the A1c is under 7.0. I have found that if the A1c is in the between 5 and 6 it is too easy to go low. Hypos are NOT fun!
Try changing your mindset. Don't think SUGAR, think CARBS. Because carbs = sugar, but carbs are metabolized a lot slower than table sugar. This is the core thinking of the Glycemic Index that this thread started out on. The key thing to remember is that diabetes effects everyone differently. You have to work at finding what works and what dosen't work for you.
Not sure about the digested part, but yes it's chemically altered replacing the various OH bonds with Cl. The chemical map looks almost the same as sugar (same bonds, just different atoms), unlike other artificial sweeteners which look completely different.
My doctor prescribed a glucose meter for me 3 1/2 years ago, after I had complained of numbness and tingling in my feet for at least three years. But he always saw patients in the afternoon, and always had me fasting since the previous night, so my glucose was always normal. But this time he also found that my A1c was elevated.
Within a couple of days, my new meter was telling me that my fondness for Chinese food over a large plate of rice was now off limits. Four hours after that signal meal, my glucose was 239 - and when I returned to the Dr. two weeks later with my readings, he handed me a “diabetic diet” pamphlet.
I read through it and found it unappealing, so I also started looking at Atkins, South Beach, Glycemic, and other carb-control regimens. Also, I discovered that the owner of that Chinese restaurant was diabetic, and that he could prepare some dishes that would not sugar-bomb me. My favorite was his low-carb spicy noodle soup, a full meal that left my glucose at 130 two hours later.
I changed from sweetened Cheerios to plain, and then to generic bran flakes with sweetener for breakfast. I have not had another non-diet soda since then. I don’t eat sweets at all - no candy, cake, pie, or cookies. I severely limit bread and pasta, and eat almost no potatoes or rice. I do eat several fruits daily - a banana, 1-3 apples, and a pear, peach, plum, or orange. I eat a LOT of nuts - mostly peanuts - but no peanut butter. I eat lots of meats - with fat - and non-starchy vegetables.
My Aic has been “normal” for two years now, but my glucose had been drifting upward, averaging about 110. But since August 1, I have been on a treadmill 5-6 days every week. I started much slower, but now I do 3 miles in 45 minutes (3.8-4.5 mph) at 9% slope, with the last 5 min at 15%. I weighed 225 when I started, 199 now. And my glucose average for the past 5, 10, and 30 days is down to 95.
I wish I could say that the neuropathy in both my feet was improving, but it is just the same. And since I started exercising, my right hip is the first to complain about the weather. But I have reduced one of my BP meds, and I might try reducing my diuretic as well because I don’t seem to have as much ankle swelling. I take pills for GERD, cholesterol management, my hip, prostate, and colon, but nothing at all for diabetes. With all that, I am a fairly healthy 69.
Thanks for writing your comments.
Thanks for the ping
I sound like a broken record, but just lowering blood sugar numbers may not stop the underlying damage done by having all that insulin released into the body after eating carbs. Yes, low glycemic carbs will do the damage more slowly, but a carb is still a carb.
As for the medicines for diabetes...
Are you aware that your brain only gets its energy from glucose? Thanks for the link.
I despise testing and found I can actually tell if I'm elevated (by testing after my nueropathy tells me I'm high glucose) and found the "natural" warning to be patent!
all they had to do was read one of atkins’ books and they would have known this about 30 years ago.
No experience with them.
I’m Type II. I have found that even a 10-minute leisurely stroll after a meal will lower my blood sugar readings. The longer, brisker the better but even just moving around makes a big difference for me.
You are exactly right. Medication affects either how much sugar the liver puts into the bloodstream or how effective the body’s insulin is. But exercise causes the large body muscles to directly absorb sugar from the bloodstream. With the same diet, the difference in my glucose level is night and day on days when I exercise and when I do not. A three-mile walk is my goal but even less works wonders. And this time of year diet is especially challenging!
My diabetic husband uses it. Likes it better than any of the other sugar substitutes. It’s very sweet, so only use a very little.
I have recently started taking Lyrica for my fibromyalgia. It was developed for the pain of diabetic neuropathy and shingles. It has made a dramatic change in my life. The pain is almost nonexistent. You may want to ask your Dr. if it is something that could help you.
My husband was diagnosed two years or so ago. His doctor's nutritionist put him on a high carb, low calorie, low fat diet. He immediately started gaining weight and his blood sugar just kept going up. Finally, after a year of this nonsense, he went back to low carb eating. He's lost thirty pounds and his blood sugar is back to normal. He tests about three times a day. Thank goodness for Atkins.
I tried Lyrica for about 6 months. For a while I thought it helped a little. I did have some new sensation in my feet, although calling it an improvement would be a stretch - it included tingling, pain, and occasional cramps, so I finally gave up on it. Besides, it was not only expensive but hard to obtain insurance coverage for.
My sister has fibro, and will be entering a drug trial in the Kansas City area. I don’t know if it involves Lyrica.
“Are you aware that your brain only gets its energy from glucose?”
Yes. but the body has the ability to generate all the glucose you need from protein.
If gluconeogenisis is sufficient, then why is glucose stored as glycogen?
Thanks for all your efforts.
AFAIK glucose is only stored as glycogen in the presence of insulin. It is known that gluconeogenesis is sufficient because of the ability of various primitive people to live on low (or no) carbohydrate diets.
If the diet is poor in protein, you're SOL because you will catabolize your muscle.
I don't know if you've seen this from the open access journal "Metabolism & Nutrition"
"Reduction or elimination of medication -
A striking effect of carbohydrate restriction is reduction or elimination of medication. Table 1 shows results from Yancy, et al.  in which 17 of 21 patients with type 2 diabetes reduced or discontinued diabetes medication upon carbohydrate restriction. Similar results were found by Boden  and Nielsen [10,20]. Practitioners have pointed out the need to reduce medication in advance of undertaking a low carbohydrate diet [6,10,20,21] highlighting the power of carbohydrate restriction to bring about the same therapeutic effect as drugs."
That depends on peace and prosperity, conditions that the left always undermine. We were built to withstand famine, at least for a while. Thanks for the link. Two of the authors have an impressive series of articles on carbohydrate restriction. Enter volek js, feinman rd into the query box at PubMed. http://www.ncbi.nlm.nih.gov/sites/entrez
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