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Glycemic Index
Glycemic Index
Glycemic Index
References
Brand-Miller J et al. The New Glucose Revolution 2003 American Diabetes Association. Diabetes Care 2003 The Diabetes and Nutrition Study. Eur J Clin Nutr 2000 Canadian Diabetes Association. Clinical Practice Guidelines Expert Committee 2003 Shils ME et al. Modern Nutrition in Health and Disease 10th ed., 2006 Mahan LK et al. Krauses Food and the Nutrition Care Process 13th ed., 2013
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In 1981: Jenkins defined a glycemic index (GI) to rank different dietary carbohydrates (CHOs) on their ability to blood glucose levels as compared with a reference food Glycemic indexing of food was developed to compare the physiologic effects of CHOs on blood glucose glycemic response
Definition
is an incremental area under blood glucose response curve of a 50 g CHO portion of a test food expressed as a percentage of the response to the same amount of CHO from a reference food (glucose or white bread) taken by the same subject
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Calculation of the incremental area under a glycemic response curve (IAUC). The IAUC equals the sum of the area of the triangles & trapezoids: A + B + C + D + F
Time (minutes)
Glycemic response of healthy individuals to white bread or a test food that contains 50 g CHO
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Postprandial glycemia following (A) Slow absorption of starchy fiber-rich meals (B) Rapid absorption of refined, fiber-depleted CHO foods
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Classification
High : GI >90 Intermediate: GI 7090 Low : GI <70
(Anderson JW, 1999; Foster-Powell K et al, 2002)
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Oat bran All bran cereals Whole-wheat bread Oatmeal, muesli, pumpernickel bread Most muffins Most pasta Long-grain rice Barley Most cookies New potatoes Yams Sweet corn Most dry beans & lentils
Glycemic Load
The glycemic load (GL) of foods & meals is calculated by multiplying the GI by the amount of CHO in each food and then totaling the values for all foods in a meal
Glycemic load
(contd)
The higher the GL, the greater the expected elevation in blood glucose & in the insulinogenic effect of the food
Long-term consumption of a diet with a relatively high GL is associated with an risk of: type 2 diabetes coronary heart disease
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Food form
Food components Methods of cooking and processing Physiologic effects
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Food ingredients
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Prevent hypoglycemia
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in diabetic patients
(Brand-Miller J et al. Diabetes Care 2003;26:22617, Anderson JW et al. J Am Coll Nutr 2004;23:517)
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Low-GI Diets
in the Management of Diabetes
CONCLUSIONS:
Choosing low-GI foods in the place of conventional or high-GI foods has a small but clinically useful effect on medium- term glycemic control in patients with diabetes
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ADA Recommendation
Low-GI foods reduce postprandial hyperglycemia Not sufficient evidence of long-term benefit to recommend low-GI as a primary strategy
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EASD Recommendation
Substitution of low-GI foods for high-GI foods
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The EURODIAB study: a cross-sectional study involving nearly 3,000 subjects with type 1 diabetes in 31 clinics throughout Europe, in which the GI of self-selected diets was positively & independently related to A1C levels
Lower GI food
Lower HbA1C
[Grade B, Level 2]
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