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Improved Plasma Glucose Control, Whole-Body Glucose Utilization, and Lipid Profile on a Low-Glycemic Index Diet in Type 2 Diabetic Men

A randomized controlled trial

¹ Department of Diabetes, Hôtel-Dieu Hospital, Paris, France
² Institut National de la Santé et de la Recherche Médicale (INSERM) U465, Hôtel-Dieu Hospital, Paris, France
³ Laboratory of Biochemistry, Hôtel-Dieu Hospital, Paris, France

Address correspondence and reprint requests to Dr. Salwa W. Rizkalla, Department of Diabetes, INSERM U465, Hôtel-Dieu Hospital, 1 Place du Parvis Nôtre-Dame, 75004 Paris, France. E-mail: salwa.rizkalla{at}htd.ap-hop-paris.fr

OBJECTIVE—To determine whether a chronic low-glycemic index (LGI) diet, compared with a high-glycemic index (HGI) diet, has beneficial effects on plasma glucose control, lipid metabolism, total fat mass, and insulin resistance in type 2 diabetic patients.

RESEARCH DESIGN AND METHODS—Twelve type 2 diabetic men were randomly allocated to two periods of 4 weeks of an LGI or HGI carbohydrate diet separated by a 4-week washout interval, in a crossover design.

RESULTS—The LGI diet induced lower postprandial plasma glucose and insulin profiles and areas under the curve than after the HGI diet. At the end of the two dietary periods, the 7-day dietary records demonstrated equal daily total energy and macronutrient intake. Body weight and total fat mass were comparable. Four-week LGI versus HGI diet induced improvement of fasting plasma glucose (P < 0.01, changes during LGI vs. HGI), HbA_1c (P < 0.01), and whole-body glucose utilization measured by the euglycemic-hyperinsulinemic clamp (P < 0.05). LGI diet induced a decrease in fasting plasma total and LDL cholesterol ( changes LGI vs. HGI, P < 0.01), free fatty acids (P < 0.01), apolipoprotein B, and plasminogen activator inhibitor 1 activity.

CONCLUSIONS—Only 4 weeks of an LGI diet was able to improve glycemic control, glucose utilization, some lipid profiles, and the capacity for fibrinolysis in type 2 diabetes. Even if changes in glycemic control were modest during the 4-week period, the use of an LGI diet in a longer-term manner might play an important role in the treatment and prevention of diabetes and related disorders.

Abbreviations: AUC, area under the curve • DEXA, dual-energy X-ray absorptiometry • FFA, free fatty acid • GI, glycemic index • HGI, high GI • HOMA, homeostasis model assessment • LGI, low GI • PAI, plasminogen activator inhibitor

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