The Effect of Flexible Low Glycemic Index Dietary Advice Versus Measured Carbohydrate Exchange Diets on Glycemic Control in Children With Type 1 Diabetes
- Heather R. Gilbertson, GDD1,
- Jennie C. Brand-Miller, PHD4,
- Anne W. Thorburn, PHD5,
- Sharon Evans, MND1,
- Patty Chondros, MSC2 and
- George A. Werther, MD3
- 1Department of Nutrition and Food Services, the
- 2Department of Clinical Epidemiology and Biostatistics, and the
- 3Department of Endocrinology and Diabetes, Royal Children’s Hospital, Melbourne
- 4Human Nutrition Unit, Department of Biochemistry, University of Sydney
- 5Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
Abstract
OBJECTIVE—To determine the long-term effect of low glycemic index dietary advice on metabolic control and quality of life in children with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Children with type 1 diabetes (n = 104) were recruited to a prospective, stratified, randomized, parallel study to examine the effects of a measured carbohydrate exchange (CHOx) diet versus a more flexible low–glycemic index (GI) dietary regimen on HbA1c levels, incidence of hypo- and hyperglycemia, insulin dose, dietary intake, and measures of quality of life over 12 months.
RESULTS—At 12 months, children in the low-GI group had significantly better HbA1c levels than those in the CHOx group (8.05 ± 0.95 vs. 8.61 ± 1.37%, P = 0.05). Rates of excessive hyperglycemia (>15 episodes per month) were significantly lower in the low-GI group (35 vs. 66%, P = 0.006). There were no differences in insulin dose, hypoglycemic episodes, or dietary composition. The low-GI dietary regimen was associated with better quality of life for both children and parents.
CONCLUSIONS—Flexible dietary instruction based on the food pyramid with an emphasis of low-GI foods improves HbA1c levels without increasing the risk of hypoglycemia and enhances the quality of life in children with diabetes.
- BMR, basal metabolic rate
- CHOx, carbohydrate exchange
- GI, glycemic index
- NMES, nonmilk extrinsic sugars
- RCH, Royal Children’s Hospital
Footnotes
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Address correspondence and reprint requests to Heather R. Gilbertson, Department of Nutrition and Food Services, Women’s and Children’s Health Care Network, Royal Children’s Hospital, Melbourne, Parkville, VIC, Australia 3052. E-mail: gilberth{at}cryptic.rch.unimelb.edu.au.
Received for publication 19 October 2000 and accepted in revised form 26 March 2001.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
