Cited by 718Food composition and propertiesDiabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

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Effect of a Low–Glycemic Index or a High–Cereal Fiber Diet on Type 2 Diabetes: A Randomized Trial

Jenkins, David J. A., Kendall, Cyril W. C., McKeown-Eyssen, Gail, Josse, Robert G., Silverberg, Jay, Booth, Gillian L., Vidgen, Edward, Josse, Andrea R., Nguyen, Tri H., Corrigan, Sorcha, Banach, Monica S., Ares, Sophie, Mitchell, Sandy, Emam, Azadeh, Augustin, Livia S. A., Parker, Tina L., Leiter, Lawrence A.·2008·JAMA

DOI 10.1001/jama.2008.808

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Abstract

CONTEXT: Clinical trials using antihyperglycemic medications to improve glycemic control have not demonstrated the anticipated cardiovascular benefits. Low-glycemic index diets may improve both glycemic control and cardiovascular risk factors for patients with type 2 diabetes but debate over their effectiveness continues due to trial limitations. OBJECTIVE: To test the effects of low-glycemic index diets on glycemic control and cardiovascular risk factors in patients with type 2 diabetes. DESIGN, SETTING, AND PARTICIPANTS: A randomized, parallel study design at a Canadian university hospital research center of 210 participants with type 2 diabetes treated with antihyperglycemic medications who were recruited by newspaper advertisement and randomly assigned to receive 1 of 2 diet treatments each for 6 months between September 16, 2004, and May 22, 2007. INTERVENTION: High-cereal fiber or low-glycemic index dietary advice. MAIN OUTCOME MEASURES: Absolute change in glycated hemoglobin A(1c) (HbA(1c)), with fasting blood glucose and cardiovascular disease risk factors as secondary measures. RESULTS: In the intention-to-treat analysis, HbA(1c) decreased by -0.18% absolute HbA(1c) units (95% confidence interval [CI], -0.29% to -0.07%) in the high-cereal fiber diet compared with -0.50% absolute HbA(1c) units (95% CI, -0.61% to -0.39%) in the low-glycemic index diet (P < .001). There was also an increase of high-density lipoprotein cholesterol in the low-glycemic index diet by 1.7 mg/dL (95% CI, 0.8-2.6 mg/dL) compared with a decrease of high-density lipoprotein cholesterol by -0.2 mg/dL (95% CI, -0.9 to 0.5 mg/dL) in the high-cereal fiber diet (P = .005). The reduction in dietary glycemic index related positively to the reduction in HbA(1c) concentration (r = 0.35, P < .001) and negatively to the increase in high-density lipoprotein cholesterol (r = -0.19, P = .009). CONCLUSION: In patients with type 2 diabetes, 6-month treatment with a low-glycemic index diet resulted in moderately lower HbA(1c) levels compared with a high-cereal fiber diet. Trial Registration clinicaltrials.gov identifier: NCT00438698.

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Authors: Jenkins, D. J. A., Kendall, C. W. C., McKeown-Eyssen, G., Josse, R. G., Silverberg, J., Booth, G. L., Vidgen, E., Josse, A. R., Nguyen, T. H., Corrigan, S., Banach, M. S., Ares, S., Mitchell, S., Emam, A., Augustin, L. S. A., Parker, T. L., & Leiter, L. A.
Affiliations: St. Michael's Hospital (CA)
Corresponding author: Jenkins, David J. A.
ORCID: Jenkins, David J. A.
Kendall, Cyril W. C.
Josse, Robert G.
Booth, Gillian L.
Josse, Andrea R.
Nguyen, Tri H.
Augustin, Livia S. A.
Leiter, Lawrence A.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2008-12-17
Volume: 300
Issue: 23
Pages: 2742
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.2008.808
OpenAlex: W2035569239
Cited by: 718
References: 44
Citations by year: 2026: 6 · 2025: 19 · 2024: 15 · 2023: 12 · 2022: 68 · 2021: 56 · 2020: 26 · 2019: 12 · 2018: 19 · 2017: 18 · 2016: 154 · 2015: 60 · 2014: 32 · 2013: 85 · 2012: 38
FWCI: 30.98
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: type 2 diabetes, low glycemic index diet, glycemic control, HbA1c, cardiovascular risk factors, HDL cholesterol, dietary intervention, antihyperglycemic medications, fasting blood glucose, cardiovascular disease prevention, lifestyle modification, glycemic index, dietary fiber, intention-to-treat analysis
MeSH terms: Aged, Hypolipidemic Agents, Blood Glucose, Cardiovascular Diseases, Edible Grain, Combined Modality Therapy, Diabetes Mellitus, Type 2, Dietary Carbohydrates, Dietary Fiber, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Risk Factors, Glycemic Index

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Effect of a Low–Glycemic Index or a High–Cereal Fiber Diet on Type 2 Diabetes: A Randomized Trial

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